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If the Feds wanted to use the Budget to improve population health….. (some out-of-the-box ideas)

If the Federal Government wanted to use the forthcoming Budget to boost population health, what would it do?

Raise taxation generally (plus specific hikes for tobacco, alcohol, and unhealthy foods), and remove subsidies on the use of fossil fuels. These are among the suggestions from Croakey contributors outlined in the post below.

Contributors also said they’d like to see the Budget bring increased payments to single parents and the unemployed, as a way of reducing health inequalities.

Another suggestion for addressing heath inequalities was to “publish the taxable income and tax paid by all Australian citizens”.

There is also support for having all Government policy and program decisions subjected to Climate Impact Assessment and Health Impact Assessment.

Reflecting widespread support for a health in all policies approach, one contributor suggested that health-based key performance indicators could be introduced for all portfolios.

Croakey contributors also hope the Budget will show a commitment to ongoing health reform, including a “transition away from the small business, fee-for-service model that dominates Medicare now to a capitated model in primary and community care”.

As for how the Government could make savings in health – scrap the private health insurance rebate altogether was the suggestion from some.

****

For the compilation post below, Croakey contributors were asked:

1. What is the single most important thing the government could do in the health budget to improve population health?

2. What is the single most important thing the government could do in the overall budget (ie beyond the health portfolio) to improve population health?

3. What is the single most important thing the government could do in the health budget to tackle health inequalities?

4. What is the single most important thing the government could do in the overall budget (ie beyond the health portfolio) to tackle health inequalities?

5. Any advice to the media about how to cover the budget this year? What do you most want to know about it?

6. Where could savings be made in the health portfolio?

****

1. What is the single most important thing the government could do in the health budget to improve population health?

Vern Hughes, National Campaign for Consumer-Centred Health Care
Both Labor and Liberal Parties are reliant on corporate donations from alcohol and gaming companies, and in the Liberal Party’s case, tobacco companies as well.

A ban on political donations by corporates to political parties, allowing only donations from individuals, would sever the financial relationship between these parties and the principal suppliers of products harmful to population health. A disinterested policy discussion would then become possible about how to reduce the impacts of these products.

A/ Prof Gawaine Powell Davies, CEO, UNSW Research Centre for Primary Health Care and Equity, University of NSW
Reduce the deficit by putting a tax on high salt/fat foods.

Professor Mike Daube, Public Health Advocacy Institute WA
Increase tobacco tax – reduces smoking, reduces inequalities, improves health, provides funding for health and social priorities.

Dr Greg Stewart, President-elect, Australasian Faculty of Public Health Medicine
Put money into strengthening population health expertise in Medicare Locals.

Lyn Morgain, Gail O’Donnell of Healthwest Partnership
Increase funding for evidence based work through the Australian National Preventive Health Agency which will focus effort on both national as well as local / regional campaigns that target particular issues / risk factors in local communities / population groups. Ensure the ANPHA focuses on the community and population level.

Flexibility to deliver different interventions / approaches depending on local priorities to support improved outcomes for local communities.

Reference: Dr Fran Baum is Professor of Public Health at Flinders University. At the Senate Inquiry on the Social Determinants of Health Dr Baum commented:

“while the preventative health agenda does attempt to focus on the causes of disease it is limited by the absence of a national agenda devising strategies to address social determinants of health in a systemic way. The predominant focus on individual ‘lifestyle choices’ and behaviour change as the target of interventions does not adequately address the social context in which behaviours occur, or give sufficient emphasis to the role of health promotion strategies focused on creating healthy settings and development of healthy communities.”

Professor Sabina Knight, Director of the Mt Isa Centre for Rural and Remote Health
Strengthen the critical architecture for reform – the Australian National Preventive Health Agency, The Australian Commission on Safety and Quality in Health Care, Health Workforce Australia Independent Hospital Pricing Authority, National Health Performance Authority

Luke van der Beeke, Managing Director, Marketing for Change
The government needs to ensure that the money available is spent effectively.  That means switching to measuring outcomes, not outputs. I’m a big advocate for policy before politics.

