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The Forum > Article Comments > Curing an ailing system > Comments

Curing an ailing system : Comments

By Rob Moodie, published 8/10/2007

Let’s have a health system, not an illness system, that is smart, balanced, fair and simple.

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"Let’s start with having a health system, not only an illness system - one that actively creates good health from birth and maximises our health to the grave."

DUH!

Now let me see. I wonder why people are vaccinated? The reason cant be vaccination stops people from getting sick and requiring hospitalisation.

I wonder why we have various food and health standards? The reason cant be to stop people from getting sick and then requiring hospitalisation.

Now I wonder why they introduced set belts and safety standards on motor vechiles and equipment. It cant be to stop people from injuring themselves and requiring hospitalisation.

We already live within a system that tries to prevent illness and injury and there is nothing new in this goal. People have been trying to stay healthy and alive for centuries.

What is happening is that we are getting better at managing incurable diseases and disorders, more and more people born with genetic disorders are living longer, where a few decades ago some wouldn't have survived past their teenage years.

This creates paradox which this CEO should know is that by keeping people healthy and out of hospital means that only the very ill require hospitalisation and medical treatment and when these types of patients make up the majority of patients in hospital, this increases demand on all available resources, and increases costs.

Another aspect which is happening is that in the last few years of a persons life, their hospitalisation rate increases. Something which this CEO knows.

An example of this is where an 80 year old male who has never been a patient in hospital, starts to require hospitalisation and over the next few final years of his life he has multiple admissions.

Labors or the Libs health care policies are meaningless.

Imagine another scenario where the 80 year old cant get admitted to hospital because there are no beds available, it is likely they will not survive without medical intervention, or become so sick they wind up in intensive care, a much more expensive option.
Posted by JamesH, Monday, 8 October 2007 9:56:22 AM
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The author might now be an academic, but he has a solid track record in the 'real' world. His work in reducing levels of smoking in Victoria is an example.
I go along with his views, except for the implications of government bloody-mindedness on things like dental health. At the moment, if people don't care for their teeth/gums,and spend that money on other priorities, it is the taxpayer who is expected to pick up the tab. But we need to plough more money into public dental health, or more generous health insurance, so that dentists in public clinics can match the high incomes they can earn working privately.
Some dentists I know are already helping towards a solution here. They work one day per week pro bono. Perhaps more could follow this example.
Posted by analyst, Monday, 8 October 2007 10:38:23 AM
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The full effects from reduction the reduction in smoking will not be realised for at least another 40-50 years.

A recent conversation with a mate in middle management in health and he agreed with what I said, "Nobody in their right mind is going to tell a CEO that his plans are not going to work." Well that is if they value their job.

Many CEO's are just puppets for our politicans, and any sensible CEO is not going to tell his/her political masters that their ideas are not going to work.

Just over a decade ago I said to a certain politican that all the cost saving measures and improvements they were introducing were not going to work and that it would prove to be more expensive in the long run.

Guess what health is in a much worse state now than a decade ago. So much for improved efficiencies, cost effectiveness.

The more a hospital improves its efficiencies and treats more patients, the more expensive it becomes. It is that simple.

Mind you in the private sector it means greater profits for private hospitals, however in the public sector it means budget overruns for public hospitals.
Posted by JamesH, Monday, 8 October 2007 1:43:46 PM
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Congratulations Rob. You have captured our health systems needs so well. But to make those changes will require new ways of preventing illness – particularly in identifying and “at risk“ treating patients. It is significant that our funding systems are all about treating the ill and not about keeping people well. To make the mind shift from illness to wellness we will have to reduce the impact of health professionals (especially doctors) in planning health services. They always move towards illness positions very quickly. Our health systems will have to become truly multidisciplinary. And primary health care will have to be much better resourced than it is now.

James H claims, in his first reply, that we practice preventative health now. We only do part of it. We arguably do whole of population education well and we do some medical prevention like immunisation tolerably well. We arguably pick up some chronic diseases like diabetes and prevent some of the complications of these diseases. But we fail miserably at some of our major preventative tasks – over 50% of Australian adults are overweight or obese and around 20% smoke. Our illness systems are not funded for prevention so it does not happen. The nutritionists, exercise physiologists and psychologists needed to turn around our health do not, for the large part, work closely with GPs and pharmacists who are well located and trained to identify at risk members of the population.

Thank heavens for Rob and organisations like AHCRA who continue to press for intelligent reform
Posted by John Wellness, Monday, 8 October 2007 4:48:08 PM
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"The nutritionists, exercise physiologists and psychologists needed to turn around our health do not, for the large part, work closely with GPs and pharmacists who are well located and trained to identify at risk members of the population."

I am surprised that naturopath's aren't mentioned, as they were the first "doctors" of medicine.
I wonder if any medical student or medical professional knows what goes on with Codex Alimentarius and it's effects on future healthcare systems
worldwide.
Posted by eftfnc, Monday, 8 October 2007 5:14:56 PM
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Albert Einstein observed that 'the problems that confront us cannot be solved by the thinking which created them'.

I am not qualified to comment on either Liberal or Labor proposals in the area of our ailing Health system. However, reading through the article and the ensuing comments I recall reading somewhere about a novel solution which prevailed (perhaps still does) in some parts of rural China.

There as I understand it medicine and health was delivered by travelling doctors skilled in Traditional Chinese Medicine (TCM).

The client pays the doctor to keep her/him healthy however when the client gets sick the doctor not only pays his patient but also provides his services and medicines at no cost for as long as necessary.

Food for thought that!
Posted by Ninja, Monday, 8 October 2007 6:10:13 PM
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