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The Forum > Article Comments > Australia's next health system > Comments

Australia's next health system : Comments

By Julia Gillard, published 1/9/2006

Meet next century's health system - the reforms that are needed.

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Given that the productivity commission estimates that spending on health care will increase from 5.7% of GDP currently to 10% in 2044, I welcome the discussion on Australia's health care policy.

I would like to know that health care is delivered effectively, that patients are treated with dignity, that health care workers are treated fairly.

Philosophically I would hope the system is equitable. On a more pressing issue, I am opposed to Medibank Private being fire-sold to the for-profit sector.
Posted by billie, Friday, 1 September 2006 10:55:41 AM
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Ms Gillard states'While the measure of a good health care system is the health of the population and the outcomes achieved when people pass through the system, it is also imperative that we operate on sound economic principles, and ensure that public dollars are invested wisely. The two are not incompatible.' However she does little to pose any new ideas and continues to harp on the costs rather than the delivery of good health care. Her closing statement signals her obsession with funding - that, as far as I am concerned is the root cause of most of out health system inefficiencies( not economic ones either)the ones that lead to patients needless anxiety and suffering and burnout by over worked staff. I don't have any qualifications in economics but I have been nursing for over 30 years and I have seen more problems created by applying the profit and loss argument than I ever did from incompetent staff. Health care professionals are the saints in patients eyes and yet health professionals are the first ones to be shot down by the system if something goes wrong. They are told continuously to 'be accountable for their own scope of practice' - 'take responsibility for their own education' - when I trained we supported our nurses and doctors till they knew enough to practice confidently and competently alone, patients benefitted from the hospital based apprentice training because there was more staff - patients often need other care besides professional expertise ie. an ear to listen, a kind word. It is a sign of gross inefficiency in my books that health care systems do more to employ administrative staff than hands on health care workers. Until these fundamental 'mistakes' are addressed NO party is going to get it right.
Posted by rnrofe, Friday, 1 September 2006 5:23:28 PM
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Geez, Billie, you sure change with the wind. A few days ago you were writing about how the sick old people, the wrinklies, should have the plug pulled on 'em. Now you're hoping they're treated with "dignity". What - pull the plug with dignity?

Anyway, Guillard, this all NEW exciting health reform you've got here, it sounds a lot like that OLD health reform we had to have under that Keating chap. And it was only today that I was reading, in another place, that Labor was coming up with some fabulous new directions. Frankly, I don't know, it's beginning to sound like the old mutton dressed and served up as lamb story.
Posted by Maximus, Friday, 1 September 2006 5:26:42 PM
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Minister

Thank you for your article.

I have two penetrating questions.

1. What is the Labor Government going to do about child protection? Why isn't there a commonwealth mandatory reporting system? Children must be our priority.

Most politicians ignore this "tender" area.

Most politicians have no understanding of mandatory reporting. This is a national issue - not a state issue. Our children are national.

Most politicians have no understanding of the role of DoCS. It's role is not punitive. It's role is meant to assist. As a mental health professional I have used DoCS on several occasions. It is the responsibility of the professional reporter to develop a positive and sustainable relationship with DoCS.

2. What is the Labor Government going to do about people who have a mental illness and who are homeless? Why are mentally ill people treated as second class citizens when it comes to accommodation?

Cheers
Kay
RGN RPN
Dip Teach Nursing
B.Ed Nursing
Master of Education

2.
Posted by kalweb, Friday, 1 September 2006 6:35:08 PM
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Maximus, I see no contradiction in my observation that today nursing home inmates are often starved, often left to sit in their urine, and the recipients of slip shod or scrimped medical treatment, irrespective of their ability to pay - unless they have the resources of Kerry Packer to throw at their health provision.

I am appalled at the crappy nursing care provided by agency nurses in our most presitious private hospitals but I understand the pressures the agency nurses are under trying to get enough shifts to pay their rent and I see how patient care suffers as they have to protect their own backs first [literally] on the chronically understaffed wards.

If I was in that situation, alert and aware, in pain and only able to escape into the glory days of my dim and distant legendary past I would much rather be dead that kept alive "come what may". That's my idea of personal "dignity".