Set some tough outcomes and reach for them.  Don’t set easy to achieve outputs that mean nothing in terms of population health.  For example, let’s take health communications.  You can spend $10m or $20m on a shock campaign on obesity, but if you aren’t changing people’s eating habits its all a complete waste of money. So while I think more money is needed for prevention, the most important thing they can do is ensure the money that’s allocated is used effectively.

And a quick point on social marketing.  The Federal Government talk about social marketing, but they’re not really doing social marketing. They  (and the States) are outsourcing to NGOs or big agencies that are delivering health communication campaigns that look great but change very little.

Success is getting measured by outputs that rarely relate to individual behaviours.  All too often, “success” and the associated measures are about being seen to be doing something rather than ACTUALLY doing something. We need behaviour change. And for that you need real social marketing.

Heather Yeatman, president, Public Health Association of Australia
Funding the development of a National Public Health Policy.

Lewis Kaplan CEO General Practice NSW
Fulfil its commitment to the nation’s health rather than just to the Department of Health and Ageing’s budget and invest in substantial and realistically long-term prevention programs (e.g. diabetes), even if the eventual ‘savings’ accrue to state health departments.

Anonymous medico
Improve vaccination coverage. Serious adverse events are rare, but there should be compensation for any child who has a proven disability because of vaccination. Parents are helping the community by having their children immunised, so the community should provide support if there is a problem. The Disability Care (NDIS) could be the appropriate mechanism.

John Mendoza, mental health advocate, Director, ConNetica Consulting Pty Ltd
The Government has to commit to root and branch reform of Medicare. As numerous independent reports in the past few years have pointed to, the most recent from Centre for Independent Studies and CEDA, Medicare is unsustainable and delivering poor quality care for many, many Australians.

This reform must address map-distribution of providers, access to care, cost of care, quality of care. We must begin to transition away form the small business, fee-for-service model that dominates Medicare now to a capitated model in primary and community care.

Terry Slevin, Cancer Council WA
Expand the National Bowel Cancer Screening program to include a greater number of ages being invited to screen.

Currently with only people turning 50, 55, and 65 being invited, we are missing a rolled gold proven method of reducing deaths from colorectal cancer.  We are also ignoring opportunity to save costs as treating more advanced stage disease is not only less successful but more expensive.

The other thing that is desperately needed is to allow funds to promote the program.  With current participation rates at around 40%, a meaningful investment in an effort to “sell” the benefits of participation would certainly increase participation and therefore the health benefits that are proven to accrue from doing so.

Another is a very modest investment in skin cancer prevention programs. Again another money saver with cost of treatment of preventable skin cancer exceeding the billion dollar mark, here is a case of an ounce of prevention saving pounds (and dollars) of cure.

Linda Shields, professor of nursing – tropical health, James Cook University
Stop thinking that “primary health care” is all about GP clinics. It’s not – it’s about prevention and stopping people getting sick in the first place. Investment in primary healthcare (the real one) would improve the health of all and reduce expensive inpatient costs.

Professor Paul Ward, Head, Discipline of Public Health, School of Medicine, Flinders University
The secure funding for preventive services.  There is a big problem here in South Australia, and elsewhere, whereby State governments are focusing their sole attention on acute services and assuming/hoping the Federal government will pick up the costs and mantle of preventive services.

This does not seem to be happening – it’s ‘hoped’ that Medicare Locals will pick up these services, but it doesn’t really seem to be their job either.  If we continue with this extremely shorted-sighted view, we are putting the future health of generations in danger.

*********

2. What is the single most important thing the government could do in the overall budget (ie beyond health portfolio) to improve population health?

A/ Prof Gawaine Powell Davies, CEO, UNSW Research Centre for Primary Health Care and Equity, University of NSW
For the long term, address climate change by removing the subsidies on the use of fossil fuels.

