Will the new political landscape mean a rare opportunity for some fresh thinking around health policy, particularly around how to achieve a more equitable distribution of health resources?
Dr Tim Woodruff, on behalf of Australian Health Care Reform Alliance, writes:
The political scene is now set for a very different way of developing policy and putting it into practice. The three rural independents must look at the national interest in terms of stable government but are in a position to push their regional interests as well, and health policy is something they have already identified as a key area for negotiation.
It is very clear from all the data that health outcomes and access to appropriate health services are worse in rural and remote Australia and in areas of throughout Australia. Although data on health expenditure is more difficult to obtain (hidden as it is behind the bureaucratic wall of Medicare Australia), the comparative data available indicates that rural and remote Australia and areas of lower socio-economic status also misses out on appropriate funding.
It may be possible for the three rural based independents, and indeed for the Greens and Mr Wilkie, to advocate for the principle of equity to be recognised in the delivery of health services.
For years the approach to addressing equity has been to introduce targeted programs eg financial incentives to address workforce shortages, travel costs, a grant for this, a grant for that. Many of these programs have helped, some have had limited impact, some have helped some areas but not others, and essentially the problems of geographical and financial barriers to accessing appropriate health services have continued, especially in the country.
Perhaps now it is time to look at funding regions on the basis of need and then allowing regions to decide how and on what that money is spent to maximise health outcomes using the resources and knowledge that exists locally, supplemented by mandated data collection to inform the local community of the health needs and ongoing health expenditure in the region.
National standards would be required, but the concept of local control, suggested to a very limited extent by both major parties but without a real implementation plan, could begin to redress the inequities suffered by those in both rural and poor areas of the country.
A region could decide that dental health is an issue worth prioritising, something neither major political party thought worthwhile. A region might decide that a priority for improving health outcomes is to address social determinants such as housing, education, and income inequality. It might decide that prevention is the priority and double its spending on that area.
Perhaps it is now time also to look carefully at the true benefits of taxpayer funding of the private health industry given the limited access of country people to private health facilities unless they are sick or rich enough to travel to the cities where such facilities exist.