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Analysis and Comment (117)

Australia’s health system is good, but it’s not perfect. Australia’s health system is good, but it’s not perfect. Dan Peled/AAP

What can we learn from other countries’ health systems?

Health systems in all wealthier countries face similar problems, but their solutions are widely different. That should mean we can learn from other countries. To explore these differences, this week The…
The Dutch like their health system, even though they contribute to it from their own pockets. The Dutch like their health system, even though they contribute to it from their own pockets. Bohbeh/Shuttersock

Creating a better health system: lessons from the Netherlands

Australia has a relatively strong health system by international standards, but it needs a makeover. To generate fresh ideas, The Conversation is profiling five international health systems that have important…
In the UK, surgeries are awarded points and additional funding for keeping patients healthy. In the UK, surgeries are awarded points and additional funding for keeping patients healthy. emanueletudisco photography/Flickr

Creating a better health system: lessons from England

Australia has a relatively strong health system by international standards, but it needs a makeover. To generate fresh ideas, The Conversation is profiling five international health systems that have important…
Australia is just ahead on life expectancy; Singapore is ahead on infant mortality. Australia is just ahead on life expectancy; Singapore is ahead on infant mortality. stockphoto mania/Shutterstock

Creating a better health system: lessons from Singapore

Australia has a relatively strong health system by international standards, but it needs a makeover. To generate fresh ideas, The Conversation is profiling five international health systems that have important…
Most hospitals in Norway and Sweden are government-owned. Most hospitals in Norway and Sweden are government-owned. Ariadna De Raadt/Shutterstock

Creating a better health system: lessons from Norway and Sweden

Australia has a relatively strong health system by international standards, but it needs a makeover. To generate fresh ideas, The Conversation is profiling five international health systems that have important…
Our life expectancy improvements essentially mirrored other comparable countries. Our life expectancy improvements essentially mirrored other comparable countries. Kristo-Gothard Hunor/Shutterstock

Australian health care: where do we stand internationally?

There is an old joke about one fish asking another about the state of the water and the other answering “what’s water?” When you’re immersed in something and that is your daily experience, you are not…
The US is the international outlier on returns on investments in health care. The US is the international outlier on returns on investments in health care. Andy Dean Photography/Shutterstock

Creating a better health system: lessons from the United States

Australia has a relatively strong health system by international standards, but it needs a makeover. To generate fresh ideas, The Conversation is profiling five international health systems that have important…
Specialists in Australia earn almost twice as much as GPs. Specialists in Australia earn almost twice as much as GPs. Dave/Flickr

Health budget: GP care isn’t the problem, costly specialist care is

The opening of eight new medical schools in Australia in the past decade has seen a massive increase in the number of new doctors entering the workforce. The number of new junior doctors graduating in…
Co-payments encourage GPs to under-service those who can’t afford to pay and over-service those who can. Co-payments encourage GPs to under-service those who can’t afford to pay and over-service those who can. AAP Image/ Lukas Coch

Over- and under-servicing: further reasons to scrap the GP co-payment

Treasurer Joe Hockey is struggling to sell his co-payment policy to the Senate and the Australian public – and it’s easy to see why. Charging patients $7 for GP, pathology and diagnostic services that…
The poorest households already spend more than a fifth of their disposable income on health care. The poorest households already spend more than a fifth of their disposable income on health care. Iakov Filimonov/Shutterstock

Higher health co-payments will hit the most vulnerable

Many poor families already pay a significant proportion of their household income on health care co-payments and will face increasing financial pressure with a proposed additional A$7 charge, according…
As the queue grows, small increases in waiting times soon turn into dramatic spikes. As the queue grows, small increases in waiting times soon turn into dramatic spikes. Fotoluminate LLC/Shutterstock

GP co-payment would increase emergency department wait times

The introduction of a GP co-payment could see average emergency department visits increase by between six minutes and almost three hours, new modelling shows, as more patients opt for free hospital care…
Life expectancy continues to rise, and years lived with disability decline. Life expectancy continues to rise, and years lived with disability decline. Ozgur Coskun/Shutterstock

Australia’s Health 2014 report card: experts respond

Australians have one the longest life expectancies in the world but are living with growing levels of lifestyle-induced chronic illness, according to the latest national health report card. The Australian…
Equity isn’t just a nice idea, it’s also how we create a better society. Equity isn’t just a nice idea, it’s also how we create a better society. Richard Potts/Flickr

Why the federal budget is bad for health and worse for society

Despite government claims that the budget would be fair and all Australians would contribute to the “budget rescue job”, reality has not supported these claims. And this is bad news for health and social…
The budget has introduced a $7 co-payment for visits to the general practitioners. The budget has introduced a $7 co-payment for visits to the general practitioners. Dave Hunt/AAP

Federal budget 2014: health experts react

The Abbott government has announced a A$20 billion medical research “future fund”, to help discover what Treasurer Joe Hockey calls the “cures of the future”, paid for with money generated as a result…
We’re unlikely to solve persistent challenges to the health system, such as ensuring equitable access to well-coordinated care, with quick fixes. We’re unlikely to solve persistent challenges to the health system, such as ensuring equitable access to well-coordinated care, with quick fixes. AAP Image/Quentin Jones

