Articles

Covid-19 presents us with an opportunity. A more equal society, more resilient to the challenges ahead, or a society ruled by power imbalances, struggling to cope with both natural and man-made disasters. Read more

How do we keep our population healthy?  From a patient perspective we don’t have a health system. From a provider’s perspective we don’t have a health system.

The nightmare for patients consists of multiple poorly connected pieces: the public hospital system, the publicly subsidised private hospital system, the GP system, the publicly subsidised private specialist system, the community care system, the publicly funded private allied health system, the private mental health system, the public mental health system, the private dental system, the publicly funded private dental system, the public dental system, the Aged Care system, and a myriad of other pieces. Read more

Australia doesn’t have a health system. We have a maze of poorly connected health services which barely manage to work together to provide health care of extremely variable quality depending on many competing variables such as income, geography, ethnicity, culture, and type of illness. In addition, politicians generally do not link health outcomes to other crucial factors in our lives, the social determinants of health, the conditions in which people are born, grow, live, work and age.  Read more

Much has been written about the problems of the Private Health Insurance (PHI) industry. Desperate attempts to make an inherently inefficient product less inefficient have been proposed. Such suggestions do nothing for the inherent unfairness of taxpayer subsidised PHI. But something needs to be done and it should address both the inefficiencies and the inequities. Read more

The recent election result was a major disappointment for those interested in improving the health of the nation. The re-election of the Coalition promises an ongoing increase in support for private health insurance as the Government continues its long-term agenda of two tiering the health system. Read more

Health policy reform is difficult. There are an abundance of powerful stakeholders whose number one priority is definitely not optimum health care for all Australians. But most Australians do share the view that our health care system (which isn’t really a system) needs improving. There are two broad aspects to optimising health. The first is equitable timely access to high quality care. The second is addressing all those factors outside the health system which affect health. These are the social determinants of health and of productivity. Healthy people are more productive. The key social determinant is income inequality, both absolute and relative. Read more

The Opposition Leader has announced the biggest investment in Medicare for a generation, $2.3 billion to be spent eliminating the co-payments faced by those with cancer who see specialists, need diagnostic imaging, and radiotherapy. It is also guaranteeing all new drugs approved by the Pharmaceutical Advisory Committee (PBAC) will be listed for subsidy. The latter means prescription costs will be a maximum of about $6 or $40 a month for pensioners and health care card holders or non card holders respectively.

Cancer is scary. It is debilitating. It is life changing. It is often fatal. Furthermore, as Mr Shorten correctly pointed out “cancer makes you sick and all too often makes you poor”. Labor is to be commended for addressing this challenging issue. Read more

One of my patients has epilepsy. She sees a neurologist for that and he charges $200 out of pocket per visit. He has controlled her epilepsy very well. She is on a disability support pension. She believes she will get better care seeing him privately despite the fact that he also works in the public system.

Out of pocket (OOP) costs have been in the news particularly since the ABC’s 4 Corners program exposed huge costs impacting significant financial hardship on many sick Australians. As a result of a Ministerial Committee report the Health Minister has proposed tackling the issue with a website of specialist charges and an education campaign for patients. The Committee consisted of ten health care provider representatives and one consumer representative. My suggestion to the Minister that more consumer representatives might be appropriate resulted in an intensely angry response. Read more