While it is true that the costs in health are rising rapidly and we will not be able to provide the whole range of services before we deprive the population of services we should take a hard look at what we provide.

There is a vast amount of illness that is potentially preventable through lifestyle change. The lowest estimate I have seen is around 30% and it goes up to 80% for illnesses among the elderly. Sadly we want to continue to have an illness industry rather than a health system.

Some of the solution lies in a comprehensive multidisciplinary approach using allied health practitioners such as exercise physiologists, nutritionists/dietitians and lifestyle coaches/psychologists working within general practices to help patients change their lifestyles by reducing smoking, improving nutrition, increasing physical activity, keeing alcohol consumption to safe levels, and giving stress management techniques. This is more than merely educating the population - most of us know what we should be eating and how much exercise we should take but few of us actually do it - it is a comprehensive behavioural approach. I call the solution Wellness Centres and can provide more details of the model if you email john@rbcdgp.com.au. This solution is putting a fence at the top of a cliff not a hospital at the bottom.

Sadly our current illness industry is dominated by doctors who propose medical solutions to all problems, by bureaucrats who avoid making new precedents, and a funding system that discourages most prevention and certainly anything innovative. We need some strong political leadership to change away from a system that will implode if it continues.

"Some of the solution lies in a comprehensive multidisciplinary approach using allied health practitioners such as exercise physiologists, etc etc."

While I agree a holistic appraoch to health and medicine is needed and it is better to prevent disease from occuring. The above approaches by John Wellness are extremely long term in nature, while there will some benefits gained in the short term, the real target audiunce that will beenfit from such approach are the section of the population in their teens and early twenties.

For the section of population over 50 the benefits and reduction in hospitalisation will not be as great.

So in reality having these wellness clinics is a pie in the sky at present because of the aging baby boomer generation who already are in the process of developing life style related diseases and complications.

They will not solve our looming health care crisis.

"What if it is now impossible for the health system to deliver all that the community expects of it?"
We pay for the hospitals probably somewhere between two to three times over. And we do not have amnesia. The collective memory remembers how hospitals use to be before the wrecking operation started in about 1984 when the Hawke and Keating government started closing down hospitals and handing them over for asset stripping then to their cronies for real estate speculating. A recent Ama report revealed that public hospital capacity had been cut by nearly 60 percent over the past 20 years and that “cuts to hospital bed numbers have been too deep and the risk of systemic breakdowns is too high.” This is the wrecking operation currently in progress, that is systematically running hospitals and medicare into the ground.

The media, big business and the bankers set this policy for both parties. As well, Private Health has spawned a monster of large proportion, now covering about half the population. Back in 2004 expenditure on private health was $87 billion and would far surpass this figure today. This huge profiteering is behind the the pirates moving into the public health service. Courtesy of Labor, Liberal, and their handraisers The Greens. Conditions are being created and nourished for a major catastrophe, which may be irremediable for society.

I would have thought that the major epidemic facing our health system is not about children or teenagers, it's about baby-boomers, who are about to hit old-age with increasing levels of chronic (but not fatal) diseases.

The burden of chronic disease and disability in our society is growing exponentially as more baby-boomers reach an age where such diseases and disorders as diabetes, arthritis, blindness as well as a range of other debilitating conditions. These patients will also need the assistance of our health system - unless dollars are pumped, almost immediately, into preventative health measures.

If we're going to talk about priorities - I wonder where this figures.

We could lighten the burden for the future by doing these:

regulating the advertising of manufactured and processed food;
tougher labelling laws on food;
bans on advertising foods to children which are high in fat or sugar;
keeping up a total prohibition of smoking in indoor public areas such as bars, casinos, cafes, restaurants;
restricting use of trans fats;
restricting sales of tobacco to liquor licenced premises;
putting nicotine replacement programs proven to treat dependence on the PBS;
putting orlistat on the PBS;
prohibiting tied promotions of toy and fast food;
among other things our governments have to put us first and quit kowtowing to their big mates in big business.

I think our public health system is facing an epidemic of misused, misappropriated public funding. In Queensland, we have the traditionally pork-barreled South East Queensland and the Hospital system in the North in need of the health equivalent of Drought Assistance. We can support the health system, and it can be more efficient than it is currently. I believe that a free health system is the right of all people in a nation, not just that of those who can afford the insurance or who can pay for it. We as a nation simply cannot afford to go down the dreadful American road, where people are going bankrupt due to medical bills, where people have to go on fund-raising drives just to get basic medical care - and this occurs in a "wealthy" nation?

Maybe if the hospitals were run by the Federal Government using the GST that so lavishly goes to the states we might have part of the solution. Although I dread the future in 20 to 30 years time when we have the horrifyingly overweight, overfed, under-exercised, unhealthy young people reaching an age where the disease process will reek havoc upon them in the form of diabetes, heart failure, joint diseases of various sorts etc.

Health provision is not just an after thought of live-style but also needs to be a culturally appropriate proactive solution. Health is not just education, hospitals and doctors. Health is also the equitable access to affordable healthy food, not shriveled fruit, fatty meat, nor hideously expensive vegetables etc. Health is also a rethink of our urban landscape of McMansions on a handkerchief sized block of land with no room for the residents to garden, run about and be active. Do we really need the "Theatre Rooms" or the "Rumpus" Rooms, when this space would be more psychologically and physically healthy as open green space?