Seems to me the Mr Pittman is right in some respects. The Health System is in a mess. But why?

Solomon Reynard P/L has a vested interest in the corporate welfare system known as the Private Medical Rebate. This costs the taxpayers billions, and as we all know, increases in private health premiums are virtually automatic, well over CPI and slug the taxpayer heavily.

This corporate welfare was poorly thought through. There is no incentive for a 45 year old single earning 49,000 to join a scheme. In fact, the system discourages this. Private Health cover gives access to a glass of red with your meal when having that all important life-saving tummy tuck.

By contrast, the money spent on this scheme is being directly taken from the public system. Places people go when their appendix bursts, their gall bladder is gangrenous, their heart stops, their body is burned beyond recognition, their bones smashed, their artery is severed - people who really aren't that worried about their glass of chardonnay or their private room.

Health care must be universal. Health care must be determined upon immediate need and not the size of ones cheque book.

Better to resuscitate and cut-out the cancer that is corporate health care.

When the Government has a forecast surplus of $15 Billion, it should train more doctors and nurses to allieviate the stortage of health staff, and perhaps give more support to those already studying.

I never earned more than $25,000 p.a. when I worked as a clerk, but I always paid my fair share of tax. Imagine if the same applied to millionaires and billionaires, what revenue the government would have to ensure a great health system. Of course that would need something no Australian Government for more than 30 years has had, courage. We must keep the "unfair" system, don't ever allow it to become "fair>"

From my personal experience within nursing, one of the major issues in the profession is the casualisation and contract aspect of the workforce. The location in which I work is awash with unemployed nurses with little prospect of obtaining a permanent position. Many have given up in disgust and moved into other areas altogether. I myself have been on a part time short term contract since I began working in my specialised field. I'm middle aged and the lack of job security means that if I need to buy a new car (no public transport available where I live) I'm forced to pay cash, as without a permanent job I cannot get finance. There are many lines left vacant on the roster where permanent staff members have retired or moved on and yet these positions are managed mostly by using casual staff. Another reason nurses are leaving the profession could be accredited to the overwhelming amount of paperwork we have to complete each day. In my workplace, we simply have no time to attend to the basics that makes nursing a worthwhile and rewarding career, little things like stopping to have a chat with a client, to be able to sit with a family and discuss completely a regieme of necessary care, to help put on make-up or offer an extra cup of tea. Everything we do is regimented and to a timeframe that is all too short, then....back to the paperwork. In the last two years, I've watched very professional people go from vibrant and fun loving individuals to angry and disparing. Morale has decreased in proportion the the increase in extra paperwork. Morale has dropped even further with the cloud of IR reform hanging over our heads. God help nursing if penality rates are affected in any way. Many of my colleages are already discussing the ramifications of IR reform and how they'll cope. The concensus so far is that IR reform can only exacerbate the nursing crises. Wildcat.

I agree with Keith Pittman generally, our health system has gone from best to dilapadated.
I do disagree with his view on nurses, re partime. Nurses spend more time with patients than anyone else in the system, they would be forgiven for only wanting to work part time, when the system is run by those who only care about the fiscal factor and not on quality of care given. Nurses bear the brunt when mean spirited cost cutting is the order of the day, their working day is severeley effected, emotionally and physically, due to reduced numbers of nurses, as a result of leaving the profession or making the choice of working part time to lessen their load. It is obvious that work satisfaction has declined.
Nursing has changed greatly over the past decades, especially when university training commenced which meant huge savings for governments and less bed side nursing, also technology meant less bed side nursing and added major costs to the health system. Medical machinery is good news for the suppliers, but not good news for the patient in a hospital setting, the fact is you still need people at the bedside, and hands on nursing is therapuetic in itself. The dilemma is funding for the machinery along with funding for people at the bedside, the fiscal people are unwilling to do both and they are happy to leave well alone. Howard's strong economy is a nonsense when we have such a dilapadated health system. Howard is old enough to be aware of the past and the present pros and cons.
Keith made a comment about Nurse Practicioners, they have been around for decades in many areas, such as Bush Nursing.
In 1978 i was working for the Prison Medical Service as a nurse, and there were not many doctors employed, so the nurses [hospital trained], learning on the job, became unrecognised Nurse Practicioners doing much more medical procedures than expected of the current Nurse Practicioners. I experienced job satisfaction, i am sure if nurses today had the same experiences, they would not want to work part time

"Let’s talk about health care workers. The argument that we aren’t training enough of them needs nuancing. More would be good but a major part of the problem is that many now don’t want to work full-time. The loss of doctors and nurses through a reduction in average working hours is even more significant than numbers lost through retirement. Where do we draw the line? How many can we afford it if training more health care workers just allows them work shorter hours?

Reluctance to work full-time affects specialist numbers. Research says many doctors choose general practice rather than becoming specialists solely to work part-time. Hence we have a shortage of specialists. Similarly, many nurses aren’t interested in becoming nurse practitioners because they don’t intend to work the hours that would justify the investment in study."

The Kingsfund in the UK published a study titled 'The Last Straw' in it's findings it found that nurses were leaving the health care system because of underlying issues which are not being resolved.

"Tears and Rage; The Nursing crisis in America" is a book which deals with what was happening to nurses in America.

In the last decade their workload has increased dramactically as patients admitted to hospital become sicker and sicker.

Increasing the level of Privatization on the health care system will not, lead to greater effeciencies and use of resources. It will however lead to a much more expensive health care system. In the US 14% of GDP was spent on health care in the 1990's and less than 50% of the population had private health insurance.

The HMO's (health management organisations) out performed the finance sector in profitability.

Australia's public hospital system is not free and never has been. All Australian citizens who pay taxes contribute to funding the public hospital system.

All health care systems have their faults!

Australia's health care system should have every effort made to resuscitate it, because the alternative private system is not desirable. Individuals may find that without private insurance they will be the ones who are not resuscitated.