The Rudd/Gillard governments muddled through on health policy. There was very little to show in the way of useful reform,with one exception. That was plain packaging of cigarettes.
The record is not encouraging, and will not be better in future if the next health minister spends her time smoodging powerful providers . Necessary health reforms are hard. Without determined Prime ministerial and health minister leadership nothing much will change. (more…)
Our health care system provides, at least for metropolitan based Australians, world class management of medical emergencies. A stent in a coronary artery in the middle of the night can save a heart in danger and our dedicated stroke units routinely dissolve blood vessel blockages that could have proved fatal or caused major permanent disabilities. While we can be grateful for these interventions the reality is that the management of the majority of health issues that trouble us do not meet this standard of excellence. (more…)
Climate change. Global warming. A hotter planet. A hotter Australia. Yet few are asking the difficult question of ‘how hot is too hot?’. We have so many elephants in the room at present that ‘the room’ is getting pretty crowded, but as we are barrelling towards 1.5oC of planetary warming since pre-industrial times, the ‘how hot is too hot’ elephant is definitely ‘in the room’. We need to let it out and examine heat tolerance.
We humans are, by nature, social beings who need each other. We need the sense of belonging to communities that sustain, nurture, support and protect us and even give us our sense of personal identity – you can’t make sense of who you are without a social context. (more…)
In 2017 I referred a patient for relatively simple orthopaedic surgery on her wrist to enable her to get back to working in a café. She had been advised that she was a category 3 patient and should be operated on within 365 days. During this period she couldn’t do her usual part-time work which she could juggle around child care commitments. Furthermore, Centrelink required her to apply for jobs she couldn’t do. It took 6 months to even get on the waiting list. She finally had the surgery 15 months after I referred her.
Another of my patients had a similar problem. Retired, it stopped him playing golf. He was operated on within a month and is happily back on the golf course. He had publicly subsidised private health insurance (PHI).
Both received high quality health care except for the time delay for the first patient.
It’s true that Latin and Central Americans are coming to the US fleeing violence and poverty, much of it caused by destructive US trade policy over the course of decades. But there’s another massive “border crossing” phenomenon afoot — and Trump has not said a word about it. We’re talking about thousands of US citizens crossing the border each day in search of affordable health care. (more…)
Hidden in a pack of draft reports from the Medicare Benefits Schedule (MBS) Review Taskforce that were released by the Morrison Government without fanfare just before Christmas are a series of recommendations that, if effectively funded and implemented, could begin the long and difficult task of reforming Australia’s primary care system. (more…)
The ALP does not seem to understand its own creation- Medicare- and that the $11 b taxpayer subsidy to PHI is like a Damocles sword that hangs over Medicare. Ian McAuley in Medicare under threat from Labor points out that Labor in its”consultation document’ on a proposed reference of PHI to the Productivity Commission suggests not only retaining PHI but strengthening it.
This may only be a stratagem to get the PHI lobby of Labor’s back in the run up to the next election. But Labor’s record on PHI is not at all reassuring. Has there been a deal done with PHI as Kevin Rudd did before the 2007 election? (more…)
Last year Labor announced that if elected it would refer health funding, particularly private health insurance, to the Productivity Commission, it being 50 years since the value of PHI was last examined by government. It appears, however, that Labor is squibbing on its promise to subject PHI to economic scrutiny, abandoning its historical commitment to defend Medicare from being undermined by PHI. (more…)
The professionalism in hospitals may have contributed greatly to better data collection and use of technology, but after a visit to a hospice and an ICU unit recently, I wondered what has happened to care. Our system is failing us.
In a world divided by conflict and greed, the Global Fund’s fight against AIDS, tuberculosis, and malaria is a matter of enlightened self-interest and a reminder of how much humanity can accomplish when we cooperate to save lives. For public and private donors, that means providing the financing needed to eliminate all three scourges by 2030.
Well done John Menadue for starting 2019 off with something that must strike at the heart of all Australians- out of pocket medical expenses. Some of the highest in the world and showing no sign of slowing and driven by – let’s be honest – greed on the part of some of our most highly paid doctors. Despite comments over the last few years from some of the Colleges saying that they do not support the significant fees charged by some doctors (and remember it is not a small minority), little has changed. Comments from the Colleges have stopped and out of pocket expenses continue to increase. Australians are opting out of health insurance, placing strains on both the public and private systems. How long should Australians put up with this behaviour from the medical profession which seems hell bent on destroying the ‘golden goose’ (uncapped fee for service – i.e. charge what you think you can get away with) that has funded their lifestyle. (more…)
In the blue-collar area where there have been very substantial workforce reform and improvements which have helped transform the Australian economy. It was begun under the Hawke/Keating governments and continued under the Howard governments.
But the health sector the largest and fastest growing in the economy has not been seriously reformed. I ‘guesstimate’ that there is a potential productivity dividend of at least 40% in health workforce reform over the next decade. That 40% may be on the low side.
In 1974, the Whitlam Government decided to exclude dental care from Medicare for two reasons. The first was cost. The second was political in that Gough Whitlam felt that combatting the doctors would be hard enough without having to combat dentists as well.