The state of Australia: health

In the lead-up to the budget, the story of crisis has been hammered home, but there’s more to a country than its structural deficit. So how is Australia doing overall? In this special series, ten writers…
The Pharmaceutical Benefits Scheme (PBS) is the tenth largest Commonwealth Government program, now costing over $9 billion a year. The Pharmaceutical Benefits Scheme (PBS) is the tenth largest Commonwealth Government program, now costing over $9 billion a year. Taki Steve/Flickr

PBS savings: two sides of the coin

When it comes to pharmaceuticals expenditure, the National Commission of Audit’s proposals rate highly on any policy change scale. Its two main recommendations are designed to reduce the overall cost to…
For general patients, the minimum co-payment would be A$15. For general patients, the minimum co-payment would be A$15. Shutterstock

GP co-payments: a triple fail for the Commission of Audit

The Commission of Audit’s proposals about GP co-payments are just that, proposals. They are not government policy, nor should they be. Some aspects of the Commission’s recommendations are good. But the…
The Commission report recommends private health insurers take on a greater role in Australia’s health system. The Commission report recommends private health insurers take on a greater role in Australia’s health system. AAP Image/Lukas Coch

Commission of Audit’s health hit list: experts respond

The National Commission of Audit has made 86 recommendations with a focus on the federal government’s 15 biggest and fastest-growing areas of spending. Health is near the top of the list, with the Commission…
Fixing the pricing of combination therapies could save around A$120 million a year. Fixing the pricing of combination therapies could save around A$120 million a year. Bart/Flickr

Want PBS savings? Fix the pricing for combined drugs

Last week, Treasurer Joe Hockey made a “case for change” in the way government spends money. His focus was largely on macro policy settings, such as pension entitlements, including access to schemes such…
Replacing registered and enrolled nurses with lower-skilled workers leads to poorer patient outcomes. Replacing registered and enrolled nurses with lower-skilled workers leads to poorer patient outcomes. DIBP images

Replacing registered nurses isn’t the answer to rising health costs

A shortage of qualified nursing staff and rising health costs have led to an increase in the employment of unregulated nursing workers. In 2012, the average weekly salary for full-time nursing professionals…
Progress on GP super clinics is mixed, but it would be a mistake to condemn the program without a closer evaluation. Progress on GP super clinics is mixed, but it would be a mistake to condemn the program without a closer evaluation. Shutterstock

GP clinics aren’t so super but it’s too early to pull the plug

The former Labor government’s GP Super Clinics Program has come in for a bashing. The Coalition has derided it as “a total waste of money” and News Corp has dubbed it a “dangerous health care experiment…
It passes the ‘milk bar test’ but once you look behind it, big risks emerge. It passes the ‘milk bar test’ but once you look behind it, big risks emerge. AAP Image/Dave Hunt

Save now, spend later: why co-payments for GP visits are a bad idea

Like a movie zombie, a policy idea that should have died has arisen from the dead and is likely to feature as a cost-savings measure in next month’s budget. The idea is simple: most GP patients should…
With the right training and supervision, assistants could safely take on 15% of nurses' workloads. With the right training and supervision, assistants could safely take on 15% of nurses' workloads. John Keith/Shutterstock

Hospital workforce reform: better jobs and more care

Employees are the public hospital system’s most valuable resource, and its biggest cost. Wages account for nearly 70% of recurrent hospital spending. To keep hospital care affordable in a time of rising…
There is no publicly available, solid evidence to show that such outsourcing generates savings for governments. But it could. There is no publicly available, solid evidence to show that such outsourcing generates savings for governments. But it could. Alexander Tihonov/Shutterstock

Does contracting public care to private hospitals save money?

In the lead-up to the budget on May 13, the Tony Abbott government is looking for ways to make the health dollar go further. In 2011-12 the federal government spent A$14.4 billion on public and private…
Investors who remember former floats of government entities might be excited by the prospect of a Medibank Private IPO. Investors who remember former floats of government entities might be excited by the prospect of a Medibank Private IPO. Dean Lewins/AAP

Medibank Private IPO: no sure thing for investors

The proposed sale of Medibank Private is not popular, but as I wrote last year, and as Finance Minister Mathias Cormann points out, it’s hard to find public policy grounds to justify ongoing public ownership…
The United States, which relies heavily on private health insurance, spends 18% of its GDP on health care, well above the OECD average of 9%. The United States, which relies heavily on private health insurance, spends 18% of its GDP on health care, well above the OECD average of 9%. Shutterstock

Private insurance reliance means countries pay more for health care

Ahead of the May budget, health minister Peter Dutton has said he wants to start “a national conversation about modernising and strengthening Medicare”. A national conversation would be welcome, but is…
‘Going private’ may speed up your time to treatment, but Medicare shouldn’t pick up the tab. ‘Going private’ may speed up your time to treatment, but Medicare shouldn’t pick up the tab. Shutterstock

Want Medicare savings? Stop paying for private hospitals

The polls this week suggest half of Australians think the Abbott government should reduce the cost of Medicare. My solution? Claw back some of the A$9 billion the government pays to private hospitals…
Finding ways to deliver high-quality care at an affordable cost to the nation is just as important as finding cures for diseases. Finding ways to deliver high-quality care at an affordable cost to the nation is just as important as finding cures for diseases. DWaschnig/Flickr

