Professor Ian Hickie, Executive Director of the Brain and Mind Research Institute, writes:
Now that the NHHRC has released its interim report, it’s time the Federal Government gave us some serious indication of whether it is genuinely committed to the sort of real reform that our health system needs.
It’s time for the Rudd Government to signal its real intentions, rather than leaving the wider community to wonder for another six months.
Put simply, if the Government is serious about giving us a health system capable of meeting our needs in the 21st century, then the Government has only one real choice.
It’s not option A, “continued shared responsibility between governments with clearer accountability and more direct Commonwealth involvement”. This option, despite media headlines suggesting this would mean the Feds taking over primary care (don’t they already run that show?), would simply mean more of the same, ie a system that fails to meet the community’s needs.
It’s not option B, “Commonwealth to be solely responsible for all aspects of health care, delivering through regional health authorities”. Instead of barneys between the feds and a handful of state and territory governments, we’d have barneys between the feds and dozens of regional providers, amongst many other problems.
The answer can only be option C, “Commonwealth to be solely responsible for all aspects of health and health care, establishing compulsory social insurance to fund local delivery”. Despite the AMA’s best efforts to portray this as “US style managed care”, this option is more about the European model of social insurance.
It’s exactly the sort of model we need to drive real reform. The AMA has immediately argued that it would increase administrative costs and reduce patients choices, but I’m confident it would have the opposite effect, in empowering patients, driving innovative service models and helping to hook health services up to wider community-based social services.
Unfortunately the NHHRC report – while I’d give it full marks for clearly enunciating the problems with our health system – doesn’t yet explain adequately how the options might work.
And unfortunately – judging by the journalists’ questions at the National Press Club launch yesterday – we are unlikely to be able to rely on the media to generate the type of public debate which would help the public to understand the pros and cons of the various options.
Instead, the questioning suggested the debate will be reduced to simplistic discussions such as “doctors versus nurses”.
Let’s not be distracted from the main game: in 2009, does the Rudd Government have the political will to lead genuine health reform? If not, we will be left once again with endless tinkering at the edges?