I thought that this forum might have provoked discussion of how to spend less than 10.3% of GDP in 2044 on health care. Or perhaps posters might have wanted to discuss the efficacy of private health provision in aged care but I guess every one knows that its very hard to glean a profit out of aged care and provide a decent level of care to your patients. Is this an example of 'tacit consent'?
Posted by billie, Friday, 1 September 2006 10:05:06 PM
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Well billie,this is the result of a totally socialised health system.It is fast approaching the point of being totally dysfunctional.Make anything free and people will abuse it.

Everyone should pay something to see a doctor.This vastly decreases over servicing and whimsical visits to the doctor.

Society cannot afford to pay for all the whizz bang new drugs or operations,since our taxes would eventually be greater than our incomes.That is the reality we must all face.Each one of must eventually face mortality and we should not expect the rest of society to live in poverty so we can squeeze a few more years out of our lives.That notion is very selfish.
Posted by Arjay, Saturday, 2 September 2006 12:09:34 AM
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Julia is just using semantic double speak spin as she along with others haven't a clue what to do. It looks like she wants to privatise the system as well by stealth. More and more resources will be needed, but not for the old, but for the young as their health breaks down under the onslaught of dietary disease.

We need to tackle the easily surmountable problems of removing the causes of 90% of health situations. Once the causes are removed, so will our health costs. This won't happen for one glaring reason.

If the truth were told about our health, pharmaceutical companies would go broke, as they not only provide drugs to cover the symptoms, but they provide the additives and chemicals placed in our foods that cause the symptoms in the first place. As long as we have the dairy industry lying about the true effects of dairies on human health, there is no chance of change.

Our medical science is so advanced we can tackle just about any surgical or re constructive situation with success. Our traumatic medicine is state of the art. But they can't cure a cold, stop cancer, heart or vascular disease, collapsing joints or organ failures. All they can do is drug or replace the parts with temporary mechanic bits.

If we tackle the causes by concentrating on preventive medicine and lifestyle, we would have progress. But you see profits, money and control are more important than peoples health, as we can well see.
Posted by The alchemist, Saturday, 2 September 2006 7:33:19 AM
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I am a staunch supporter of Julia, but her party will not change the status quo re health.
The PM in his using the ageing of the population, as a fear for future health funding is a nonsense, we have too many unhealthy young Australians now, if we just look at the age of type 2 diabetes sufferers as young as 9, which used to be around middle age. This is a reflection of gross negligence and shows up the lowering standards of health care and complete lack of preventing the rise, unnecessarily, of the health dollar.
This has happened in mainstream Australia, I hate to think what the situation is like for first Australians, who do not count in the minds of politicians who make the rules.
I disagree that rational economics should be paramount in health care and services, governments have a responsibility for the welfare of the people, democratic and responsible governments do not line the pockets of corporations.
The PM has dismantled our health services in order to pay for his khaki ambitions in our region and Iraq and Aphganistan.
On coming to power in 1996, the PM dismantled dental care, treating the mouth as unimportant in a persons general health.
He unfairly favours for profit, private health funds, by providing public money to them, to the tune of 2 billion dollars each year.
The PM's business first government, will never act in the interests of the Australian people, there is no hope for a fair health system.
I do not see the opposition under Beazley, ever turning back the clock to a health system where there were no waiting lists and everyone received first class health care.
We had it, it has been taken away, business mania will be the norm well into the future. Prevention is better than cure, so good health.
Posted by Sarah10, Saturday, 2 September 2006 7:52:57 AM
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Apart from Sarah10's rant (why is it that Labor supporters cannot spell Afghanistan correctly by now?) there are some good observations so far on the health care system in Australia from other commentators.

While Julia Gillard is an anomaly on the left in Australia as she is one of a handful of Labor politicians who actually have some ideas (Rudd, Emerson, Tanner and Burke being the others), this is a very disappointing speech.

There is no substance to it, rather a "mash-up" of motherhood statements that leaves one wondering what Labor would actually do.