Digital tools for a better, more sustainable health system

It seems that almost every politician, health economist, policy expert and health-care worker has a different take on the state of the nation’s health system and ways to make it more sustainable. But notably…
The cost of operations varies from hospital to hospital but a higher price doesn’t equal better care. The cost of operations varies from hospital to hospital but a higher price doesn’t equal better care. TheTun/Shutterstock

Public hospital efficiency gains could save $1 billion a year

Public hospital spending has been the single fastest-growing area of government spending over the past decade. As governments, policymakers and economists put health spending under the microscope, it’s…
Rather than looking back, we need to decide on the future foundations of Australia’s health system. Rather than looking back, we need to decide on the future foundations of Australia’s health system. Image from shutterstock.com

On being treated well: reforming Medicare after 30 years

Treasurer Joe Hockey and health minister Peter Dutton have been in overdrive this past week lowering expectations for the May budget and reminding Australians that its 30-year-old Medicare system is “unsustainable…
Government spending is already targeted toward poorer households. Government spending is already targeted toward poorer households. AAP Image/Dave Hunt

Making the rich pay more isn’t the answer to a better Medicare

Should the rich pay more for their health care? This question has raised its ugly head again after health minister Peter Dutton announced the Coalition government was considering more user-pays options…
Four of the five members of the Commission of Audit during a Senate hearing at Parliament House in January. Four of the five members of the Commission of Audit during a Senate hearing at Parliament House in January. AAP Image/Lukas Coch

Commission of Audit should know costs but appreciate value

The Senate Select Committee into the Commission of Audit is holding its third Hearing in Canberra today. Witnesses include the Consumers Health Forum and Australian Health and Hospitals Association, so…
Big announcements aren’t the answer – the health system needs a long-term plan. Big announcements aren’t the answer – the health system needs a long-term plan. AAP Image/Quentin Jones

Mr Abbott, make 2014 a year of health reform, not regression

This year is crunch time for Prime Minister Tony Abbott’s health policies. The financing and policy changes from the Rudd-Gillard government are finally taking effect and the National Commission of Audit…
Medicare guarantees free public hospital care and funds a range of primary care and other health services. Medicare guarantees free public hospital care and funds a range of primary care and other health services. Image from shutterstock.com

Explainer: what is Medicare and how does it work?

Medicare is Australia’s universal health scheme. It is a Commonwealth government program that guarantees all citizens (and some overseas visitors) access to a wide range of health services at little or…
Some Australians are struggling to get timely access to affordable health care. Some Australians are struggling to get timely access to affordable health care. AAP Image/Dave Hunt

Medicare turns 30 and begins to show signs of ageing

Tomorrow marks an important Australian milestone: 30 years of Medicare and the guarantee of universal access to health care. Before Medicare, it was not that uncommon for people to avoid using health-care…
Some insurers are testing opportunities to expand their involvement in primary care. Some insurers are testing opportunities to expand their involvement in primary care. AAP Image/Mick Tsikas

Balancing public and private as health insurers move into primary care

Prompted by the government’s Commission of Audit, health policy analysts have spent the first weeks of the year vigorously debating ways to rein in Australia’s rising health budget and to make the system…
Medicare Locals plan for better, tailored health services by drawing on local knowledge. Medicare Locals plan for better, tailored health services by drawing on local knowledge. Image from shutterstock.com

Let Medicare Locals find their feet and improve primary care

Primary health care in Australia is a messy beast, with many heads and all sorts of body parts. But it’s centrally important because it plays a major role in achieving public health outcomes, such as better…
An identical patient with an identical presenting symptom of ‘tension headache’ might lead to a thousand different discussions. An identical patient with an identical presenting symptom of ‘tension headache’ might lead to a thousand different discussions. DIBP images

GP consultations are often more complicated than you think

When we think of what defines a medical consultation, we quite reasonably think of the “presenting complaint”: the medical problem which the patient brings to the doctor. In movies, literature, common…
Co-payments are an unfair tool for reducing health costs. Co-payments are an unfair tool for reducing health costs. Alex E. Proimos

Six dollar co-payment to see a doctor: a GP’s view

As a GP, when I prescribe a drug, I need to know its likely benefits and risks, and I need to base my decision-making on the best available evidence. I’d like to think the same principle applies to the…
Innovative health policy solutions could help the health budget and improve patients' health. Innovative health policy solutions could help the health budget and improve patients' health. Image from shutterstock.com

Paying doctors to keep patients healthy – if the price is right

Consensus and evidence suggests a compulsory co-payment of A$6 for a visit to the general practitioner will reduce population health but might save some money. Can we not try a bit harder and think of…
The financial pain of a A$6 co-payment won’t increase health literacy or self-management. The financial pain of a A$6 co-payment won’t increase health literacy or self-management. Image from shutterstock.com

Mind the gap: $6 GP visit proposal ignores the evidence

Incremental creep and massive holes in universal health coverage (think dental care) have left many Australians questioning whether there’s any such thing as “free health care”. One recent study estimated…
Governments setting out to control spending, or move it in more efficient directions, must have strong backbones. Governments setting out to control spending, or move it in more efficient directions, must have strong backbones. AAP Image/David Crosling