Forty-four years later, with Australia much richer and the proven success of Medicare, it is now time for dental care to be progressively included in Medicare. (more…)
‘Perhaps [we could consider] a review of what Pierre Trudeau and his government (in Canada) did in 1984 when they took on a system not dissimilar to ours – uncontrolled fee for service – and legislated that doctors could charge what they liked BUT unless they adhered to the fee negotiated between the provincial government and the profession (on an annual basis) the doctor lost all access to a Medicare reimbursement. The system still works today in Canada and few doctors opt out of it. Now there is a thought and a significant game-changer.’
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Aboriginal and Torres Strait Islanders have got it right when they frame the conditions we label as mental illness as issues of social and emotional well-being. They do not consider the endemic problems in their communities, as mental illnesses.
For many years experts in the field of drug policy in Australia have known existing policies are failing. Crude messages (calls for total abstinence: “just say no to drugs”) and even cruder enforcement strategies (harsher penalties, criminalisation of drug users) have had no impact on the use of drugs or the extent of their harmful effects on the community.
No ad breaks, declares Fox Sports of its coverage of the Boxing Day cricket test in Melbourne. Well none, if you don’t count the scoreboard endorsements, perimeter branding and other in-game adverts promoting one brand or another. All of them impossible to miss. (more…)
One of the few issues that many Americans can agree on in 2018 is, improbably, marijuana legalization. Pot is now legal in thirty-three states and Washington, D.C. In April, John Boehner, the former Republican Speaker of the House, made the rounds of the morning TV talk shows to announce that he now supported decriminalization. Boehner, a former Big Tobacco lobbyist, had declared in 2015 that he was “unalterably opposed” to making pot legal. Now, perhaps hoping to cash in on the marijuana “green rush,” he sits on the advisory board of Acreage Holdings, a New York City–based marijuana startup headed by investment bankers. Acreage hopes to be to Big Pot what R.J. Reynolds, Boehner’s other employer, is to Big Tobacco. Acreage’s CEO, Kevin Murphy, optimistically predicts a “massive consolidation in this business” that will earn his company billions by 2020. (more…)
Last year, 165 Indigenous Australians died as a result of suicide. Despite continued efforts to improve suicide prevention programs, there has been no no appreciable reduction in the suicide rate in ten years. (more…)
The A$1.25 billion Community Health and Hospitals Program Prime Minister Scott Morrison announced this week should be awarded a big policy fail. (more…)
The 2018 version of the Australian Atlas of Healthcare Variation was released on December 11. This is the third such annual atlas, which examines differences in healthcare use according to where people live within Australia and is produced by the Australian Commission on Safety and Quality in Health Care in partnership with the Australian Institute of Health and Welfare. This year it looks at healthcare use in four selected clinical areas: paediatric and neonatal health; cardiac tests; thyroid investigations and treatments; gastrointestinal investigations and treatment. Specific recommendations for improvements are made. There are interactive features available. (more…)
JENNIFER DOGGETT. Keeping people well and out of hospital should be a primary focus of our health system. Yet the evidence is that we could do much better in preventing and managing problems in the community, before they require hospital treatment.
In the post below, Professor Stephen Duckett, Health Program Director at the Grattan Institute, provides some useful advice to state/territory governments on how to focus own hospital avoidance without losing funding under the current ‘activity-based’ system. (more…)
From a rubber band lizard tail shooter to a molecular biologist and later medical scientist, it took a life time to understand why the lizard loses its tail and is able to regenerate it completely. The advancement of molecule biology in science and medicine has created sophisticated tools for looking into the stimulation and mechanism of tissue repair and led to the introduction of the field of Tissue Engineering and Regenerative Medicine. A current example of fingertip regeneration is presented.
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Scientific breakthroughs in the prevention and treatment of tooth decay and dental disease have not yet converted dental practice, and consequently dental costs, in Australia. It will take a paradigm shift in how we organise and train our dental work force and how we fund dental services to deliver the benefits if these new prevention-focused treatment modalities. The improvements in outcomes and reductions in costs that are possible offer real incentives for governments to deliver dental care to all Australians. (more…)
The Victorian Government’s election commitment to a $395.8 million program to provide free dental care to schoolchildren will be welcome in a state where affordable and timely access to dental care is increasingly difficult. It’s time for a concerted campaign to ensure that improved access to dental care and better prevention initiatives are on the agenda for the upcoming New South Wales and federal elections. Governments must be persuaded that their failure to see oral health, dental services and caries prevention as essential components of health care is a false economy. (more…)
As a researcher, I have always been suspicious of statistics touted as incontrovertible truths; and of propagandists for a cause who claim to be the holders of effective remedies for complex social problems. The current ‘truths’ being touted (and winning huge increases in government funding) are that one in every five Australians has a mental disorder, that mental health problems are on the increase, costing the economy billions of dollars, and that a few chosen mental health experts have the solutions, if only their services were better funded. (more…)
Our dental care system is not working for a lot of Victorians. More than half a million Victorians say that the cost of dental care stopped them from getting care when they needed it in the past 12 months. (more…)
Health costs are rising through greater use of technology, ageing, lack of coordination and waste. Doctors provide many services that should be provided by others. Mental , indigenous and dental health have serious problems. Services are being delivered less equitably. There has been very slow progress, particularly in prevention of illness and disease .Our health system is provider not patient driven. (more…)
Australians have some of the best health outcomes in the world measured for example by high life expectancy and low death rates, although that is not the case with Indigenous Australians. (more…)