Some valid arguments indeed Andrew. The current system has us pay when we are sick (pay to go to the GP, to the specialist, to the private hospital). How about incent us to be healthy! If we are 'healthy' then give us discounts on Medicare and health insurance.

Andrew
Of course you are correct in all you say in this article. The trouble is that for the majority of people, little value is placed in good health and their attention is only paid to the days when poor health prevails. How many times do you hear "Oh, I feel lousy today"?

While there are noticeable aberations following recent events in Qld and elsewhere in the country - by far the majority of Australians insure their houses and their cars but don't insure their health in the same way. We register our cars and have the compulsory Third Party insurance (just like compulsory Medicare insurance) but look at the divergence between proportions of car owners who have comprehensive insurance cover compared to people who have private health insurance. We seem to value our car far more than our own good health.

Governments at all levels (including the one in which you served until Novemeber 2007) have spent millions of dollars in health promotion and health prevention programs. We need to see them spend more in health research as the majority of us don't know how to help ourselves. We can have all the campaigns about eating right foods, avoiding the sun, stop smoking, safe driving, reduce alcohol consumption and the like.

It is the reasearchers who will come up with cures and preventions that are the saviours. Not John Citizen himself.

You neatly point out that we visit GPs quite frequently but we go there for medical treatment. And GPs are paid to fix people up not to stop getting them ill.

The problem is that GPs either do not see their role in prevention or don’t know what to do when it happens. They are certainly not rewarded for keeping their patients well. The answer must lie in changing the funding system so that their practice (not the individual GP) is rewarded for providing preventative care. Practices need to be able to employ their own lifestyle coaches/psychologists, dietitians/nutritionists and exercise physiologists/physiotherapists who are experts in their own areas and can remove work from our endangered GPs. The GP can then concentrate on doing what only they can – medical diagnosis, prescription and care coordination. Their status in the community means that they should get good results in identifying and motivating patients with lifestyle issues who come in for the many minor medical issues that arise. They can then pass these patients over to their lifestyle team for ongoing follow up and care (and yes a lot can be handled by phone, email and SMS). This lifestyle team must be part of concerted practice and an ongoing coordinated approach – not a one off contract unrelated to the rest of their health care.
The alternative is to wait until the patient has become a diabetic or had a heart attack, is too obese to undertake enough physical activity to have health benefits and may also have depression making it difficult to get them going. Surely a fence at the top of the cliff is better than an ambulance at the bottom. We won’t be able to afford the costs of our illness system as patients are now being diagnosed with what used to be called “adult onset diabetes” in their teens and even earlier and will have to carry the disease with all its complications (and costs) for at least 60 years – not the 20 years we used to fear.