Let’s not begin the election campaign debating whether private health insurance is too expensive or whether it offers good value to consumers, patients or even the wider community.
If that is the starting point for #HealthElection16 debate, we will not get very far, or at least not as far as we need to go at a time of such profound challenges to planetary health.
In the interests of encouraging some wider discussions around what healthy policy might look like in the run-up to the federal election, here are five conversation-starters.
1. Climate change is the defining issue for public health in the 21st century, according to the Director-General of the World Health Organization, Dr Margaret Chan. “A ruined planet cannot sustain human lives in good health,” she said. Perhaps election candidates could take a briefing from these young Aboriginal and Torres Strait Islander people who are working for climate justice, “an opportunity to create a more just and sustainable world”. (There seems to be little point asking the Federal Health Department for such a briefing, given the portfolio’s lack of leadership to date).
2. Human rights. It’s impossible to have healthy people and communities if human rights are not upheld and respected. In recent years we have seen unprecedented activism and advocacy by health and medical professionals and organisations on behalf of asylum seekers and refugees. The health sector is also increasingly speaking up, together with human rights advocates and social policy and law reformers, about the urgent need for governments to tackle the over-incarceration of Aboriginal and Torres Strait Islander people. Read more at Croakey’s #JustJustice project. And sign this pledge for health equality for Aboriginal and Torres Strait Islander people (it’s a human rights issue).
3. Healthy, safe environments. Perhaps it’s easiest to start this conversation by identifying environments that are not healthy or safe. It’s not healthy or safe for children to be exposed to a relentless stream of marketing for alcohol, junk food and gambling. It’s not healthy or safe when sugar-laden drinks and sweet, fatty processed foods are cheaper and more accessible than fresh produce. It’s not healthy or safe when violence against women and children, and discrimination and racism are so prevalent. And the list of environmental threats goes on, and on…
4. The importance of the social determinants of health is inversely related to the amount of space they occupy in public debate about health. Affordable housing, equitable access to quality education, quality employment, a livable income for those not in work – these are all important health matters, as is tackling social and economic inequality, and ensuring a fair tax system. Where are the political candidates who are committed to talking about and doing something about health inequities?
5. Equitable access to healthcare. Somehow, we have arrived at the situation in Australia where people often can’t afford the healthcare they need. Or it is not available or accessible for various reasons, perhaps because they live in a rural or remote area or even in the under-served suburbs of the big cities. So much of our health policy (including massive public subsidies for the private health insurance industry) has served to reinforce rather than undermine the inverse care law (which was coined in 1971 and holds that “The availability of good medical care tends to vary inversely with the need for it in the population served. This inverse care law operates more completely where medical care is most exposed to market forces, and less so where such exposure is reduced.”) Ensuring equitable access to healthcare also means tackling concerns such as waste and over-use. It means resourcing, supporting and enhancing primary healthcare in particular.
So those are a few conversation-starters. Your turn. As you may have read recently here at Croakey, we are encouraging readers and contributors to help promote a wide-ranging focus on health in election debate. There is plenty more we could be talking about – what have I missed?
Don’t forget to use the hashtag #HealthElection16.
• Images by Mitchell Ward, Croakey’s creative director.