Securing Australia’s future: health care

SECURING AUSTRALIA’S FUTURE: As the Commission of Audit reviews government activity and spending, The Conversation’s experts take a closer look at key policy areas tied to this funding – what’s working…
Peter Dutton and Tanya Plibersek at the National Press Club where, like the rest of the campaign, the parties seemed to vie to be blander. Peter Dutton and Tanya Plibersek at the National Press Club where, like the rest of the campaign, the parties seemed to vie to be blander. Penny Bradfield/AAP

Bland is best? Bipartisan health platform left no room for policy

The dictionary has many words that could describe health policy in the 2013 federal election campaign – anodyne, soporific and vapid all come to mind. Australia’s health policy problems cannot afford the…
Opposition Leader Tony Abbott during a visit to St Vincents Hospital in Sydney, on the day the Coalition released its health policy. Opposition Leader Tony Abbott during a visit to St Vincents Hospital in Sydney, on the day the Coalition released its health policy. Alan Porritt/AAP

Coalition health policy is all barbs and no risks

The Coalition’s Policy to Support Australia’s Health System is a cautious document, despite shadow health minister Peter Dutton’s promise of a “cracker of a health policy”. Tony Abbott set the scene at…
This is one of the first elections in decades where health isn’t a headline issue. This is one of the first elections in decades where health isn’t a headline issue. Image from shutterstock.com

Election 2013 Issues: How we live and die

Welcome to the The Conversation’s Election 2013 State of the Nation essays. These articles by leading experts in their field provide an in-depth look at the key policy challenges affecting Australia as…
Paying the price for jumping the gun. Paying the price for jumping the gun. PA/Rebecca Naden

Potential issues with NHS111 were lost in rush to roll it out

The NHS 111 telephone service was designed to direct people to the right help for urgent medical problems but has faced a barrage of criticism since it was implemented in April. The most recent blow was…
Dementia prevalence down but not out. Dementia prevalence down but not out. Flickr/Sparkle Glowplug

Dementia stats down but postcode lottery drives uneven care

Dementia has been described as a ticking time bomb, with the number of those affected predicted to double in the next two decades. But a new study suggests that the prevalence of people with dementia in…
Not carpet bombs, but competition.. Not carpet bombs, but competition.. Pixabay/LoboStudioHamburg

If anything, the NHS should be carpeted with more competition

David Nicholson, the retiring Chief Executive of NHS England, has warned against what he called “carpet bombing” the NHS with competition. For him, and others, less focus on competition is a good thing…
The key question is whether the new prime minister regards the hospital system as having been fixed. The key question is whether the new prime minister regards the hospital system as having been fixed. AAP Image/David Crosling

Will the buck stop with Rudd on fixing the hospital system?

One of the key platforms of the first Rudd government was to reform the health and hospital system. The key message from then-prime minister Kevin Rudd was that the health, and particularly hospitals…
Passions run high when it comes to the NHS but despite some unprecedented challenges it will do what it always does - survive. Passions run high when it comes to the NHS but despite some unprecedented challenges it will do what it always does - survive. PA

Despite the difficulties, the NHS is not dead yet

The NHS in 2013 is facing a series of unprecedented challenges. A rapidly ageing population is just one of a number of factors fuelling a rise in demand for services and hospitals are struggling to cope…
One-third of rural patients wait 24 hours or longer for an urgent GP appointment. One-third of rural patients wait 24 hours or longer for an urgent GP appointment. Image from shutterstock.com

Country practice: recruiting doctors to work in the bush

If you live far from a city, you are likely to be in poorer health than your urban counterparts; you’re also less likely to use health-care services and if you do, you’ll have to wait longer for care…
Based on current evidence, expanding these services is the right thing to do. Based on current evidence, expanding these services is the right thing to do. Image from shutterstock.com

A rational expansion of breast cancer screening

In the ninth part of our series Health Rationing, Stephen Duckett examines the government’s decision to extend the breast cancer screening program. As one of many pre-budget teasers, Health Minister Plibersek…
Health rationing assessments compare different aspects of health such as pain, anxiety, mobility and social interactions – but what’s more important? Health rationing assessments compare different aspects of health such as pain, anxiety, mobility and social interactions – but what’s more important? Image from shutterstock.com

Comparing apples, pears and hips: health rationing at work

In the seventh part of our series Health Rationing, Richard Norman and Rosalie Viney explain the controversial system governments use to decide what will and won’t be covered under Australia’s universal…
The health budget isn’t limitless: decisions have to be made about to how to allocate funding between competing choices. The health budget isn’t limitless: decisions have to be made about to how to allocate funding between competing choices. AAP/Dave Hunt

Health funding under the microscope – but what should we pay for?

In the sixth part of our series Health Rationing, Mark Mackay examines the latest think tank blueprint to rein in Australia’s rising health costs. But he warns that before funding models are adjusted…
The current fee-for-service model makes it difficult to contain costs and boost the quality of care. The current fee-for-service model makes it difficult to contain costs and boost the quality of care. Image from shutterstock.com

Phase out GP consultation fees for a better Medicare

In the fourth part of our series Health Rationing, Peter Sivey explains why it might be time to abandon Medicare’s fee-for-service model. Teachers aren’t paid a fee for each lesson they teach, nor are…
We need a more rational debate about how and where we spend our finite health budget. We need a more rational debate about how and where we spend our finite health budget. Image from shutterstock.com

Explainer: what is health rationing?