Professor Mike Daube, Public Health Advocacy Institute WA
Sort out the shambolic alcohol tax system – especially abolishing the Wine Equalisation tax (WET) that enables wine to be sold cheaper than bottled water. Again reduces harms, protects the vulnerable, raises money for other health and social priorities.

Dr Greg Stewart, President-elect, Australasian Faculty of Public Health Medicine
Increase taxation.

Elizabeth Harris, Senior Research Fellow, Centre for Health Equity Training Research and Evaluation (CHETRE)
Ensure that the universal nature of Medicare is not undermined by need for increased co-payments, shifts of responsibility for core services to private sector.

Gail O’Donnell and Lyn Morgain, Healthwest Partnership
A comprehensive early childhood strategy, education funding and education system reform (as per Gonski recommendations). Increasing social benefits for unemployed people and single parents.

There has been significant progress in using health impact assessments to understand the effect of program and policy changes across Government on the health system and service costs. This means that a reduction or increase in effort in one part of government / community is understood for the impact that it will have on the broader service and support system. This ‘health in all policies’ approach is the best way to understand the true cost and achieve efficiency in the primary care space and allow a more rigorous approach to policy consideration and program development.

A commitment to the recommendations of the Senate Committee inquiry into the Social Determinants of Health.

Luke van der Beeke, Managing Director, Marketing for Change
Health in All Policies is without a doubt the most important thing the government can do to improve population health.  At present government departments work in silos.

Why not introduce health-based KPI’s for all portfolios?  All of them have significant direct or indirect impacts on population health.  There needs to be a shift in the way we think and talk about health in Australia.

There needs to be a shift in the way we think and talk about health in Australia, and most importantly, a change to WHO talks about health in Australia.  If health practitioners and experts are the only ones talking about health we will never fix public health.

Associate Professor Heather Yeatman, president PHAA
The establishment of an Australian Centre for Disease Control (ACDC).  As a first step the Government must to commission a study to examine the benefits and costs of establishing an ACDC.

The establishment of and requirement for a Climate Impact Assessment and Health Impact Assessment to accompany all Government policy and program decisions (in a similar way to the current requirement for Regulatory Impact Assessments).

Elizabeth Harris, Senior Research Fellow, Centre for Health Equity Training Research and Evaluation (CHETRE)
Maintain investment in smoking cessation and mental health and well-being.

Lewis Kaplan, CEO General Practice NSW
Make health in all policies a requirement across all portfolios – eg South Australia.

Anonymous medico
We spend $billions treating diseases resulting from people’s lifestyle choices. While a fat tax would probably be difficult to implement, alcohol is still far too cheap.

John Mendoza, mental health advocate, Director, ConNetica Consulting Pty Ltd
Slash the size of the Federal Bureaucracy. Since 2004, an additional 40,000 people have been employed in the APS. This does not include those now employed in organisations like Medicare Locals. Only about 1 in 4 of the APS actually deliver an end service. The duplication of project management, the inefficiency of the APS has become a high cost factor.

The Federal Government should literally get out of the business of delivering services. It should focus on policy development and setting parameters for delivery.

Second they must wind back all middle class welfare and industry welfare – this adds tens of billions to our nations taxation system.

Linda Shields, professor of nursing – tropical health, James Cook University
Preventing illness in the first place would save heaps of money down the track. A very good investment.

Professor Paul Ward, Head, Discipline of Public Health, School of Medicine, Flinders University
To work on joined-up government to tackle the social determinants of health.  There is evidence globally, and locally, of the benefits of Health in All Policies in terms of illness prevention, health promotion and overall health gains.

**********

3. What is the single most important thing the government could do in the health budget to tackle health inequalities?

Vern Hughes, National Campaign for Consumer-Centred Health Care
There is no quick fix for health inequalities, which are a product of social and economic well-being. The single most useful thing the government can do in the health debate is state this publicly.

A/ Prof Gawaine Powell Davies, CEO, UNSW Research Centre for Primary Health Care and Equity, University of NSW
Improve the Newstart payment.

