Quite right Michael. What we've seen over the last few weeks re Rudd's new health plan is a classic example of why Federalism is in trouble.

We have waiting lists for public dental surgery over a year long, more than 9 months for some elective surgery, under resourced public hospital - and still a few states whined and held out - the most notable being John Brumby.

Ask SA and their Murray River water issues if dealing with Brumby is easy. Both SA and Vic will head off to court over water allocations soon.

Even after a deal has been struck with all of the states (except WA), I'm not sure we have a workable health plan. It's convoluted and shows no elegance or simplicity.

Can we honestly say to our elderly and those boomers without private insurance that things will be OK? No

People are confused by smoke and mirrors if they think that creating a big mega-bureaucracy in Canberra can provide health services cheaper and better. Health is a personal responsibility and professional health services are a service. There is no such thing as a 'right' to human effort.

The same people who enthuse over a health 'system' that provides free access for then seem surprised or indignant when people go to public outpatient departments for trivial concerns and, the price being zero, the demand can never be satisfied. The result is to take resources away from more urgent uses, and devote them with greater expense and delay, to less urgent uses. The problem cannot be fixed by more political meddling - the problem is caused by political meddling.

The people of the country have to pay for medical services one way or the other. We can't all be so poor that we are unable to pay.

Universal compulsory health insurance is as crazy as requiring all people who buy food to take out compulsory insurance against not having enough food. What do you think would happen to the "food system" then? (People only talk about a good as being a "system" when it's in government control and behaving chaotically. No-one ever talks about "our" pizza system, or "our" shoe system, because they are operated along private lines and there is no disjunction between supply and demand.

Can you imagine what a disaster would ensue if the goverment were responsible for supplying food and meals? Or if it was the responsibility to provide milk? It is nothing but a delusion that the problems caused by central planning can be remedied by a greater degree of central planning.

All government interventions in the market for health goods and services should be abolished. The result would be much greater innovation and variety of services, at lower costs, than at present. The poor should be provided for by direct cash donations, not by government taking over the hospitals

if you are going to put patients first you would not give more power to the most incompetent Government since Gough. Whether it be installing pink bats, building tin sheds for schools or immigration failure they how shown that they are marginally ahead of Zimbabwe.

Peter Hume's suggestion;

"All government interventions in the market for health goods and services should be abolished. The result would be much greater innovation and variety of services, at lower costs, than at present."

Would see the price and cost of health care in this country skyrocket faster than a ballistic missle.

Would the removal of the PBS mean higher costs of medications?

You can bet your bottom dollar that the lid was lifted off the price restraint applied by the governments PBS, medication costs would increase.

I think people only need to look at what the privatisation of power has done to the prices.

We were sold that privatisation would mean cheaper, more efficient services, yet prices are surging ahead. Blackouts in some areas become routine, the private companies use market forces, and cut back on maintenance of the network and since routine maintenance was neglected, the public are now expected pay for the upgrading of the supply network.

Peter Hume is right. While we are providing 'free' public hospitalisation and emergency care, we will continue to have a health system in crisis.
Why are people willing to pay up front for their vet fees, but not for their own health fees?

Instead of taking money from those of us who work,via the medicare levy, public patients should be means tested and sent a subsidised bill for using the public hospital's facilities.

All Australians should have this basic hospital and emergency care subsidised, and then if you want more services such as non-elective surgery or cosmetic surgery, then you also take out private health.

Maybe then we wouldn't have the ridiculous situation in our accident and emergency departments where one can just pop in for a sore throat or some basic earache, and get free treatment at any time of the day or night!

In December, I had the misfortune of being admitted to our local casualty department after a surgical wound abscess developed.

While being treated and admitted to the hospital ward, I witnessed two men arrive at different times to the department at 8pm.

One had a 'mild headache' but didn't have any panadol at home and came in to request some free pills. The other one came in with an earache he had had for 3 days, but stated he couldn't take time off work during the day to go to the GP!
The Doctor told him his ear was full of wax, and he should see his GP the next day!

What a waste of time and resources!
They may well have had second thoughts if they had to pay at the hospital.

To give the Qld Minister for Health advise you'd need to engage a Proctologist.

Health what health. We all know this whole plan has been a load of rubbish and nothing will change in health. It is the management of hospitals that must change. Nurses work in difficult conditions with a work load that is unreasonable, there are no where near enough doctors and the hospitals are either too small or to old. To make it worse the administration is so unbelievably incompetent that they can not even devise an admissions system that allows the accident and emergency to clear patients to a ward in under 6 hours. The problem across the country is resources, staff and incompetent administration always has been always will be.

Lets first get rid of this rubbish that all medical staff are pillars of virtue.

When my 90+ year old mother was in a large QLD hospital recently the weekend staff had not noticed that her food had to be cut up & fed to her. When I found her on Sunday evening, her lunch, & dinner were both sitting untouched, & she was inconherent.

She had not eaten for 40 hours, & had not been given any of the modified water, [& no other drink of any kind] for 30 hours.

After my explosion, they had to give her 2 units of blood, & a saline drip for 30 hours, to get her able to even sit up.

As for the rest of the article, it depends on some strange idea that the commonwealth government can run something better than the state government. Granted the state lot are bl00dy hopeless, I have still to see any evidence that the national lot are not worse, in fact everything they have done recently tends to give this indication.

Given that the very same people will pretend to do the job, after the take over, I can see only a cash/power grab by that incompetent control freak, Rudd.

May god protect the sick.

Do you think elective waiting time will ever become extinct.
The more you do the more that will have to be done.
The more the cost of med ins will rise.
There is no waiting time for emergencies.

There is no waiting time for getting a tooth pulled out with severe pain.
Those waiting for dental should be saving up while they are waiting and pay for it them self.