HEALTH RATIONING – a series which examines Australia’s rising health costs and the tough decisions governments must make to rein them it. Any mention of the “R” word in health care immediately brings to…
The biggest and fastest-growing spending category in health is hospitals. The biggest and fastest-growing spending category in health is hospitals. Image from shutterstock.com

Tough choices: how to rein in Australia’s rising health bill

With health costs rising and costly medical innovations on the horizon, it’s crunch time for health funding. In the lead up to the May budget, The Conversation’s experts will explore the options for reining…
Research should be routinely performed as part of health-care delivery. Research should be routinely performed as part of health-care delivery. Image from shutterstock.com

Don’t bury the benefits of research to improve the health system

If you missed the release of the McKeon review on Friday you’re not alone. The Commonwealth government released the Strategic Review of Health and Medical Research just before the weekend – a time usually…
Medicare locals aim to reduce visits to emergency departments by coordinating after-hours care. Medicare locals aim to reduce visits to emergency departments by coordinating after-hours care. image from shutterstock.com

Give Medicare Locals a chance to improve health equity

While independent, government-funded Medicare Locals are still in their embryonic form, opposition health spokesperson Peter Dutton has hinted that, if elected, a Coalition government would scrap the bureaucracies…
Nurses are providing many primary care services traditionally performed by doctors. Nurses are providing many primary care services traditionally performed by doctors. Image from shutterstock.com

The nurse will see you now – sharing patient care in general practice

With Australia’s population growing, living longer, and experiencing more disease and disability, there’s no doubt demand for health services will increase. But how are we going to pay for it? With this…
The recent rise in the number of GPs could be welcomed as addressing the shortage. The recent rise in the number of GPs could be welcomed as addressing the shortage. Image from shutterstock.com

Is the national doctor shortage a myth?

Monash University demographer Bob Birrell is quoted in today’s Australian newspaper as saying the national doctor shortage is “a myth”. He points out a large recent increase in the number of GPs, a rise…
Anaesthetist James Latham Peters transmitted the virus to his patients after he injected himself with the drug fentanyl. Anaesthetist James Latham Peters transmitted the virus to his patients after he injected himself with the drug fentanyl. Image from shutterstock.com

How was a drug-addicted doctor with hep C able to infect his patients?

Fifty-five women contracted hepatitis C after having abortions in Melbourne between 2008 and 2009. James Latham Peters, an anaesthetist with a drug dependence, has been prosecuted in Victoria for infecting…
Health Minister Tanya Plibersek (centre) announced the Commonwealth would pay the $107 million directly to hospitals. Health Minister Tanya Plibersek (centre) announced the Commonwealth would pay the $107 million directly to hospitals. AAP/Julian Smith

Medi-muddle: hospital funding fight is resolved but the blame game goes on

After months of battle between the Commonwealth and Victorian governments on hospital funding, Federal Health Minister Tanya Plibersek dramatically intervened last Wednesday by announcing a A$107 million…
Even if the potential donor is registered with the Australian Organ Donor Register, the family may still veto donation. Even if the potential donor is registered with the Australian Organ Donor Register, the family may still veto donation. Flickr/cabbit

Organ donation boost requires action, not just talk

Yesterday marked the beginning of DonateLife Week, in which Australia’s Organ and Tissue Authority ramps up efforts to promote organ and tissue donation with a week-long media blitz and program of public…
We need to reduce waste and inefficiency in the health system. We need to reduce waste and inefficiency in the health system. Image from shutterstock.com

Forget the blame game, let’s focus on making health dollars go further

The latest round of the health blame game is in full swing, with service cuts to Victorian hospitals, and neither the state nor federal government taking responsibility. Commonwealth and Victorian health…
Key health policy issues that need to be addressed include co-payments, private health insurance and resource allocation. Key health policy issues that need to be addressed include co-payments, private health insurance and resource allocation. AAP/Alan Porritt

Clear thinking needed on election health priorities

There was a time when health policy involved intense ideological conflict along partisan lines. In the 1940s, the Chifley government fought all the way to a constitutional referendum to introduce subsidies…
The Commonwealth and Victorian governments blame each other for hospital budget cuts. The Commonwealth and Victorian governments blame each other for hospital budget cuts. Image from shutterstock.com

Blame game: cutting through the spin on Victoria’s hospital funding cuts

As Victorian hospitals have announced bed closures, job losses and elective surgery delays over the past six weeks, cuts to health service budgets look set to significantly affect patient care in the state…
Taxpayers should get something in return for their investment – good doctors, where they’re needed. Taxpayers should get something in return for their investment – good doctors, where they’re needed. UoNottingham

Medical intern crisis won’t be solved with just more hospital places

Almost two hundred medical students from diverse countries have just finished their medical education as full-fee-paying students. They’re now looking for the one year of employment (internship) they need…
Pathology service providers should be encouraged to adopt a code of conduct similar to that of Medicines Australia. Pathology service providers should be encouraged to adopt a code of conduct similar to that of Medicines Australia. Waiting room image from shutterstock.com

Small step for transparency in medicine but what about pathology?