Associate Professor Mark Wenitong, Public Health Medical Advisor
Apunipima Cape York Health Council, School of Public Health, Tropical Medicine and Rehabilitation Sciences, 
James Cook University, Cairns
Understanding the synergies between health and social portfolios re Aboriginal and Torres Strait Islander health inequalities, and thinking about “bundling” program funding (across FACSIA/DOHA eg) to address early childhood/family functioning support and health in a prevention sense.

We also need to have a more sophisticated understanding of health $ investment for long-term health outcomes vs GFC pushed “corporate health” approaches to efficiency.

We need to measure efficiency against a human capability framework, rather than “efficiency” driven by the accountancy consultants (ie KPMG PwC E&Y etc that are basically accountants, hence an inbuilt bias towards fiscal efficiency) – that do ALL of the scoping for DoHA.

Gail O’Donnell and Lyn Morgain, Healthwest Partnership
Provision of funding through improved local service delivery to target populations and geographies where particularly poor health outcomes exist.  A move away from waiting until an acute service response is required (surgery or emergency department) and towards community based primary care.

Targeting intergenerational poverty through a focus on child health.  A comprehensive early childhood health and wellbeing strategy combined with a social protection system would be a positive step towards addressing social and health inequalities.

Luke van der Beeke Managing Director, Marketing for Change
To tackle any issue it needs to be taken seriously.  The Federal government needs to commit to action on tackling health inequalities.

Associate Professor Heather Yeatman, president PHAA
Invest in building the competence and capacity of a national preventative health workforce who understand inequity and the social and economic determinants of health and are skilled to effectively deliver preventive health services at the local level.

Maintaining the funding of Medicare Locals, Locals and Women’s Health at a level that will allow comprehensive primary healthcare based on an understanding of the social determinants of health.

Retain and extend funding for the “Close the Gap” measures including additional support for Aboriginal Medical Services and Aboriginal Health Services.

Develop a National Aboriginal and Torres Strait Islander Social Determinants of Health Policy as a key strategy in closing the gap and overcoming Indigenous disadvantage. The policy needs to describe the social determinants, focus on social inclusion and support the provision of real opportunities in education, employment and health status, with funding tied to delivery of outcomes.  While retaining current levels and build in future growth of funding for the “Close the Gap” measures.

Elizabeth Harris, Senior Research Fellow, Centre for Health Equity Training Research and Evaluation (CHETRE) 
Ensure access to high quality services for all Australians irrespective of who they are and where they live.

Lewis Kaplan CEO General Practice NSW
Make the social determinants of health the primary driver of health budget allocations.

Anonymous medico
Many inequalities result from poor access to services. There should be more incentives to get health professionals into areas of need.

John Mendoza, mental health advocate, Director, ConNetica Consulting Pty Ltd
Transition away from fee-for-service asap.

Linda Shields, professor of nursing – tropical health, James Cook University
Same thing. If primary health care programmes targeted at the disadvantaged were supported, then the gaps would begin to close.

Professor Paul Ward, Head, Discipline of Public Health, School of Medicine, Flinders University
To commit to the Australian National Preventive Health Agency agenda – philosophically, financially and in terms of services and systems.

*****

4. What is the single most important thing the government could do in the overall budget (ie beyond health portfolio) to tackle health inequalities?

A/ Prof Gawaine Powell Davies, CEO, UNSW Research Centre for Primary Health Care and Equity, University of NSW
Publish the taxable income and tax paid by all Australian citizens.

Dr Greg Stewart, President-elect, Australasian Faculty of Public Health Medicine
Raise the dole.

Gail O’Donnell and Lyn Morgain, Healthwest Partnership
To look at health in the broadest sense and understand the economic and social benefits of health improvement and prevention activities.  But this requires more than one activity.

For example to ensure the implementation of a comprehensive early years strategy as well as improved funding and reform of the education system to improve outcomes for poor and marginalised communities / individuals; greater access to training and employment opportunities for individuals and communities facing exclusion / disadvantage; commitment to the National Disability Insurance Scheme; funding for public transport in growth corridors; support food security in remote and urban communities; improved access to early intervention community based mental health services; programs that will use the NBN to reduce the digital divide; more secure housing for low income individuals and families.

