Category: Health

Recent articles by John Menadue on health costs in Australia have emphasised the high fees charged by private procedural medical specialists. In a paper to be published next month (McLaren, N., “ECT in Context,” Ethical Human Psychology and Psychiatry, April 2018), I examine costs associated with the use of ECT (electroconvulsive treatment) in psychiatry. This is a short version of that paper.   (more…)

Two roads converge in a yellow wood when it comes to preventing obesity – blaming the victim (eat less sugar, exercise more, you lazy sloth) and thinking that if we focus on children all will be well.  Follow either and you will end up in the same sulphurous place – lost. (more…)

 This week I posted an article ‘Health Ministers may be in office but they are seldom in  power’  I pointed out how doggedly and often quite selfishly the provider institution-  mainly the AMA, the Pharmacy Guild of Australia, Medicines Australia and the parasitical Private Health Insurance funds-resist  almost all health reform unless it benefits provider interests. The public, patients and the community run a poor last. (more…)

Imposing a tax on sugar-sweetened beverages has become the go-to policy for health and medical advocates wanting an effective population-wide intervention to deal with the world’s growing problem of obesity and poor diet. (more…)

The major barrier to health reform is the power of providers. A succession of Australian health ministers Liberal and Labor for three decades have failed in any serious health reform.  It is a very sorry story. Any Minister, Liberal or Labor who wants to reform health must be prepared to take on the providers.  Otherwise, we can forget serious health reform.  (more…)

This “fair go mate” country of ours is wealthy but in reality ever less egalitarian. Increasing Inequity is palpable and most notable in the problems we have with housing, education and health. Health outcomes for Individuals are increasingly dependent on personal financial wellbeing. Australians are spending about 30 billion dollars a year to supplement the care available from our universal health care system. Many, of course, do not have the resources to to cover “out of pocket” expenses. Many of these problems have become chronic as political intransigence inhibits the development of bold, informed and even courageous policies. Policy development, such as it is, is often insular, ignoring the successful tactics of other countries in addressing similar problems. The Commonwealth Fund, which compares the worlds health systems for quality, is critical of our efforts to swing our health system around to focus on the prevention of disease. Eleven other OECD countries are currently doing a better job than we are.How can we change this unsatisfactory situation? PART 3. (more…)

This “fair go mate” country of ours is wealthy but in reality ever less egalitarian. Increasing Inequity is palpable and most notable in the problems we have with housing, education and health. Health outcomes for Individuals are increasingly dependent on personal financial wellbeing. Australians are spending about 30 billion dollars a year to supplement the care available from our universal health care system. Many, of course, do not have the resources to cover “out of pocket” expenses. Many of these problems have become chronic as political intransigence inhibits the development of bold, informed and even courageous policies. Policy development, such as it is, is often insular, ignoring the successful tactics of other countries in addressing similar problems. The Commonwealth Fund, which compares the world’s health systems for quality, is critical of our efforts to swing our health system around to focus on the prevention of disease. Eleven other OECD countries are currently doing a better job than we are. How can we change this unsatisfactory situation? PART 2 of 3. (more…)

In hospital this week after surgery, I learnt some things I already half knew. That I don’t cope well with pain, that time slows down in the middle of the night, (I swear I saw the hands of the clock in ICU move backwards sometime after 3am) and that nurses are a most precious resource, more valuable to our nation than iron ore and more deserving of recognition and celebration than our Test cricket team. Then I read the Herald’s warnings about a long-term recruitment crisis in nursing and was disturbed by the news that nurses were virtually priced out of certain areas of Sydney due to house prices. We ignore these warnings at our peril. (more…)

Patient safety in acute hospitals is often described in limited terms such as infection rates and pressure areas without considering that many people gain little or no benefit from being admitted there in the first place. We also ignore the impact on patient safety when management make decisions such as closing hospital wards, prolonging waiting lists and reducing front line health care delivery. (more…)

You won’t believe it, but my birthday was on Tuesday and I got a present from the federal government. I also got a card from my state member, sending his “very best wishes” for reaching such an “important milestone” in my life. (more…)