You’ve probably given little thought to the slip of paper your GP hands you when she sends you off for a blood test. After all, you’re likely to have more important things to worry about. But the next…
It’s time to rethink Australia’s specialist-driven health workforce and rise to the challenge of chronic disease management. It’s time to rethink Australia’s specialist-driven health workforce and rise to the challenge of chronic disease management. Hands image from shutterstock.com

Hike in health costs should prompt workforce rethink

Data released recently by the Australian Institute of Health and Welfare shows the nation’s health care bill is rising rapidly, from $77.5 billion in 2000-2001 to $130 billion in 2010-11. The largest increases…
All available evidence tells us that more investment is needed in preventive health – not cuts. All available evidence tells us that more investment is needed in preventive health – not cuts. angelsk

Brace yourself for a fatter, unhealthier Queensland after health promotion cuts

Queensland appears intent on dismantling its public and preventive health services. Health Minister Lawrence Springborg last week outlined the rationale for getting rid of more than 150 jobs in nutrition…
Australia has almost no capacity to fill international medicine shortages. Australia has almost no capacity to fill international medicine shortages. artisrams

Cutting off Australia’s drug supply: why outsourcing isn’t the solution

The earthquake in the Northern Italian town of Medolla this May devastated the local community, killing 17 people and leaving 14,000 homeless. Because Medolla is the manufacturing epicentre of the Italian…
A new review of international studies shows up to 62% of lab tests and 36% of radiology tests aren’t reviewed by doctors. It is believed the rate may be similar in Australia. A new review of international studies shows up to 62% of lab tests and 36% of radiology tests aren’t reviewed by doctors. It is believed the rate may be similar in Australia. Waiting room image from shutterstock.com

Medical test results – why no news doesn’t mean good news

In health care, communication can be a matter of life or death. Take the case of an American woman diagnosed with a blood clot in her leg. She died suddenly of a pulmonary embolism the following day, while…
Political responses to obesity have been more about creating a spectacle of “doing something” than solving the problem. Political responses to obesity have been more about creating a spectacle of “doing something” than solving the problem. Bruce A Stockwell

Why we’re losing the battle of the bulge: the politics of obesity prevention

There’s no doubt that obesity has received considerable political attention over the past decade. But data recently released by the Australian Institute of Health and Welfare shows Australians are losing…
With limited support for public dental care, most Australians bear the open-ended costs of high-expense treatments. With limited support for public dental care, most Australians bear the open-ended costs of high-expense treatments. massdistraction

Moving beyond patchwork reform for dental health

The Commonwealth’s government’s $4bn Dental Reform package, announced last week, promises to address many current inequities in access to dental care. It has been praised for its potential to reduce dental…
Health-care budgets are far from infinite, so how do we decide what’s funded and what’s not? Health-care budgets are far from infinite, so how do we decide what’s funded and what’s not? stumayhew

Who deserves more health-care funding? Let’s hear from Australians themselves

Health-care reform in industrialised countries is usually motivated by ageing populations, shaky economic conditions and shifting demographics. Health budgets are finite, so decisions must be made about…
Relying on FIFO health-care workers is expensive and can end up disempowering local providers. Relying on FIFO health-care workers is expensive and can end up disempowering local providers. AIA web team

Fly-in, fly-out heath care fails remote Aboriginal communities

This is a story about two small Aboriginal communities in the Gulf region of North Queensland: Mornington Island and Doomadgee. They share two key characteristics with many other remote communities: very…
The poor suffer the greatest burden of disease but are less able to deal with the costs. The poor suffer the greatest burden of disease but are less able to deal with the costs. Brooks Elliott

Next steps in health care reform

Australia is facing an epidemic of chronic lifestyle-related diseases, including type 2 diabetes, heart disease, stroke and chronic lung disease. We have many treatments for these that aren’t necessarily…
New Zealand wants to largely be tobacco free by 2025; Finland has set 2040 as its target date. New Zealand wants to largely be tobacco free by 2025; Finland has set 2040 as its target date. Iago A R

Should we set a date for a tobacco-free Australia?

It’s been 100 years since the first medical textbook identified a link between smoking tobacco and lung cancer. So how strange is it that in 2012 we can walk into Coles and Woolworths and buy cigarettes…
There are a number of design flaws in the new hospital funding system. There are a number of design flaws in the new hospital funding system. xparxy

Why the new way of funding public hospitals won’t work

The first of July saw the introduction of one of the most important health care reforms for Australia’s public hospitals: national activity-based funding (ABF). Hospitals will now be paid a fixed price…
Overseas-trained doctors deserve better treatment in Australia but they’re not the solution to rural workforce shortages. Overseas-trained doctors deserve better treatment in Australia but they’re not the solution to rural workforce shortages. syauqee

Overseas-trained doctors can’t fill rural workforce shortages forever

The recently released report from the House of Representatives' inquiry into the registration processes and support for overseas-trained doctors highlights some major shortfalls in how Australia’s health…
We need to rethink our aged care workforce and funding for dementia patients. We need to rethink our aged care workforce and funding for dementia patients. Alex E Proimos