Further work to reduce income inequality and the experience of poverty is necessary.  This would include reversing the decision to push single mothers onto Newstart and increasing the level of the Newstart allowance.

Associate Professor Heather Yeatman, president PHAA
The PHAA seeks a comprehensive approach to improving health through applying strategies (financial disincentives) known to influence behaviours positively, and at the same time raise funds for initiatives to tackle health inequalities:

TOBACCO REVENUE: Cigarette prices in Australia are lower than in some comparable countries. An increase in excise duty of ten cents per stick would reduce smoking and raise approximately $1.25 billion.

ALCOHOL TAXATION: Projected savings of $849 million if a volumetric tax is applied to wine and the WET rebate abolished.

JUNK FOOD: Implement a tax/levy on selected nutritionally undesirable foods (such as sugary soft drinks), using the funds raised for preventive programs and to promote and subsidise nutritionally desirable foods for disadvantaged groups.

LOWER CARBON USAGE: Build on the range of taxes and revenues so far introduced to lower carbon usage.

Elizabeth Harris, Senior Research Fellow, Centre for Health Equity Training Research and Evaluation (CHETRE)
Increase Newstart Payments.

Lewis Kaplan CEO General Practice NSW
Create a single, accountable health care and disease prevention system with priority given to primary health care – this would mean educating the public too as to why acute care needs to be re-thought.

Anonymous medico
There is an association between unemployment and ill health. While overall unemployment is reported to be low, there are areas/ages of high unemployment, which should be addressed.

Linda Shields, professor of nursing – tropical health, James Cook University
Make health a federal priority and remove it from the states (yes, I know – hell will freeze over because of states’ rights etc).

Professor Paul Ward, Head, Discipline of Public Health, School of Medicine, Flinders University
To commit to quality education for all.  The Gonski Review partly deals with this, but it is still my belief that part-funding private education (as the Government does) is drawing money away from services for the most needy children and families.

I cannot understand public subsidizing of private education (or private healthcare for that matter) – if parents want private education for whatever reason, they should pay for it – ALL of it.  They would release public money to do what it’s there for – focus on the public system.

******

5. Any advice to the media about how to cover the budget this year? What do you most want to know about it?

Vern Hughes, National Campaign for Consumer-Centred Health Care
The big public need is for long-overdue media scrutiny of budgetary handouts to provider interests in health care across private and public sectors, beginning with public funding of provider peak bodies and the role of this public funding in the formation and continuation of provider-centred health policy.

A/ Prof Gawaine Powell Davies, CEO, UNSW Research Centre for Primary Health Care and Equity, University of NSW
Look at the equity impact of measures; get away from the obsession about having a surplus, please.

Gail O’Donnell and Lyn Morgain, Healthwest Partnership
Look for investment that will reduce the rate of growth in health spending, rather than perpetuate the sometimes inefficient investment in the acute settings – when early intervention and more coordinated care will result in cheaper and better health outcomes.

Given the political environment and the likely change of Government what is the Opposition’s proposed approach to the infrastructure that has been developed in recent years (Medicare Locals, Australian National Preventive Health Agency, the Organ and Tissue Authority, the Health Workforce Agency, local health networks etc) that seek to improve system planning and performance.  What is their commitment to funding prevention and health promoting work?

Associate Professor Heather Yeatman, president PHAA
Where will the cuts be made in health?

What effort is made to take a LONG TERM VISION?

Is there any attempt to deal with the COST SHIFTING of jurisdictions such as Queensland and South Australia that are removing so much of their prevention and primary care resources and arguing it is the responsibility of the Medicare Locals?

Elizabeth Harris, Senior Research Fellow, Centre for Health Equity Training Research and Evaluation (CHETRE)
Establish a ” truthometre” that assessed assertions/ commentary made by all parties for truthfullness and make his transparent and easy to access. (Note from Croakey to readers – see the new PolitiFact initiative).

