Yet another health policy has hit the e-waves this week — this one is from the Australian Medical Association (AMA).
The AMA’s policy hits all the politically-correct buttons — indigenous health, hospital care, rural health and tackling obesity and chronic disease. Not surprisingly it proposes a lot of additional health spending, much of which would be to purchase additional services from doctors — of whom, by the way, there is a critical undersupply.
A quick calculation suggests that if all the AMA measures were adopted, Commonwealth health outlays would grow by around a billion dollars a year.
Most of the proposed measures make a lot of sense, especially the significant investment in prevention and primary care. Others are more “knee-jerk”, such as automatic increases in spending on hospitals.
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The disappointment is that there is no attempt in the policy document to look at better ways of running the health system or of measuring its performance. The AMA does not ask the question: “are we getting the best value for our health spending?”
The AMA has simply said: “here are the priority areas; spend more money on these”.
The AMA is simply following the trend in health policy. Other health policies appearing in this pre-election period adopt the same approach.
A couple of months ago, the State governments collectively issued a report on the state of the Australia’s health system. That was effectively a critique of the Commonwealth’s performance in health policy and an election bid for the Commonwealth to spend an additional billion or so dollars a year on public hospitals.
The ALP health policy released a couple of weeks ago promises several additional billions of dollars in health spending (although in fairness to them, some of that is smoke and mirrors and there is a passing reference to harvesting efficiencies).
The Government has adopted a rolling approach to health policy. Presumably having fixed the “big picture” of health, it sees the task as putting out the “spot fires”, e.g. buying a hospital here or there.
Health spending in Australia now accounts for ten per cent of our GDP. This put us in the high spenders club internationally. A decade ago we spent around nine per cent of GDP and were in the moderate spenders group.
Is Australia any better off as a result?
Undoubtedly many of us are much better off. Those who can afford private health insurance (around 45 per cent of us) can now receive top class care with hardly any delay. The private insurers and providers have never had it so good.
But there are others who are definitely not better off. Indigenous Australians are still much sicker and die younger than other Australians and than indigenous people in New Zealand, the US and Canada. Those who cannot afford private health insurance still face lengthy and unpredictable delays for the care they need. The two million Australians living away from the major cities continue to have problems accessing even basic health services. We seem no better at managing the growing burden of chronic disease than we were a decade ago, even though there has been plenty of time to prepare.
A sound health policy will not just spend money, it will spend it wisely. It seems we might well be disappointed this time around.