Individual Policy Assignment
Executive Summary.3
Introduction .4
Overview of the Issues 4
1 Economic..5
2 Political 5
3 Epidemiologic ..6
4 Sociological...6
Conclusion ..7
References 11
Executive Summary
This report describes an economic, political, epidemiological and sociological analysis of issues brought up by Minister of Health and Minister of Sport Peter Dutton during a speech to the Australian Healthcare and Hospital Association on the government’s putative policy to reform the Australian healthcare system, namely changes to how the system should be financed, administered and improved. After a survey of the Australian healthcare system and a summary of Minister Dutton’s speech, this report establishes a framework for analyzing healthcare reform generally and the particular areas mentioned by Minister Dutton specifically. Finally the report will discuss it analysis as well as set out a number of recommendation to effectively design and implement a policy of reform.
1. Introduction
In his keynote speech at the annual Australian Healthcare and Hospital Association (AHHA) conference, Minister for Health and Minister for Sport Peter Dutton presented his views on what he sees as the challenges facing the Australian healthcare system as it strives to balance increased demand for medical services and increased expenditures for performance with decreased budgets. According to Minister Dutton, the healthcare system as it is current administered is financial unsustainable and a national debate needed to be started on how best to supply services without bankrupting the nation. Indeed, Minister Dutton suggested that without a change in policy, the Australian healthcare system was bound to breakdown. In his view, everyone should pay a co-contribution people for their healthcare and people who could afford to pay more should be allowed to if they so choose through the private sector and private insurers. Minister Dutton went on to explain that positive changes to the healthcare system can be accomplished with new ways to finance and sustain services which focus on innovation, value for money, the elimination of waste, duplication, unnecessary bureaucracy and ineffective programs. Minister Dutton also highlighted a number of ways how innovative thinking could make quality count. In short, Minister Dutton’s speech laid out the groundwork for the government’s policy initiative for the reform and modernization of the Australian healthcare system.
2. Overview of the Issues
2.1 Economic
In his speech, Minister Dutton called into question the sustainability of the healthcare system. .” According to the Australian Institute of Health and Welfare (AIHW 2014), healthcare system was designed to deliver quality services to all people in the promotion, restoration and maintenance of health (WHO 2013b). The healthcare system is open to all citizens from the day they are born to their very last day and covers all aspects of care including primary, secondary and emergency care as well as newer areas such as personally controlled electronic health records (PCEHR).The Australian healthcare system is funded mainly by federal, state and territory governments with the remainder of costs covered by the patients themselves or through private health insurance providers (AIHW 2014). The government’s contribution to healthcare is made through Medicare, the nation’s universal public health plan. A person can elect to either have full Medicare coverage or a combination of Medicare coverage with supplemental coverage through a private insurance provider (PHIO 2013). According to Minster Dutton current spending is in the system is expected to double within the next couple of years. The economic impact of healthcare programs can be considered in two ways: do they improve the health of the patient and can they be administered in a financially sustainable manner. Any reform policy would need to effectively address these aspects. A healthcare system that first and foremost improves the health of the population would necessarily spend less in treating illness
2.2 Political
Healthcare reform has broad support from the majority of politicians. Over the last several years, however, action on reform has increasingly become a contentious argument over the how best to achieve low-cost, high-quality services healthcare system. To be sure, there is no lack of studies, research and policy recommendations for healthcare reform. In his speech, Minister Dutton added to pile with a few ideas of his own such as using evidence based research to inform medical decision-making; focusing on advanced care planning and “end of life care.” The issue is that difference policy goals are attached to different political persuasions. Accordingly, there is a lock of consensus on the value or effectiveness of any one policy. Indeed, while one policy might produce an effective result, it will nevertheless be deemed at ineffective from a politician from an opposing party. Presently, the party in power commands the ability to reform the system as they see fit although there is always the possibility that a compromise can be agreed upon.
2.3 Epidemiological
Healthcare reform needs to ensure that the treatment of illness as well as the promotion of health occurs with as little different as possible between the different populations in the nation. Accordingly, it must include coverage for illnesses that may be a higher risk for one population as well as illnesses that are an equal risk to all populations. This also includes an analysis how and where different groups live and ways that can decrease the outbreak of illness within each defined group. The most effective way to guarantee that any healthcare reform proposal is fully aware the “state of the nation’s health” is through the use of well-funded, comprehensive epidemiological research. Certainly, before any reform is implemented, policy-makers should endeavor to learn as much as the can about the health, nutrition, common disabilities and morbidity of all Australians as well as any links that may exist between well-being and, poverty, overcrowding and housing. This information will provide a clearer picture of Australian health in general including which group has the greatest need for healthcare; and which group has the least access to healthcare. Only after gathering and analyzing this information can effective reform be accomplished.
2.4 Sociological
One of the major issues in healthcare reform is the lack of understanding about the healthcare system itself. This is true of policy-makers, medical professionals and patients themselves. Although the Australian system is considered fairly centralized, there are a so many gaps between the layers of coverage that that it is difficult to determine the best place to start the process of reform. What is certain is Australians are a sociologically diverse both in the viewpoints towards what is best for the healthcare system and their individual health concerns. While universal healthcare requires an equality of minimum coverage for all people, a determination of proper coverage will difficult. Certainly, healthcare reform will need to be analyzed through the different viewpoints of all affected stakeholders regardless of social or cultural class. Any reform, however, must limit the simple use of income, gender or ethnicity of a person is the sole determinant of what healthcare coverage is granted. Budget constraints on the improvement and expansion of healthcare services must be spread evenly among the population. One group such as those with a higher income should not be allowed to take advantage of the system to the detriment of the indigent. Success will only be attainable with broad consensus and trust.
