This thesis is more than timely, it is almost too late to turn around the health policy machinery in time to prevent a wholesale health holocaust.

This is akin to the global climate change debate. Alarmed professionals are reading the dire warning, sounding the alarm bells.... but are unable to turn around a locked-in culture that is inhibiting the reforms that Blind Freddy can see are needed.

We all know about child obesity and bad diet and what that means for the health of our nation in 20 years time, yet all of the funding and policy focus is locked into last century's thinking and appeasing 'sexy' health sectors that are already advantaged, over-funded and even, by default, encouraging bad health.

The private system may be more efficient at performing certain outcomes (elective procedures), but is not necessarily so when measured in broader acute medical care outcomes. Ignoring the fact, for the moment, that by far the greatest cost-benefit ratios are found (initially) in spending on primary health care (smoking bans, public school food regulations, fair industrial relations policies), the private system, unless bound by regulation, will be opting out of providing less profitable health care services (aged care, non-procedural). Per dollar spent, efficiency (based on only certain initial outcome measures i.e. no. operations done etc) will be greater in private but those savings will eventually become absorbed into the profit margin as shareholders expect growth. We can see this partly in the repeated request for elevation in premiums, and regular refusal of care for those patients requiring less profitable acute non-procedural care in the private system.
There is a role in private health care for elective procedures which would not be a priority in a public system but we cannot expect it to take responsibility for all health outcomes which will never be "profitable". If this is the case then it should be a strictly user-pays private system with no ongoing financial support from tax-payers and have some clarity where there currently appears to be none