At present the fee-for-service system suits the majority of health care providers and the majority of patients who do not need continuing care and wish to be able to purchase access to a primary care provider without let or hindrance.
Problems with this system emerge only when one is concerned about questions of equity of access and efficiency of care (the example of refugees at Coffs Harbour, Indigenous health, rural and remote health care), or when the needs of people with chronic illness surface, as they are doing with increasing frequency.
The first force that will drive change is a demographic shift that will alter the politics of health care. By 2038 the number of people aged 51+ will exceed the number aged 50 or less, and the political dynamic of this will be strong. It is probably then that the political pressure to change the form of our health system will peak.
The second force for change is the realisation that we are wasting resources at present and that this is costing patients length and quality of life. The Commonwealth and states are in serious debate about the way that publicly funded health services are managed between them in the quest for greater efficiency.
What changes would you like to see in the health system?
What might help drive these changes?