Julia Gillard as well should have been moved from this portfolio considering her responsibility for the disastrous "class-warfare" driven excuse for a health policy that Labor had last time.

The bottom line is one suspects (and hopes) the speech is more the product of a university student who has recently joined her staff than Julia herself.

Score: 4/10
Posted by matt@righthinker.com, Saturday, 2 September 2006 1:43:54 PM
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Dear JULIA

Jesus said to Nicodemus (a prominent political figure of the day)

"you must be born again"........

He was of course referring to the spiritual conditon of Nicodemus (and all of us) from a heavenly perspective, but the radical change implied would suit the Labor Party well also.

I'm inclined to choose the Coalition as the best of a bad bunch, or more accurately, I'll choose that party which most reflects the values that seem important to me. (Economic Rationalism/Globalization NOT being among them)

Having said that, I would love to see a truly born again Labor.

It would have the following characteristics:

1/ Encourage women to return to homes and families and engage in home based work and business, rather than commuting. Or..shock horror, engage in family life/home management... wow.

-More babies
-Less stress
-Happier families
-Lower Household income, LOWER HOUSE PRICES and other items. (market forces)
-Less need for immigration.
-A more cohesive society.
-More productive men. (happier men are productive men)

2/ Dissassociate itself with the selfish vested interest of Unions.
-Immediately become relevant to MANY others in the Community who would not normally vote for them.

I can't possibly outline the whole new Labor character, but those are things I'd love to see.

The day Labor RIDS itself of union interference and agenda setting, is the day I will seriously consider voting for them.
At present, I see toooo many fingers in the pie, and don't like how immigration is used as a political opportunity.
Same goes for Indigenous communities. DON'T for goodness sake just go on about 'funding'.... The problems are much deeper than that. Employ some experienced anthropologists and put them to work in the most serious problem areas... get at the root of the problems. Most of all don't listen to RANIER on this forum...

Perhaps look at the difference between Aboriginals who have embraced Christ and those who have embraced Judas Priest and Metalica.....I'm sure you will observe some 'minor' differences .....

Heal the soul first, the body second.
Posted by BOAZ_David, Saturday, 2 September 2006 4:41:25 PM
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Everyone must take more responsibility for the well being of themselves.The Socialists' state,to a large extent,has removed the survival component form our lives.Way before the evolution of the apes,survival of the fittest was our mentor who kept us constantly alert and prepared for changes in environment.Only in the last few thousand years have humans been able to change their environment and thus not have the discipline of survival to prevent social decay.

Without some form of discipline whether it be environmental of self imposed,our humanity with its' present genetic structure,will decay.We are witnessing this right now.

If we really want better lifestyles and more time to indulge ourselves,it is better that we as individuals,pay for that responsibility, since the wastefulness of Govt bureacracy and the avarice of the private system,will cost far more.
Posted by Arjay, Saturday, 2 September 2006 7:01:38 PM
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Out of the current 535 members of the Australian parliament in Canberra, more than 530, are followers of god.
36 accused of spouse abuse.
7 arrested for fraud.
19 accused of writing bad cheques.
117 directly or indirectly bankrupted at least 2 businesses.
3 have done time for assault.
71, repeat, 71 cannot get a credit card due to bad credit.
14 have been arrested on drug-related charges.
8 have been arrested for shoplifting.
21 currently are defendants in lawsuits.
84 been arrested for drunk driving in the last year.

This same group of Idiots, are cranking out hundreds of new laws each year designed to keep the rest of us in line. If you believe anyone of them, even Julia, your a fool deserving more of what they are dishing up now. This is not health care, its economic exploitation, designed to prop up vested interests and economic growth.

Any sensible person would be taking control of their lives, using dietary regimes giving good health, not growing discomfort and illness. Caused by people lazily gorging themselves on sweetened rubbish.

I doubt any poltician would write anything, they just read what they're told to say and repeat it over and over. Gillards article spells that out very well, no substance just illusuiary spin. There's no one in any of the parties who has a brain capable of making positve policy, their just brain dead religious economic robots.
Posted by The alchemist, Saturday, 2 September 2006 7:01:52 PM
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Fair-go Australia. Convey enabled focus to the accord of the Millennium Development Goals through Health.

