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Australians give an upbeat diagnosis of health system

Community attitudes towards the health system have improved significantly over the last four years. Sarah Reid

More than half of the Australian population believe they’re in very good to excellent health, have a high level of confidence in the health system and support the policy direction that the federal government’s aged care reforms are based on.

The 2012 Menzies-Nous Australian Health Survey provides a wide-ranging snapshot of the perceptions and attitudes of Australians toward their health and the health and aged care systems. First conducted in 2008, the biennial survey focuses on the accessibility, affordability and confidence in health-care services and how these views have changed over the past four years. It’s based on a representative national sample of 1,200 people, surveyed by telephone in July 2012.

The survey showed that support for “fundamental” reform of the health system remains strong – at over 60%. But community attitudes towards the health system have improved significantly over the last four years, with the proportion of people indicating “the system needs to be rebuilt” at just over half the level of those who thought so in 2008.

These views varied according to where people lived. Those in metropolitan areas had a more positive view of the health system in terms of affordability, access to doctors and their confidence of receiving quality care if they needed it. Australians outside the big cities and those with high levels of financial stress were much less confident.

The report shows only 37% of Australians under high financial stress are confident they can afford the care they need. This has been a consistent finding over the past four years. This group is also half as likely to use dental and private hospitals as those reporting low financial stress – despite self-reporting poor health status.

It’s a matter of concern that this hasn’t improved, despite reforms aimed at improving access to basic health care, especially GP and other primary care services. It underlines findings by other researchers that out-of-pocket payments remain a major problem for those facing economic hardship.

The picture was brighter for older Australians. People aged 65 years and over generally reported greater confidence in the health system if they fell seriously ill compared to other age groups.

But Australia’s aged care system will need to shape up if it is to meet the expectations of Australians who responded to the survey.

The baby boomer generation is now making important decisions about aged care for their family and loved ones and their views about what it takes to provide excellent aged care will ramp up over the next 20 years as they get closer to having to use it themselves.

The aged care questions in the survey shed some light on what Australians think is important to make aged care services better.

For those who knew someone using residential aged care recently, it may come as no surprise that satisfaction rates sit at 54%, the second lowest for all health services rated in the survey. This compares badly to community care where the satisfaction rates were higher at 72%; GPs at 78% and; pharmacists at 89%.

Putting more resources into a new National Home Support program is an important part of the government’s aged care reforms. In a big tick for the plans to shift the focus of aged care away from nursing homes and into home care, the survey showed resounding support for more care services in people’s homes. Half those surveyed saw the most important improvements needed in aged care as more home support, followed by better pay and conditions for aged care workers.

There were mixed sentiments about consumer-directed care, increasing the say of consumers and their carers on who delivers care. There was strong support (95%) for the proposal that consumers should decide what care they receive. But when posed in a slightly different way (to avoid bias), more than two thirds (69%) agreed aged care professionals should decide.

The message on the location of care remained strong. Only 53% thought aged care professionals should decide where people receiving aged care should live, reinforcing the general view that people should have the final say in their location of care.

One of the survey’s most compelling findings was on the funding of reforms. Almost two-thirds agreed they would pay more taxes if it meant older people could stay at home and receive the required levels of care.

Overall, Australians overwhelmingly agree that the community should contribute towards paying for aged care, with 92% indicating the public should pay some of the costs towards aged care based on financial means (but not at the expense of selling their house) and the government should pay the rest.

Health reform is about transforming the way we organise health services to meet the growing burden of chronic illness. In contrast, public opinion as measured by this survey, is content with the existing system. But the findings on aged care funding suggest that public opinion, given an open enough policy debate, can make the politicians look timorous.

Gillian McFee from the Nous Group helped write this article.

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