Lewis Kaplan, CEO General Practice NSW
Stop focussing on hospital waiting lists and address the reason why they exist, which is poorly integrated primary health care and inadequate national prevention programs coupled with inadequate policy on health promotion e.g. alcohol and obesity, exercise and diet.

Anonymous medico
I would like to know about the policies, not the politics!

******

6. Where could savings be made in the health portfolio?

Vern Hughes, National Campaign for Consumer-Centred Health Care
A shift from a provider-centred health system to a consumer-centred health system would involve removal of failed service coordination programs that attempt to connect fragmented providers; abolition of Medicare Locals; removal of subsidies to practitioner training programs; removal of capital and block funding grants to hospitals; and removal of public funding of industry peak bodies in public and private sectors.

A/ Prof Gawaine Powell Davies, CEO, UNSW Research Centre for Primary Health Care and Equity, University of NSW
Remove the subsidy for private health insurance

Associate Professor Mark Wenitong,
 Public Health Medical Advisor
Apunipima Cape York Health Council, School of Public Health, Tropical Medicine and Rehabilitation Sciences 
James Cook University, Cairns
I think there are real savings to be made in well considered across portfolio strategic program funding to address health inequality, (and CONGRESS/NHLF is the structure to support this from Aboriginal and Torres Strait Islander perspective, and it supports real Aboriginal and Torres Strait Islander leadership).

Dr Greg Stewart, President-elect, Australasian Faculty of Public Health Medicine
Eliminate the private health insurance rebate completely

Gail O’Donnell and Lyn Morgain, Healthwest Partnership
PBS.

Ongoing focus on ensuring that the price that the Australian government pays for both patent protected and generic medicines reflects the international market and that particular points of the delivery system (such as pharmacists) are not achieving reimbursement for services which do not reflect cost of service or a high risk profile.

Health workforce reform.

Focussing health care professionals at the ‘top of their scope of practice’ requires recognition of the diversity of health care roles across the spectrum and also allows care/ interventions to be delivered at the lowest workforce cost. Currently decisions around the location of treatment are based on professional boundaries which were designed over the course of the last century and show little resemblance to either a modern risk / clinical governance approach or indeed any assessment of best outcomes for clients / consumers.

The need for a systems approach that accounts for the linkages between all parts of the service and support systems (regardless of funder) has never been more apparent.  In seeking to promote better health outcomes, increase the effectiveness of services and seek to reduce the rate of growth of health spending this interface is an area that has been consistently overlooked.

There is a growing body of evidence that the single greatest efficiency that could be made to the health budget is to move (where clinically appropriate) from high cost, high tech acute care settings to lower cost, community based primary care.  However despite this knowledge this systems approach continues to be undervalued.

Associate Professor Heather Yeatman, President PHAA
Rather than savings in federal health, we should be looking at the revenue raising side (see question 4).

Associate Professor Jan J Barendregt, School of Population Health, University of Queensland
As we reported in 2010 in our ACE-Prevention results, and in journal articles since, Australia pays far too much for cardiovascular disease prevention, due to a combination of missing out on the most efficient interventions, and paying too much for generic drugs.

Mandatory salt limits in food is very cheap, but is not being pursued.

Pharmac in New Zealand pays only a fraction of what we do for some very much-used generic drugs.

We went out of our way to make these results known in policy-making circles, and are frankly baffled by the complete lack of response. Why do policy makers keep wasting taxpayers’ money while the facts are known to them?

Lewis Kaplan, CEO General Practice NSW
Savings – not this time – it’s critical that the nation invest strongly in its future health via prevention and integrated primary health care or we will go broke.

Anonymous medico
Stop the federal-state cost shifting. Greater use of generic medicines.

John Mendoza, mental health advocate, Director, ConNetica Consulting Pty Ltd
$1billion per annum from reducing DOHA from 6000+ to 600 staff in a policy ministry for starters. Then tackle PBS, MBS issues.