Affirm the World Health Organisation’s call for a "global emergency" on Mental Health.

Align Australia’s Mental Health goals through the accords of the World Health Organisation.

Director, Dr Benedetto Saraceno, has now officially declared a "global emergency" in human rights on the mental health system worldwide.

Dr Benedetto Saraceno is the WHO Director of the Department of Mental Health and Substance Abuse in Geneva, Switzerland.

Ms Julia Gillard, this is extremely important.

To consider just one reason why, please see problematic areas in Australia’s legislation. The link-below highlights the burden for just one consumer, here in Cape York, where all requests for assistant have not been recurrent, progressive; but malevolent.

http://www.miacat.com/Media_Pan_One/WorldSystemsOfHealing/Health_Rights/The_Problem.html

Dr Benedetto Saraceno, Director for the World Health Organisation (WHO), has asked the United Nations to declare a "global emergency" on Mental Health, during UN meetings on the 23 August 2006, last week.

"I insist on the word global", said Mr Dr Benedetto Saraceno, "as people believe that these kinds of violations always occur everywhere else."

Dr Benedetto Saraceno said, "A human rights violation is not just a matter of denied access to treatment but also and often consists in treatment itself which is inhuman or simply of very bad quality".

I declare Ms Gillard, Australia has a “national emergency” in Human Right examples including;

1) Undue influence of the pharmaceutical industry: Australia unlike NZ, Canada and some parts of Europe has an increasingly narrow "medical model" of mental health. This is squeezing out non-drug socially engaging alternatives. While drug companies continue to dominate the future of the mental health field, the humane non drug options are seldom made available.

2) The rise of involuntary and "direct" electroshock in Australia is an outrage.

WHO demands an immediate ban on forced electroshock.

The power of the "medical model" is growing, but drugs are expensive and electricity cheap and, most often given against the expressed wishes of the subject.

I believe this is “shameful” in a country as knowledgeable and economically advanced as Australia.

www.miacat.com
Posted by miacat, Sunday, 3 September 2006 8:15:16 PM
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MIACAT

I purchased some text books used in our medical degrees from a Uni book store. I opened the first page and found this:

"The organism......" and that was it... not the 'person' but 'organism'.... perhaps in the absence of God in the medical understanding of humans, we are left with ONLY the 'medical model' ?

ALCHEMIST... and your 'source'(s) for all that interesting information is ?

Mental health has not been 'born again' it was aborted by the Left and the foetus discarded into 'half way houses' and into the families of those ill-equipped to cope.

That was the classic 'Political Opportunism' and I watched it all.
"rant against instututions and how unjust and dehumanizing they are.. we can score BIG political points by doing so" yesssss.. and all this proved is we reap what we sow.
Posted by BOAZ_David, Monday, 4 September 2006 6:02:53 AM
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We talk about the crisis in healthcare without ever really teasing out the causes of the crisis.

I regard the underlying cause as the demand for healthcare.

An analysis will show that the demand for healthcare is strongly influenced by:

the impositions of nature;
the decision to smoke and drink or both;
other lifestyle choices;
old age.

Are we as a society going to fund a healthcare system equally for all these causes.

In effect how are we going to manage demand for the healthcare system.

A fully privatised system will just depend (ignoring charity) on the ability to pay.

A publically funded system will have to have some form of rationing (currently the waiting list).
Posted by 58, Monday, 4 September 2006 10:46:12 AM
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Bd, thought that may give some real sense to the veracity of the “honourable persons” (horrible politicians), pumping their righteousness, whilst denying the causes of ill health. Those statistics where supposedly derived from parliament houses statistics office. It may not be 100% accurate, but considering the veracity of what they say relating to health and all portfolios and the number of times you see them with their snouts in someone else's trough, bet its not far from wrong.