3. Conclusions
The foremost goal of any policy to reform the healthcare system should be to improve the quality of care and reduce medical errors or inefficiencies. Consequently, a policy to reform should attempt to retain what works in the existing system while focusing on the areas that need improvement and eliminating the areas that fail. The Australian healthcare system, however, is a large and extraordinarily complex system and measuring the quality of service might be difficult. Accordingly, the first step of any reform policy should be to develop a means to test measure of quality in the system. More specifically, efforts must be undertaken to identify the most effective ways to collect, analyze and disseminate information about the best tactics to improve the quality of care. As Minister Dutton mentioned in his speech, there is clear evidence of problems of quality in the healthcare system. To be sure, quality problems in healthcare services are found everywhere in the current system including in the underuse of some services, the overuse of others and misuse of some services.
Every year, thousands of people fail to receive the necessary care they need. This not only causes suffering to the patient individually but at the same time adds to costs and reduced productivity of the healthcare system as a whole. For example, as the population ages, failure to emphasize advanced care planning can cause a number of individual and systemic problems. One of the key priorities of advanced care planning is considering which treatments a patient may want in case of a medical emergency such as a “do not resuscitate” order for an elderly patient. Failure to draft such an order can lead to prolonging the life a person that does not wish to continue living; thereby causing them mental anguish while forcing the hospital to continue outlaying costs that could be better used elsewhere.
While problems in quality affect all people, there are some populations such as ethnic and racial populations or the indigent who are adversely affected to a greater extent. To be sure, equality of access does not guarantee equality in health and this is especially meaningful because the Australian healthcare system is basically focused on fight illness rather than promoting good health and wellness. Accordingly there are disparities the quality of care that needs to be addressed. Moreover, misuse of services is a well-known issue in quality analysis. Each year a number of patients are injured during the course of their treatments or hospital stays do to the misuse of services or negligence. Any policy that allows this to continue is wasteful, redundant and ineffective.
In addition to measuring and understanding where quality exists or does not exist in the system, a policy of reform should also push for a program of continuous research and development in ways to improve the system. This includes researching more effective treatments but also more looking into more effective way to administer hospitals, train medical personnel and better integration all healthcare stakeholders from patients to general practitioners to government health departments. As Minister Dutton suggested, one of the best ways to accomplish this is bringing evidence based medicine into the operating room.
The secondary goal of a policy for reform should be to accomplish the improvements in quality stated above while also reducing or maintaining current costs. One of the ways this has been accomplished in other industries such as the financial sector is through the use of information technology. Information technology not only provides tremendous cost savings but also large increases in efficiency, speed and accuracy.
4. Recommendations
Recommendation 1: Determine which services are being underused and implement a plan to increase their integration into the over system of services.
Recommendation 2: Strengthen or expand programs that promote good health especially for populations with well-defined or traditional ailments that can be reduced through proactive rather than reactive healthcare measures. Eliminate misuse or negligent use of services.
Recommendation 3: Increase budgets for research into all aspects of healthcare administration from direct services to patients to back office principles and infrastructure.
Recommendation 4: Facilitate the continuing adoption and integration of information technology such as PCEHR into all aspects of healthcare administration.
Recommendation 5: Develop a plan to achieve an sustainable level of medical coverage in the medium and long term.
References
Australian Bureau of Statistics –ABS. (2013). Year Book Australia, 2014. Retrieved on October 12, 2014, from Year Book Australia, 2012.
Australian Health Ministers' Advisory Council – AHMAC. (2013). Retrieved on October 12, 2014, from Australian Health Ministers' Advisory Council.
Australian Institute of Health and Welfare – AIHW. (2008). Retrieved on October 12, 2014, from Review and evaluation of Australian information about primary health care: a focus on general practice.
AIHW. (2010). Australia’s Health 2010. Retrieved on October 12, 2014, from Australia's health 2010.
AIHW. (2012). Australia's Health 2012. Retrieved on October 12, 2014, from Australia's health 2012.
AIHW. (2013a). Australia's Hospitals 2011-12: At a Glance. Retrieved on October 12, 2014, from Australia's hospitals 2011-12: at a glance
AIHW. (2013b). Health Expenditure Australia 2011-12. Retrieved on October 12, 2014, from Health expenditure Australia 2011-12.
Fox, S., & Duggan, M. (2013). Tracking for Health. Retrieved on October 12, 2014, from Tracking for health.
Government of Western Australia Department of Health. (2013). What is Primary Care. Retrieved on October 12, 2014, from What is primary health care?
Private Health Insurance Ombudsman – PHIO (2013). What is Covered? Retrieved on October 12, 2014, from What is covered
World Health Organization – WHO. (2013a). Health Systems. Retrieved on October 12, 2014, from Health systems
WHO. (2013b). Health Systems Strengthening Glossary. Retrieved on October 12, 2014, from Health systems strengthening glossary