Improving care for dementia patients in our ailing aged care system

Last week, Alzheimer’s Australia released a report that was highly critical of the way Australia’s aged care sector responds to the needs of dementia suffers and their families. It’s an issue that demands…
Current strategies to increase the number of Australian trained medical graduates entering rural practice are not working. Current strategies to increase the number of Australian trained medical graduates entering rural practice are not working. Paul Hocksenar

We need new ways to get more doctors into country practice

The Australian Medical Association (AMA) is urging the government to consider the establishment of new medical schools in rural and regional areas to boost the number of doctors in the countryside. The…
Health performance targets can come with unintended consequences. Health performance targets can come with unintended consequences. AloneAlbatross

Health targets, indicators and incentives: handle with care

The Gillard Government’s health reform legislation passed through parliament without too much fanfare last year, marking the end to the political debates around health reform. Importantly, the legislation…
A strong health system can balance public and private care – just look at Australia. A strong health system can balance public and private care – just look at Australia. AAP

Private sector reforms don’t spell the end of the NHS

After a long, painful political and legislative process, the United Kingdom’s Conservative/Liberal Democrat Coalition government has finally been given the green light to proceed with its National Health…
Almost 90% of the world now has access to drinking water, but there is still a long way to go. Almost 90% of the world now has access to drinking water, but there is still a long way to go. barefoot photographers of tilonia/flickr

Is this progress? Watering down the Millennium Development Goals

Did you hear about the latest success for the Millennium Development Goals (MDGs)? Don’t be ashamed to say no – most of the world missed it with you. So what happened? You’ll remember that the MDGs are…
After the election, healthcare reform needs to be a priority for the Queensland government. After the election, healthcare reform needs to be a priority for the Queensland government. AAP Image/Dan Peled

Queensland’s top five health priorities this election

No matter who wins the Queensland election this Saturday, the next premier of Queensland will have to face up to some serious challenges within the state’s health system. There were improvements made under…
Better diets and more exercise could prevent 43,000 cancer diagnoses a year. Better diets and more exercise could prevent 43,000 cancer diagnoses a year. joshbousel

One in four cancers preventable – but first we need the willpower

Cancer is one of the most common public health threats facing Australians and accounts for nearly one-fifth of the disease burden in this country. The direct cost to the Australian community is approaching…
Predictions that people will leave private health insurance are unlikely to come true. Predictions that people will leave private health insurance are unlikely to come true. AAP

Private health insurance means test passes – what now?

The government finally got its bill on means-testing private health insurance rebates for high-income households through the House of Representatives this morning. Fortunately, the dire predictions about…
A private health insurance means test is unlikely to affect insurance uptake. A private health insurance means test is unlikely to affect insurance uptake. Flickr/mahr

Private health rebates should be means tested – and here’s why

The government’s bill to means test private health insurance rebates for high-income earners is scheduled for debate on Thursday in the House of Representatives. The package would deliver around $2.4bn…
Good dental health is important for overall health - so when will Australia see a national dental scheme? Good dental health is important for overall health - so when will Australia see a national dental scheme? AAP

Healthcare reform in 2012: whose health system is it anyway?

As many of us recover from the festive binge of overeating, drinking too much and not exercising enough, spare a thought for the new health minister as she plans for 2012. An exciting agenda looms – will…
Plain packaging is one of many health reforms to enter or pass through parliament last week. Plain packaging is one of many health reforms to enter or pass through parliament last week. AAP

Plain packaging wraps up a big year for health legislation in 2011

The final sitting of federal parliament last week lacked no drama, ending with the sudden induction of Peter Slipper as speaker. It was also a mammoth week for health legislation, with the passing of the…
Day 15 of OccupyMN protest that has occupied Minneapolis. Meanwhile corporate greed continues unabated. Day 15 of OccupyMN protest that has occupied Minneapolis. Meanwhile corporate greed continues unabated. Fibonacci Blue

Health savings accounts: just another greedy corporate scam

At a time when the “Occupy Wall Street” protests against corporate greed are proliferating in the United States and around the world, it’s ironic to read the floating of yet another corporate “get-even-more…
A 40% public hospital budget cut has restricted access to care. A 40% public hospital budget cut has restricted access to care. AAP

Greece’s financial crisis takes toll on the nation’s health

Another round of violent protests erupted in Greece last week, following the latest austerity cuts to public service jobs and pay. Meanwhile, the creeping consequences of austerity measures are beginning…
Current fee-for-service payments for doctors don’t reward quality care. Current fee-for-service payments for doctors don’t reward quality care. Flickr/larique

Should doctors be paid to keep patients healthy?

Going to the doctor is, in many ways, like visiting a car sales yard. The customer has a limited knowledge of the product and the supplier may have a financial incentive to over-service or overcharge…
Older people are finally being consulted about the type of care they need. Older people are finally being consulted about the type of care they need. EPA/Diego Azubel

Ask the elderly what they need, not the care industry

Australia’s population is ageing, presenting an economic challenge to look after the most vulnerable members of our society. The Productivity Commission released a report last month recommending a complete…
Bringing research, education and health care delivery together will improve patient care. Bringing research, education and health care delivery together will improve patient care.