JamesH
> "[Abolishing government intervention in health care services] would see the price and cost of health care in this country skyrocket … "

Where do you think the government is getting the money from to subsidise health care prices to keep them lower than the market price? A moonbeam?

You are only demonstrating that you are confused by smoke and mirrors. Pouring money through a government bureaucracy doesn’t reduce costs, it increases them, and hides the extra charge in your tax bill so naive people like you think they’re getting something for nothing.

The government can’t even install pink batts for free without killing people, burning down houses, and wasting billions of dollars. What makes you think they are being any more efficient in running hospitals, licensing medical schools, and regulating medicines?

Hasbeen (Sat 24 April 10:25:33 AM) and suzeonline (Sat 24 April 12:21:12 AM) make good points.

So much incompetence and inefficiency is generated by the dumb actions of a few dumb or incompetent people - individually or collectively (viz. the cost of 2 units of blood and some i/v fluids vs some oral food and water).

The level of health care in Australia is second-to-none. The only negatives are things like Hasbeen's and suzeonline's examples above; and, a bloated inefficient bureaucracy which well get worse with Rudd's Dudd plan, and which will eat up the extra funds; the lack of acute mental health options; and, the obesity epidemic.

What I’m having great difficulty with is trying to understand how any of this “reform” actually works. I’ve read just about everything that has been published and I still don’t get it.

Not one journalist has been able to explain “how”, they only talk about “what”. Even the flow chart graphic in the Australian addressed only the transfer of funding responsibility and the additional administrative layers.

The constant references to “beds” and “efficiency” tell us little. Beds are a composite of the ward to put them in, the technology to support them, the nurses, doctors, technicians, pharmacies, lab facilities and so on.

Efficiency is I suppose about more effective use of existing beds, increased throughput. But hospital beds are also used by aged and mentally ill, which is now a federal responsibly. Does the federal government now pay for the use of these beds or are they going to provide new beds, outside our hospital system for aged and mental patients? How will this be administered, how will decisions in progress be reduced by more administrative layers, who has the authority to make decisions and who is accountable for what?

If the funding responsibility ratio has changed, who gets to decide how each funding source is separated, allocated and accounted for? How will duplication and conflict over resources be eliminated?

Nowhere have I seen a definition of any actual problems, just generalizations about more doctors, beds, nurses, waiting lists, crisis and squishy comments about efficiency.

I’ve lived and worked in many western and third world countries. My personal experience has been that Australia’s Healthcare system is light years ahead of the next best. Is it possible that healthcare reform is based upon a false or exaggerated premise for political gain?

Does anyone have any answers or are we all in the same boat, in the dark and no paddle?

I'll have to agree with spindoc.

I have no idea how the changes will work in practice. I have to admit that most of my knowledge of the health care system is as an occasional patient.

I have also lived and worked in many overseas countries bost developed and underdeveloped and Australia has a good healthcare system in comparison. And yes in all the other developed countries people complain about their healthcare systems too.

As far as the negotiations go the deal was in the bag all the time. The premiers got to gain billions and a look as being tough on Canberra as well as offload healthcare.

Specifically
Rudd got to fullfill his election promise and go in the history books as a reformer. The billions can easily be hidden in with the stimulus package.
Brumby has got an election coming up so needed to look tough on Canberra.
Keneally has inherited a disaster of a government and any tough on Canberra look was going to win some votes.
The SA guy just won an election so he was happy to get rid of healthcare as a state responsibility at no extra gain.
Barnett was never going to hand over another 3rd of WA gst. Canberra already takes a third of WA's gst as well as all the royalties of the Northwest shelf.

Barnett being a liberal probably didn't help either but the plunder of the west feeling crosses party lines. Nobody minds paying taxes when it is used for legitimate purposes like healthcare, education, pensions etc but when those taxes vanish into Sydney's bottomless pit of state corruption then it is only normal for people to protest.

Under the motto of "no taxation without representation" all the other states should get seats in NSW parliament and clean the place up but that is another topic...

Part of the GST needs to be locked into Health Care , having Young Kids and elderly People Dying from Flu , Food Poisoning etc as they did in the past is untenable despite what the Red Necks seem to think .

I am determined to believe that Kevin Rudd is not the right person to be in control of Health Care getting his inputs to "Work" seem always to evade him . We definately must modernize what we have now performs like a 40 yr. old S/H rusty Car .

Why not raise the GST 4% or whatever is required to assure a sensible ongoing Health System . Do we want to be a Healthy Country ? Unhealthy People tend to inadvertently spread their malaise to others .

Can the GST be locked in to Health Care Specifics and lawfully not available for Statues or Drives or Paintings or Portrates or Anything else Irascible Dudes might Covert ?

Good idea but why not raise the medicare levy to reflect the true cost of health care. Or add a medicare component to the GST to tax spendig instead of income.

Very interesting, health reform is the only remaining "big ticket" platform for the government leading up to the next federal election, it is presented as a major reform and yet, no one on OLO can explain it?

C’mon, surly we can do better than this?

Your right Spin Doctor every things right on track all Tickity Boo just as Duddy-Rudd envisaged........Meanwhile some mongrel chucked a magic Bong at Tones , now the poor bugger will have to do another frantic marathon to Peck's back all the errant 30 yr old Liberal's relaxing on the Dole . Jeez it's gunnah be a big ask Tones , what with the price of worms these days , it's pretty hard to get excited .

Meanwhile guess who is josting with Red Kerry crooing up some meritorious "Promises" for everyone to simply die for , be it they must because some of the troup are getting restless nervous indeed !
Kerry wants Rudd the Dudd to stoop for the Group , reignite the passion but the Dudd's not sure Jules would be up to it .................