Category: Health

Part 2 – Best practice and improved surgery outcomes

As the population ages, total knee replacement surgery is becoming commonplace.  It is one of the most expensive surgical procedures. Most replacements are performed as elective surgery in private hospitals. Those patients who must rely on the public system are waiting longer than ever.  

In Part 1 of this paper, the variations in frequency of knee replacement were considered. Given that most such procedures are cnducted in the private sector, the dependence on private health insurance creates disparities in access. Little information is available on preferred prostheses.

Part 2 considers patient satisfaction with knee surgery, access to rehabilitation after surgery and the broader consequences of knee surgery for national productivity. (more…)

 PART 1 – Access and affordability

As the population ages, total knee replacement surgery is becoming commonplace.  It is one of the most expensive surgical procedures. Most replacements are performed as elective surgery in private hospitals. Those patients who must rely on the public system are waiting longer than ever.  

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Australia’s productivity growth has been stagnant for over a decade and, according to a new report, our health policies and programs could be partly to blame. Released today, the Productivity Commission report also highlights how the health-care sector (among others) could play a starring role in improving productivity. (more…)

The notable feature of Australia’s heavy investment in health insurance is the lack of hard evidence to support the cost and performance of subsidised private health insurance. For health fund members baffled about the real impact of the Government’s private insurance reform plan, there was one indicator immediately available.  (more…)

So “Private Health insurance is in the DNA” of the Coalition government we hear from Minister Hunt. That may well be the case but there is no evidence to suggest that the delivery of equitable, quality health care to all Australians is so programmed. Indeed many have commented that the recent focus on private health insurance and the need for younger Australians to embrace a very poor deal is couched in rhetoric which suggests that Private Hospital care is better than Public Hospital care and, in any case, the public hospital system may not be there for you when you need it. (more…)

Obtaining first-line medical attention at night, especially if the patient is house-bound, has become increasingly difficult. Proposals to improve affordable access to such services need to take account of changing urban structures, medical culture and community expectations.  (more…)

So “private health insurance is in the DNA” of the Coalition government, we hear from Minister Hunt. That may well be the case but there is no evidence to suggest that the delivery of equitable, quality health care to all Australians is so programmed. Indeed many have commented that the recent focus on private health insurance and the need for younger Australians to embrace a very poor deal is couched in rhetoric which suggests that private hospital care is better than public hospital care and, in any case, the public hospital system may not be there for you when you need it. (more…)

Last week’s announcement from the Turnbull Government purported to be about making private health insurance “simpler and more affordable” but in fact delivered more for health insurance funds’ bottom lines than for Australians’ budgets and highlighted the contorted, confused and controversial logic that underpins the government’s push requiring taxpayers to contribute to the financing of both tiers of a two-tiered healthcare system. (more…)

The government’s changes to private health insurance have little, if anything, to do with health policy. Rather they are about staving off the insurers’ death spiral of rising premiums and desertion of profitable customers, and protecting the government from the embarrassment of yet another five or six per cent rise in premiums in 2018. (more…)

It’s been widely known for fifty years that the health of Aboriginal people lags far behind that of other Australians. Despite that and the expenditure of billions of taxpayers’ dollars, serious gaps persist between Indigenous versus non-Indigenous health and wellbeing. (more…)

Community Pharmacists spend too much time dispensing prescriptions and not enough time promoting the safe and effective use of their customer’s medicines. Reform is needed. (more…)

There is an obvious conflict of interests in any care industry where profits have to be made and returned to shareholders, rather than ploughed back into better care. Profit is never a good incentive for the common good. It’s easier to cut back on staff, food quality, proper supervision and social activity for those in care, while ramping up schemes that confuse people about entry and exit costs in aged care homes and deny families peace of mind and financial justice. Lack of enforcement of proper standards means the providers too often get away with it.  (more…)

Private health insurance has been allowed to undermine the universality Australian healthcare to the extent that international experts now downgrade the Australian system in comparison to those of similar countries because it is two-tiered. Growing public concerns about increasing premiums, unexpected out-of-pocket costs and inequalities have led to a focus on whether health insurance provides value for money. The focus should be widened to investigate the extent to which private health insurance supports low-value and low-quality healthcare services. (more…)

Private health insurers are losing their most profitable members, younger people whose contributions subsidise older members. Rather than forcing young people back into private insurance, the government should break private hospitals’ dependence on private insurance and let private insurance go the way of other high-cost industries.

The media and the PHI lobby consistently understate the taxpayer subsidy to PHI. It is not $6b per annum. It is $11b pa (more…)

Will legalised suicide, even when presented as ‘assisted dying’, adversely impact on efforts to reduce do-it-yourself suicide?

If it looks like a duck and it quacks, then . . . (more…)

In 1970, conservative republican US President Richard Nixon introduced a health bill into the American Congress. It passed but was defeated in the Senate. He didn’t realise it was a health bill, nor did many of his fellow politicians. It was called the Family Assistance Plan, a guaranteed income for families with children, not adequate to bring the income up to the poverty line, but substantially more than was previously on offer. (more…)

Jeremy Hunt, Health Secretary in the UK, accused Stephen Hawking of a ‘pernicious lie’: “(he) is a brilliant physicist but wrong on lack of evidence.”  Stephen Hawking had said his survival for 75 years with motor neurone disease was due to the care he received from the British National Health Service (NHS) and he now feared it was being turned into a “US-style insurance system.” (Guardian Weekly, 25  August). (more…)

Infections acquired in hospitals are a major contributor not only to avoidable deaths but also to the cost of health care. Among preventative measures the simple but often neglected practice of hand-washing stands out. (more…)

Across Africa there are examples of governments trying to introduce policies that improve health and protect the environment only to find their efforts undermined by unhealthy corporations and their industry associations.  A case in point is South Africa’s efforts to introduce a tax on sugary drinks to reduce the growing burden of obesity.  In the process they are facing a barrage of resistance.  This is one small example of unhealthy industries undermining the public’s health and the global environment. This is about how rent seekers go about protecting their selfish interests. (more…)

The transformation of big health funds into for-profit business enterprises sheltered by significant government subsidy and regulations has failed to prompt a complementary  response from federal governments, Coalition or Labor, to even the playing field for consumers. (more…)

Australians pay too much when they go to medical specialists. The government can and should do more to drive prices down. A current Senate Inquiry on out-of-pocket costs will hopefully lead to some policy action. (more…)

Our quality of life is about much more than our standard of living. (more…)

“The problem is ………. that we have been pursuing economic policy that benefits the one per cent. Trickle-down economics is defunct and does not work”.

“Politics quickly departs from evidence into the realm of ideology ….. But evidence must be a key part of the conversation.”

“One senior Conservative politician in Britain put it to me that my agenda is closer to Social Democrat than to Conservative thinking …… I make my case on the evidence, not on prior political beliefs.”

These quotes are from Michael Marmot’s book, The Health Gap.  Some may find them controversial, or at least provocative.  (more…)