I received it via email with some other stuff, from a pretty reliable religious source. They were trying to support the moral veracity shown by religious politicians by saying, see more than 350 are followers of god and look at all the good work they are doing. They Just forgot to delete the other statistics that came with it, typical monotheist, can't see the truth through their veil of deceit.

Nothing new's been brought up on this thread, except Julia's just like the rest, incompetent and lacking any ability or intention of really addressing the health problems. The first thing needing to be done, is address the growing mental illness raging through society. It seems their pushing it under the carpet, or should I say being drugged under the carpet.

Could this mental breakdown have something to do with the make up of our diet and foods, causing chemical changes and imbalances within the brain. We may never know, with mentally ill politics running the country. We may be doomed to social insanity for awhile, as the chemical imbalance within the brain, combines with the enslaving evolutionary gene deficiencies of the religious. The mind boggles, well at least a good “Dr who” show.
Posted by The alchemist, Monday, 4 September 2006 10:50:38 AM
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58 I think your analysis of factors causing increase in demand for healthcare ignores the fact that our expectations of the healthcare system are far greater than they were 50 years ago,

The improvements in medicine and health care have lowered the mortality rates for child birth, heart attacks, TB, pneumonia, serious car accidents etc. We are definitely more aware of the risks associated with smoking, poor diet, not enough exercise and pollutants in our environment. Overall I think Australians are living healthy productive active lives for longer, so that people can continue to work in their 50s and 60s because they are not crippled by occupational injury and diseases like arthritis are better managed than they were in the past. Only half of the projected increase in health care costs is expected to come from provision of aged care.

The fact that posters are discussing the wisdom of closing the large mental health asylums that used to incarcerate inmates for years, is only possible because there are many powerful and effective psychotropic drugs that can be used to manage psychiatric conditions allowing sufferers to control their condition and return to the community. Miacat expects that the health authorities support these people more adequately than they do currently.

I cant see the relevance of discussions religion, political dirt files and return to patriarchal society to a debate on health care expectations in 2044
Posted by billie, Monday, 4 September 2006 11:46:06 AM
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Dear Julia,

How disappointing! The lack of any sort of serious thought or analysis in your piece is most concerning. Stripped of the criticisms of the Howard government's efforts (and your comments here are hardly insightful) there are but two central thoughts: partnerships with the private sector and a single funder. What might these partnerships entail? You seem to have no idea. Single funder? Must be examined properly... benefits must outweigh costs...

Oh dear! Why bother to write this blah? It is an insult to all of those who work in the health service and who care about the future of our health service.

Oh and to cap it off, not a word about Aboriginal health.

Citizens' juries on health in WA, with ordinary, randomly selected citizens, have made a much better fist of analysing the health service than this. They have also wanted to give priority to the health of Aboriginal people.

How about just listening to the informed voice of the public Julia? They have a much better idea of how to improve our health service.

Gavin Mooney
Posted by guy, Monday, 4 September 2006 12:20:07 PM
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Miacat, I'm just wondering who in the WHO are wanting a ban placed on what you term "electroshock?" As one who works within the field of Mental Health, I know of several people for which ECT (electroshock to you) is the only way in which they can retain a degree of sanity. All the pills and potions have failed, so to the alternative theraphy. These people only get to a reasonable degree of "wellness" after having ECT (Electroconvolsive Theraphy). Without it they're practically non functional. It's been withdrawn by well meaning medical practicioners who totally disagree with ECT, but eventually, even they admit it's the last resort and the only thing that seems to work. Now, I'm not saying that there isn't a cause for their condition such as Alchemist has pointed out. I'm positive that many so called mental illnesses are caused by food additives or allergies, but sadly we don't have the expertise in general society to test all the theories or possibilities, so for now, ECT is the best we can do for them. And BOAZ_David, you're so right with your insight concerning institutions. In the major Victorian city in which I work, they had a large mental hospital. Approx 12 years ago, they removed the 1000 plus residents and threw them out into an uncaring public domain where many were and continue to be exploited. Some couldn't cope, even in assisted accomodation and now spend their days in crowded little wards, abandoned by both society and Government. How they must miss the days when they had their own little shop within the grounds where they could spend their pocket money as they saw fit and wander in secure open spaces enjoying the sunshine. What took the place of their old mental hospital?? A multi million dollar housing estate full of McMansions. Win for the Government who finally unloaded their "bottomless money pit" and a huge win for the developers who paid bugger all for the land and sold it for an overblown fortune.
Posted by Wildcat, Monday, 4 September 2006 2:47:44 PM
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Wildcat.