Explainer: why Australia needs Advanced Health Research Centres

In an attempt to bring Australia’s medical research, education and healthcare sectors into line with world leaders, the National Health and Medical Research Council (NHMRC) is planning to develop a new…
If the government wants to support private health, it should fund the system directly. If the government wants to support private health, it should fund the system directly. Robin Thom

Means testing is a start but private health rebates should be scrapped

The government’s plan to means test the 30% private health insurance rebate faces an uncertain future after yesterday’s scheduled parliamentary debate was delayed. Under the scheme, singles with health…
Four year-old Ayen Chol died after being attacked by a neighbour’s pit bull cross (AFP PHOTO/William WEST) Four year-old Ayen Chol died after being attacked by a neighbour’s pit bull cross (AFP PHOTO/William WEST)

Breed blame-game: banning Pit Bulls won’t work

The recent death of four year-old, Ayen Chol from a pit bull attack has again prompted calls to ban the breed. But instead of focusing on a particular breed, or responding to single events as they occur…
If health and water reform are anything to go by, COAG is in for a challenge. If health and water reform are anything to go by, COAG is in for a challenge.

The rocky road to a national disability insurance scheme

The stakes are high for today’s Council of Australian Government (COAG) meeting in Canberra, as it decides how to respond to the Productivity Commission’s report into disability care and support in Australia…
A test case is slated to challenge Myriad’s claim for breast cancer genetic mutations next February. A test case is slated to challenge Myriad’s claim for breast cancer genetic mutations next February. TheAlieness GiselaGiardino²³/Flickr

Patent controversy: don’t let breast cancer gene genie out of the bottle

The US Court of Appeals for the Federal Circuit has found Myriad Genetics is entitled to patents on two sets human genetic mutations used to predict if women have an increased risk of breast and ovarian…
Federal governments should fund pharmaceutical research and development. Federal governments should fund pharmaceutical research and development. AAP

Patent controversy: it’s time Big Pharma took its medicine

Over the last couple of decades, the pharmaceutical industry has come under attack for its perceived shortcomings amid claims that it’s greedy, profiteering nature has caused significant harm. However…
Preventive health is the the biggest loser in the health deal. Preventive health is the the biggest loser in the health deal. AAP

Can we now close the book on health reform? Not quite

The deal’s been done and health reform is in the bag. It may not be quite as bold as originally planned by then prime minister Rudd – there’s even been a fair amount of watering down on Julia Gillard’s…
The deal has a narrower focus than the original but still delivers $20 billion of extra funds. The deal has a narrower focus than the original but still delivers $20 billion of extra funds.

Health agreement diagnosis: ‘watered down but not a total cave in’

Health professionals and patients alike breathed a sigh of relief yesterday when Prime Minister Julia Gillard announced she had struck a final deal with the states to reform the nation’s hospital system…
Home help is much more effective than written instructions from a doctor. Home help is much more effective than written instructions from a doctor.

Why home help is the best bang for our health buck

The new Victorian Health Plan 2012-22 offers a bleak prognosis: forever rising medical costs, doctors in the wrong places, hospitals overwhelmed. To make matters worse, it claims that patients can’t be…
The government has made a mistake by not listing pain drug Targin on the PBS. The government has made a mistake by not listing pain drug Targin on the PBS. J Hawk

Scrimping on pain drugs is bad medicine and worse economics

In an attempt to contain growing health costs, the Australian Government has resisted recommendations to subsidise the pain medication Targin on the Pharmaceutical Benefits Schedule. Not only is this a…
It is far from clear whether Philip Morris' tactic against plain packaging will succeed. It is far from clear whether Philip Morris' tactic against plain packaging will succeed. AAP

Big Tobacco v Australia: Philip Morris jumps the gun on legal challenge

In the latest salvo in the fight over plain packaging for tobacco products, Philip Morris is launching legal action under Australia’s bilateral investment treaty with Hong Kong. The key aspect of Philip…
Achieving equity is less about grand gestures than meeting the actual needs of Indigenous Australians. Achieving equity is less about grand gestures than meeting the actual needs of Indigenous Australians. Sorry by butupa/Flickr

Playing number games with Indigenous Australians' health

The Australian Institute for Health and Welfare (AIHW) has released its latest report on how much money the Commonwealth and State governments spend on the health of Indigenous Australians. Despite being…
More data on the effects of alcohol and energy drinks is needed to inform policy. More data on the effects of alcohol and energy drinks is needed to inform policy. loop oh/Flickr

Alcohol and energy drinks: too early to make bleary-eyed policy calls

The Australian Medical Association (AMA) has called for a ban on the sale of pre-packaged alcoholic energy drinks based on recent research, echoing a similar call for bottle shops to stop selling pre-packaged…
Means testing will not necessarily increase pressure on the public health system. Means testing will not necessarily increase pressure on the public health system. AAP

Hard habit to break: means testing isn’t a deal breaker for private health

Could it be a case of third time lucky for the Gillard Government’s plan for means testing of private health insurance? Any legislation will require the support of four of the six cross-benchers. The Government…

Research and News (5)

Boys to receive Gardasil HPV vaccine

Boys are likely be offered subsidised vaccinations against the sexually transmitted, wart and cancer-causing human papillomavirus…

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