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    Tully Rosen

    I would love to see deep exploration of the success thus far of moving from the medical model to the social model of disability in Australia. The world health organisation long ago developed an understanding of health requiring health systems that gave equal weight to social determinants and medical techniques to address disease, yet we still heavily privilege medical understandings of most health conditions. The culturally militaristic hierarchies of most public and private hospitals strongly reflect this.

  2. 2


    This is surely the time for the many fragmented groups interested in healthcare, to come together and help create a useful solution. The Libs will not stop trying to pushing tax payers money into private specialists pockets. What they don’t want made public is the over overpriced and sub standard treatment that a lot of private healthcare really gives patients.

    What about a Trip Advisor style site for doctors/hospitals? Let patients discuss their out of pocket costs and the actual standard of care they receive. The senate submissions into the out of pocket costs enquiry are quite shocking Mine is number 29.

    The technology to give consumers much more power, are now widely available, it’s just not being harnessed in the health industry. Disruptive technology is the only way.

  3. 3

    Tim Senior

    Thank you Tully and Delia for your thoughts.
    It would be very interesting to discuss health moving away from a medical model – indeed, the definition of health used by Aboriginal Medical Services doesn’t mention disease at all. Barbara Starfield points out how Primary care is most effective when it is patient centred not disease centred. It’s a difficult message to get across to policy developers!

    Delia, you might be interested in Patient Opinion which I think does what you are asking, but with the advantage that the health services are also set up to act on the feedback.

  4. 4


    Enjoyed your short video and your obvious passion for strengthening primary care. I would be fascinated to learn why general practice only seems to have two basic models – the traditional “cottage industry” of a few GPs working together with maybe a nurse, or a corporate model aimed at maximising profits. Is it because of our outmoded funding systems that reward ill health? Is it a lack of imagination? Are GPs so fixed on the medical model that they can’t see the possibilities for multidisciplinary health practices? Why is so little effort going into preventing chronic disease and the lifestyle determinants of health? Why can’t we get a half decent shared electronic health record? Are our bureaucracies stifling innovation? Why don’t we have publicly available measures of the quality of care? And why is there so little public debate on primary health care?

  5. 5


    John, I like your questions. I suggest you read ‘Reinventing American Health Care – how the affordable care act will improve our terribly complex, blatantly unjust, outrageously expensive, grossly inefficient, error prone system’ by Exekiel J. Emanuel. Very lucid explanation of western healthcare problems, particularly in private sector. Also read the on-line pdf Bitter Pill. Basically there is no transparency on cost and quality in the health system. There is also some of the wealthiest lobby groups in the world, bullying governments into over servicing, overcharging, covering up sub standard services and blocking reform.

    Most health professionals are just as frustrated as patients are. Many doctors are part of the new health/IT/startup movement springing up everywhere, including Australia. and

    The gov produced PCEHR is reported to be badly constructed and user unfriendly. This is despite health IT being a booming area, with plenty of talented people who could have made a positive contribution. Once again, there is no transparency for cost and quality.

    What’s the answer? Start a revolution. I want to create an app that helps patients assess the cost and quality of medical care at three different types of hospitals, Aust public, Aust private and Asia private. There is NO RELATIONSHIP between huge out of pocket costs and increased quality of care, often it’s the other way around. If people want to get together to talk about ideas, I’m interested. Contact me via by my website or meetup group


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