Forced drugging and ECT is far too common in Australia, where there is much knowledge and evidence of known alternatives.... and these alternatives.... you might have heard about (as other professionals have disclosed) when you began your training in the medical world, as a student.

a) Some information you requested is on http://www.miacat.com/

b) And here is the link for the web stories from Google and WHO news.

http://72.14.235.104/search?q=cache:UNk87QCFQawJ:www.who.int/gb/ebwha/pdf_files/WHA59/A59_20-en.pdf%2B%22global%2Bemergency%22%2Bmental%2Bhealth&hl=en&gl=au&ct=clnk&cd=3&ie=UTF-8

And to the Australian Senate;

http://72.14.235.104/search?q=cache:rIDd45SqvygJ:www.aph.gov.au/SEnate/committee/mentalhealth_ctte/submissions/sub002a_attach1.pdf%2B%22global%2Bemergency%22%2Bmental%2Bhealth&hl=en&gl=au&ct=clnk&cd=9&ie=UTF-8

Dr Benedetto Saraceno, has officially declared a "global emergency" in human rights on the mental health system.

Dr Benedetto Saraceno is Director of the Department of Mental Health and Substance Abuse in Geneva, Switzerland for the World Health Organisation (WHO)

We need to broaden our minds in Australia, and include all forms of treatment, which include options presently being squeezed out by the domination of the pharmaceutical industry.

We could take much of the conflict out of this MH crisis in Australia if we attended to the fact found in reasonable arguments that affront legislative powers which presently work in opposition to the rights of consumers entangled in the net of Mental Health, being forced drugged/ECT, against their will.

Under a framework of “treatment” we burden the client and then drag them through a tiresome process of legalities (should they protest) with poor defense resources, when most client’s are only seeking an alternative system of support, especially at community levels.

My concern is to improve community infrastructures in a way that includes "consumers" through a process of "participation" and "inclusiveness" where there is supportive emphasis on recovery and wellness. I.e.: See Alma Ata Declarations descriptor 3 “Sharing Service Provision”.

I ask you to consider the value of education and building awareness of what Mental Health is about. I find the Mental Health Service system presently entraps those it wishes to assist the most, putting them often by force in a compromising situation that is not always in their best interests.

This is "traumatic", and has little to do with the idea of treatment and care!
Posted by miacat, Tuesday, 5 September 2006 8:31:49 AM
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Miacat,going through your site with the intensity it deserves will take me quite some time, so I'll not comment further at this stage. Thankyou for the information and links. Wildcat.
Posted by Wildcat, Tuesday, 5 September 2006 10:14:55 AM
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The issue of health is so complex and unfortunately, Julia's article (or extract rather) reads more like a jingoistic ad campaign for the ALP. Do the subject some justice (and the readers' intelligence) by addressing some of the more complicated and contradictary issues regarding health, including -

1. The more governments improve the "public" health system, the greater the demand. It is actually in government's (state) interest to not provide a first class health system - everyone will want it (because it is free).

2. This leads to the conundrum of health - demand will always exceed supply. The more improvements in health service provision, the more people will use it.

3. Involvement of the private sector is interesting - governments bleed financially by providing health services - but the private sector profits. Why is this? Because the private sector picks the most cost effective health services to provide. Governments seal their position in the "lose-lose" health equation by promoting private sector involvement. That's fine, so long as everyone knows what this really means.

Give us something new to read about on the issue of health. Develop some real strategies and some real policies. Explore greater the relationship between health infrastructure and health service provision. Make this a policy issue - not a soap box about the woes of the Howard Government. Aaargh, the ALP annoys me sometimes.
Posted by Blackstone, Wednesday, 6 September 2006 11:45:26 AM
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