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Last week’s landmark report on personalised medicine plays down potential for harm and oversells uncertain benefits. (more…)

One in every nine patients who go into hospital in Australia suffers a complication: when something preventable goes wrong with their care. They might develop an infection from a hygiene breach, for instance, or be given the wrong dose or type of drug. (more…)

Medicine is changing.  In Australia a baby born today will live, on average, for 90 years or more.  The common infectious killer-diseases have been eliminated.  The treatment of cancer is becoming a success story, far different from the horror with which cancer was viewed by my parents and their generation in the 1950s.  Heart disease still kills people, but often in their 80s and not their 50s.  The new medicine will put together information from a person’s DNA, their environment and diet, their habits and choices, and meld this into the new medicine, a medicine that will try to use this knowledge to prevent disease.  That is the message of the analysis of the road map for “The future of precision medicine in Australia” report recently launched by the Australian Learned Academies of Australia (ACOLA).  (more…)

Private health insurers have asked the Commonwealth Government to prevent patients paying for public hospital services through their private health insurance (PHI).  This would be grossly unfair for those people in non-metropolitan Australia who are enticed into PHI through the Medicare Levy Surcharge, but have no private hospitals in their region. More basically, the Government should abolish its $10 billion subsidy to PHI, and direct the savings to funding private hospitals more efficiently and equitably.   (more…)

The Tasmanian election on March 3^rd will provide a watershed moment in public health not just in Tasmania but for Australia as well. (more…)

Over the holidays I have very much enjoyed watching on television Australia winning the Ashes series, although they seem to be exhausted after the celebrations and are performing poorly in the ODI series. The visual TV coverage on Channel 9 is outstanding. The camera crews do a great job. I enhance my enjoyment by minimising the audio content. Except for the opening and closing of each session, and at the fall of each wicket, I keep my TV console on mute. Channel 9 is destroying a well-earned cricket legacy. Perhaps the loss of Richie Benaud was the beginning of the end.

But that is the good news. Unfortunately I can’t get away from the almost saturation picture coverage of junk food (KFC) and alcohol (XXXX and Canadian Club). Last year it was Victorian Bitter and Bear-Wine-and-Spirits or BWS.  (more…)

While in the real world consumers struggle to meet private health care costs, health funds are hoping for yet more government help. (more…)

The forthcoming round of private health insurance (PHI) premium increases — touted by the government as the lowest in a decade — will mean premiums have risen nearly 80% since 2008, far ahead of inflation and a good demonstration of why PHI companies have racked up big profit increases in recent years. (more…)

Over the last few years much as been written on the issue of out of pocket (OOPs) medical expenses in Australia including a number of contributions in this newsletter. There has been a Senate enquiry and much coverage in the media. The issue of out of pocket expenses is not new – the Grattan Institute conducted a review last year pointing out their rapid increase and that they were impacting on the most vulnerable in society . While a recent OECD Report (https://www.oecd.org/…/Health-at-a-Glance-2015-Key-Findings-AUSTRALIA.pdf) showed that in Australia OOPs account for 20% of expenditure on health care , slightly higher than the OECD average of 19%. By contrast, out-of-pocket costs account for only 10% of health spending in the United Kingdom, 13% in New Zealand and 14% in Canada, which have similar government funded health systems. Out-of-pocket costs also comprise a low proportion of health spending in France (7%), whose health system is largely funded by social security.   (more…)

Mental health problems arising out of modern despair have to be tackled with insights gained from the day-to-day lives of society’s outcasts and the social sciences.  Matthew Fisher, (Australia’s policy failure on mental health, Pearls and Irritations, 14 December 2017) argues that Australian mental health policies have failed: “(We) are subject to a deafening silence from politicians, organisations and the key individuals who shape Australia’s policy discourse and action on mental health”. The ubiquitous mental health problems arising out of social conditions and chronically stressed lives are neglected: “The social causes of mental illness and their impacts on populations, as something we might act on, are largely hidden”.  (more…)