Ian McAuley, an adjunct lecturer in public sector finance at the University of Canberra and a Fellow of the Centre for Policy Development, writes:
Mark Ragg’s report on our health care is an excellent snapshot, looking like the school report card of a brilliant kid with severe autism.
The only disagreement I have with Ragg is that he calls it a “system’.
No, our health care is delivered through a set of unconnected channels – some federal, some state, some corporate, some charity – some based on markets, some based on equity, some based on privilege to interest groups – some well-funded, some impoverished – some relics of a 1970s attempt at European-style universalim (the Whitlam legacy), some elements of a US system (the Fraser-Richardson-Howard legacy) — bits of socialism, bits of free enterprise, lots of industry subsidies. Some high tech (diagnostic equipment), some Victorian-era (paper-based administrative systems), some ancient (the Pharmacy Guild!!!!). And it ingeniously manages to fail simultaneously on equity and efficiency grounds simultaneously.
It achieves those good outcomes Ragg identifies only because of high levels of professional competence and a capacity for improvisation, but is held back by greed and inefficiency.
Hence, to quote: “You do much better in Australia’s health care system if you’re wealthy, if you’re well educated, if you live in the city and if you’re not Indigenous. Otherwise, it seems, you receive a lesser standard of care”