Robert Wells, Director, Menzies Centre for Health Policy, writes:
Mark Ragg’s analysis of the Australian health system is an elegantly simple document with a profound message. In all our argy-bargy about ‘blame games’, funding systems, ‘improved service delivery’ and ‘more appropriate models of care’, perhaps we have lost sight of a fundamental fact: the health system is riddled with inequalities.
While we already knew most of the data in the report, seeing it all together in this way has a particular impact.
Despite a massive additional investment in health over the past decade, the inequalities persist. The proportion of GDP spent on health has risen from around 8% in the early 1990s to about 10% now. Yet our public hospitals seem constantly to be in crisis, our primary care sector is severely overstretched and the queues for all services just seem to get longer. Significant public support for private health insurance seems to have had little success in reducing demand for public services.
Lesley Russell, writing in today’s Canberra Times, has pointed out that Australia is the only developed country listed by WHO as having endemic trachoma. That problem is entirely restricted to indigenous communities- trachoma was eliminated in mainstream Australian society 30 years ago. To fix the problem would take around 5 years and cost around $25m – that’s around a dollar for every Australian. We know the problem, we know how to fix it and we can certainly afford it. Yet we have not.
Let’s hope that an outcome from the various COAG reform processes and the Rudd government’s health reviews will highlight the need to tackle the fundamental inequalities that persist across our system.
Err… trachoma, rheumatic heart disease, mental illness, drug and alcohol abuse et al. With time I am becoming more and more aware that despite the myth of Australia having a classless society there is anything but. Middle or upper and hope the rest goes away.
The problem is that there is no will to improve things. There seems to be no intrinsic sense of responsibility from politicians. They ignore what they can, presumably hoping it will quietly go away rather than seeing it as an issue that must be dealt with. I recall Prof Fiona Stanley say that politicians need to be made more accountable for their promises. How one does that I’m not sure but elections seem to be not good enough for this job.