Where will we find the political leadership to take us on a health reform journey? Not from the current bunch and not in my lifetime!

State/federal and adminstrative structures are dysfunctional and self serving.

Doctor shortages remain a problem. Even any reforms that might for example extend medicare benefits to non doctors is compromised by a genuine shortage of profesisonal in all disciplines.

With respect to nurses pay, the problem has as much to do with the numbers at the bedside as it does the money paid - this is true in the acute sector and more so in the aged care sector - nurses complain more vociferously about work loads than remuneration - most want to be able to do their work thoroughly and safely. - it is the pressure of work as much as anything that saps their morale and energy and causes many to walk away.

A gaurantee for nurses that they can come to work confident that there will be enough human resources avaialable for them to work in an environment that assures not only the safety of their patients but themselves also has the potential to draw people back to the job.

Dwyers case against the dominance of the fee for service arrangements has been raised before and usually sinks like a stone in the face of opposition by the medical lobby.

Major reform will take political will - some may argue the current government has what it takes and might point to the IR changes for example - in spite of the negative publicity and the plethora of reasoned arguement that the reforms were palpably unfair - the reforms went through.

I would contend however that we now have a less unified worforce and a bunch of unions with no clout. Add that to the coalitions command of numbers on the senate the Government really took on a pretty soft target - the lobby of vested interests represented by health administrators, public servants and the medical lobby will not roll over so easily and I doubt that they will be taken on.

Yes, the health system needs reform, but what Professor Dwyer and Sneekeepete understand by the meaning of the word "reform" is probably not the same as the majority of Liberal parliamentarians.

I have heard one Liberal parliamentarian suggest that Australia needs a user pays health care system. If you have cancer that's your bad luck. It's your problem and your responsibility to look after yourself.

We need less money on:
plant beautifications by councisl

indigenous land claims, wasted money on programs
money away from multicultural departments
illegal immigrants
iraq war
africans coming here for aids treatment...

all sorts of crap we shouldnt have to pay for

more on:
education
traineeships
health
nuclear bombs
police...

good forum and information here
http://www.stormfront.org/forum/forumdisplay.php?f=38

Cut the dribble on Health Care! Nurses and Doctors who cow-tail to the multi-proned-cultural-denials-just to keep their own jobs...degrade any real efforts to enhance empathy with structural and practical change, for all.

Ie: 1) Medicare... a few months ago, a private practice charged Medicare $58 for a vitamin B injection...Is this a correct billing or a rip-off?

2) Many citizens (I believe) are flown by the flying doctor service out of rural areas to be judged-assessed and classified by MH services in larger townships... do not necessarily need the "crisis-care", away from their immediate-support networks.

Figure This: The Justice Order.

The cost of Staff (Police and Health Staff), Food, Board and "attention"... the cost of questionable Medication... and the fuss encountered until returning them back to a community ...

A MH_Health Tribunal (hearing one ) and more often another Tribunal Hearing (two) -Legal Aid alongside the engagement of associated officials, to prepare the way to the Mental Health Court... wow... I figure some $100,000 (so far) at least on just one (individual)... who apposes the ITO - MH medication treatment ... prehaps with good reason!

Think of the many local community programs that this sort of money could be spent on... alteratively... to encourage the engagement of a community... in the prevention of Mental Health...

Reasonablity.... where is it? Section 14 of the MH Act... 'patient can't see their own illness'... How do we protect those who have understanable "life contributing difficulties" that are not directly associated with "MENTAL ILLNESS" and who may need instead some strategic practical assistance?

I am not referring to those who do need critical; "care", I am saying directly... many persons entangled in the Mental Health System are "stero-typed" and "labelled", being forced to enter a "cycle of legal conflict" rather than care... to free themselves of the drastic measures presently offered by this "insane" MH system. It makes me mad just thinking about it...!

Maddness is a reflection of a diverse society, to cope we require support options that go further than 17th Century utterances of conventional notions, beliefs and hackneyed mono-expression.

Surely the fundamental problem is that in a finite world the resources required to provide the health system that people want are unlimited. As a result, politicians all over the world engage in humbug and prevaricate over health, as that is the only realistic option. There are only so many doctors, nurses etc., and those that are here are being enticed by other countries to move overseas to fill shortages there. As the population of the west ages, and as it becomes more unhealthy through obesity and lifestyle, demand for health services will rise to the point that only the rich can afford them. There is no magic bullet. Welcome to the 21st century. With the profound reduction in living standards that we can expect from the end of cheap energy these problems can only be expected to get much worse. We have been living in a golden age.

To end on a more positive note, I read in the Christian Science Monitor some months ago their assessment of world medical services.

Their judgment on the best in the world was:

1. France 2. Sweden 3. Australia

John,

State and Federal governments working together? Now there's fantsay.

Even when State governments are the same colour as Feds they don't get on. It's the perfect formula for both sides as they simply point and refuse to accept responsibility. Unless we reform the political/voting system there will be no change, except for the worse.

This user pays rubbish is great if you have plenty of money. Clearly the direction of all our governments has been to aim costs at the largest group, the middle to low income earners. To such an extent that Howard now controls the budgets of many families by making them dependent on welfare. Note that politicians pay very litle for the services they use.

Workforce shortfalls are a fallacy really. It has been created by governments that do not provide sufficient study options and deliberate underfunding. What good doctor or nurse would stay where they do the work of more than one person. Rather than a skills shortage we have simply pushed many qualified people out of our system as it is not sustainable to work the hours they are required to.

Many specialists have essentialy priced themselves out of the market to such an extent we see regular appeals on TV from desperate people who can't afford to be saved.

The private health care system is a rort. Since Howard donated the 30% discount to people by paying these funds directly their fees have gone up by 30%. Total waste of money. Close them down, pool the money and allow private health care for those that pay the lot, no assistance.

Health has suffered essentially the same as most of our infrastructure. Governments have focused on "making profits" by squeezing the life out of people simply to be able to boast they have surplus budgets. Yes they do but people are dying both waiting and in hospitals with people like Dr Patel.

Where will this user pays crap end? Will they start "putting down" people who can't afford to be treated? Seems logical doesn't it, it's economical.