Tuesday, July 28, 2009

Health, Holidays & Wealth

I'm back - I've had 5 weeks off, an extended break. I felt refreshed, till I went back to work last week. I've been just as busy as ever.

The big news is the release of a report into Australia's health system by the National Health and Hospitals Reform Commission. It confirms what many pople already knew.

The health system focusses too much (more than $90 b) on ill-health, rather than wellness
like campaigns against smoking, binge-drinking, too much sugar et al. Australians don't change the habits that adversely affect their health. Like smokers and drinkers they KNOW the messages about healthy living; they just choose to ignore them! Well, many people. Yet the report highlights that these lifestyle diseases consume more than 2/3 of the health budget! The report says "We have a health system skewed to managing sickness rather than encouraging wellness."

The recommended change in focus to preventative health has been welcomed by many. The politicians will be wary of being seen to "take away".

Hospitals remain a festering sore. They were once one of the jewels in the crown of State rights, and responsibilities. While Kevin Rudd has talked tough about how states have to reform hospitals, the States will argue strongly & concertedly to keep them. But the public knows that hospitals are underfunded, understaffed, and over-populated. NSW hospitals routinely operate at 99%-107% of bed capacity, because they don't have the budget to operate (pun intended) at the best-practice level of 85%-87% of capacity. Such levels would have seen considerably fewer operations delayed because the hospitals' priorities had to change to those with the H1N1 virus ('swine flu').

Money! Whichever of the reforms are implemented, partially or wholly, it will cost. Even better health in the long term costs, as people live longer, and acquire more age-related conditions. If voters want a better health system, they need to better fund governments. Ouch - that means more tax money. Voters will need to decide: better health care, better health programs, better hospitals; or a 2-cups-of-coffee-a-week tax cut? The effects on singular personal wealth might be ever-so-slightly dented, but communal wealth will increase significantly. Kevin Rudd shied away from questions about how any reforms might be funded. No surprises there - no Prime Minister wants to announce increases in taxes.