In 2005 when Health Minister Tony Abbott addressed the Centre for Independent Studies on the topic ‘What if we could start again?’ he said, ‘In health the challenge is not so much to dream big dreams and think radical thoughts. The challenge is to solve practical problems.’
But the subsidisation of private health insurance has already put us on the path of radical change — a path that leads to a two-tier system, with costly private services for the privately insured and under-funded public services to mop up the leftovers. It leads us, in short, to an American-style system — at a time when US spending on health is almost double our own, yet US health indicators are only on a par with those of the poorer OECD countries.
Echoing the values and principles outlined in Our Common Wealth, A Health Policy for Australia: reclaiming universal care argues that we can restore universalism and increase both equity and efficiency in health care – at no additional cost to the taxpayer.
Private insurance is weakening the government’s ability to use its bargaining power to control costs. We need to restore and embed universalism before it becomes too late to avoid an expensive American-style two-tier system. A universal system not only promotes social cohesion; it is also the fairest and most cost-effective option available.
A Health Policy for Australia calls on federal and state ministers and their departments to:
- shift to a single, universal insurer (but not necessarily to provide universal ‘free’ services);
- focus program delivery in primary care health centres, providing an integrated range of services;
- involve citizens in health care to counter the strong lobbies of service providers;
- organise health care programs around the needs of users – fundamentally re-shaping programs and budgetary allocations;
- rationalise user payments, to achieve equity and efficiency in resource allocation;
- provide and fund services on the basis of therapeutic need;
- retain Commonwealth responsibility for funding and standard setting, and deliver programs through joint Commonwealth/state administrations;
- focus ministerial concern more on health than on health care.
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This document is intended to provide a starting point for the development of more detailed proposals and program designs. We invite stakeholders, CPD readers and contributors and others to give us their own ideas, either through comments, or by contributing an article for publication in InSight.
Latest news on ‘A Health Policy for Australia’
The launch of this paper was covered by The Australian (Call for a single health care insurer) and the then Shadow Health Minister Julia Gillard commended our contribution to the debate in a statement on the day. This was followed by discussion in parliament by Julia Gillard and Tony Abbott of our criticism of the private health insurance rebate.
The launch was also covered by The Age, the West Australian, SBS Radio and the NSW Nurses Association Journal. An article by Nick Coatsworth in Policy, the magazine of the Centre for Independent Studies, discusses our proposal for a shift to a single, universal insurer. (‘Australia’s State of Health’, Policy, CIS, Vol. 22 No. 4, Summer 2006-07)