Dr Peter Arnold, retired GP
I have been singing from the same song-book since 1973, when I was so publicly opposed to universal benefits (as being introduced by Medibank) and when I argued unsuccessfully in favour of selective benefits – aimed at those who needed them (pooh-poohed by Bill Hayden and his advisers because people would feel ‘stigmatised’). Today, my attitude has become commonplace, with its own jargon: “middle-class welfare”.

The answer to your question is simple – targeted (selective benefits). Taxpayers should not be funding the health care of the affluent – neither through Medicare nor through government’s propping up of private health funds. You want savings – here they are!

Professor Paul Ward, Head, Discipline of Public Health, School of Medicine, Flinders University
Bureaucracy!!!!!!

*******

BUT…Was Croakey asking the wrong questions?

Ian McAuley, lecturer in public sector financing, Canberra University
I’d find these questions easier to answer if the word “budget” were left out.

The budget is simply a set of appropriation bills.  The policies on which those appropriations should have been developed and articulated over many years.

But the budget has morphed into the major statement of government policy. Fiscal considerations drive policy, rather than the other way around.  Instead of considering what is needed and then finding how these needs can be funded, funding drives policy.  The budgetary process is one in which revenue is taken as a “given”, as are most pensions and other personal transfers, and all program portfolios have to accommodate their programs into what is left over.

Some would say that this leads to worthwhile expenditure restraint. But it also leads to cost shifting.  In health care costs get shifted on to consumers with co-payments and private health insurance is called on to do the a job which taxation and Medicare do much better.

So what would I like to see?  A health policy, rather than a set of fiscal projections. Funding is important, of course, but funding considerations should be about all sources of funding, instead of the current narrow focus on that funding which passes through the budget.

How can we structure co-payments so that they send appropriate price signals without not discouraging useful therapy?  How can we fund private hospitals without having them linked to private insurance?  How can we control the moral hazard which results when services are free at the point of delivery, be that because of Medicare or private insurance?  How can we phase out private health insurance as we have done with other high cost industries such as clothing and footwear?

***

More reading on the Budget and health

• Jennifer Doggett recently compiled this very useful overview of the federal budget submissions from peak health and social welfare group. Increased action on prevention, the social determinants of health, Indigenous health, primary care, and consumer engagement were high on the list of priorities.

John Menadue suggests tackling increases in medical servicing, especially in pathology and radiology.

• Australian Drug Law Reform Foundation president Dr Alex Wodak suggests better use of the funds currently spent on law enforcement of illicit drugs policy.

• The St Vincent de Paul Society calls for an increase in the Newstart allowance.

 

 

 

Comments 2

  1. Margo says:

    What is a real concern is the continued disconnect between evidence-producing academics and policy-makers. Clearly, more needs to be done to bridge the sort of divide that Peter Sheargold and others have referred to and which has caused bodies such as the Australian Primary Health Care Research Institute to employ ‘knowledge brokers’. But if academics are still genuinely ‘baffled’ by policy makers who do not respond to their research results and who continue to seemingly ignore ‘the facts’, then maybe we need to provide public health academics with a crash course in the realities of policy-making.
    Also, in relation to health funding: as Profs Clarke and Graves have written in today’s ‘The Conversation’: “There’s no better example of technical inefficiency in our health-care system than the way we set prices for generic drugs on the Pharmaceutical Benefits Scheme (PBS). Australians are paying some of the highest prices in the world for generic medications because of poor policy decisions as detailed in a recent report by the independent think tank Committee for Economic Development of Australia (CEDA). If we could improve our purchasing of generic drugs, more than a billion dollars extra a year could be released for other uses.”

  2. Harry Rogers says:

    Pleasing to see that a minior number of suggestions actually didnt asked for:

    Banning something

    More funding to their hobby horse

    More lifestyle intrusion

    ad nauseum.

    But where were the ideas?? Do they understand the definition.

    How about as a start people taking responsibility for their own life!

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