Australia has a good health care system when compared to most of the world. It provides access to primary heath services, hospitals and medication for the vast majority of its citizens at no or low cost. This is achieved through Medicare, the PBS and the public hospital system. It is far better than the American situation where health care is almost fully profit-driven, wildly expensive and completely out of reach of the poor and uninsured. However Australia’s claim to have a universal heath care system is not true, when many vital services are only available privately – dental care and mental health care being two of the most obvious examples.
The system is also marred by lack of funding, an over-complicated organisational structure, a profit driven private sector as well as a parasitic health insurance industry. Together this has created a situation where Australia’s health system is underfunded, overstretched and so fragile that it is always on the verge of collapse. And during the 6 months of the pandemic, nothing has been done to strengthen it.
There is no doubt that public hospitals would have failed to meet the demand placed upon them by the coronavirus pandemic if it had affected Australia to anything like the extent that it has affected most of the rest of the world. What can be done to address these problems before the next health crisis hits?
“Australia’s health system is underfunded, overstretched and so fragile that it is always on the verge of collapse. And during the 6 months of the pandemic, nothing has been done to strengthen it.
Money in Healthcare
Funding in healthcare is never enough, because the ideologies of “user-pays” and privatisation are so dominant. For many years hospitals have been struggling to keep up with demand – waiting lists for non-critical surgery (elective surgery) have been an election issue over and over again. New treatments and newly developed medical machines and equipment are expensive. People who work in hospitals need to be paid decent wages. In a medical setting, buildings and infrastructure must be maintained at a high standard if they are to fulfil their function.
The Australian health system divided not only horizontally by the involvement of different levels of government, it is also split vertically into private and public sectors. There are private service providers in all sectors, and then there is primary health care: most GPs are self-employed, pharmacies, which include small businesses to national chain stores, private hospitals and allied health professionals; health professionals that are not part of the medical, dental or nursing professions.
The health system of Australia can never be completely uncoupled from Australian capitalism or world capitalism. We are not in a position to research, develop and produce our own medications and modern medical equipment.
However it is possible to reduce the amount of money taken out of the system as profit. A much greater provision of free services and the abolition of private hospitals would reduce the opportunities for profit-making as well as greatly shrinking the role of private health insurance. We need healthcare for people not profit.
Administration
On one of their web pages the Department of Health writes that “The Australian, state and territory, and local governments share responsibility for running our health system.” This statement is followed by more than thirty bullet points that detail which level of government is responsible for what and which are shared responsibilities between multiple levels of government.
The fact that the health system is administered and funded by multiple layers of government leads to excessive bureaucracy and inefficiencies. The shared areas of responsibility, particularly the joint funding of public hospital services, leads to time wasting arguments between the different states and territories and the federal government. A single centralised department that covers the funding and administration of all areas of the Australian health system would be more effective and responsive to the changing health care needs of Australia’s population.
None of this has been fixed in the 6-months of lockdown to manage COVID
Although politicians argued that the reason the lockdown measures were necessary was because an influx of sick people with COVID would over-burden the healthcare system, nothing has been done to resolve the bureaucratic quagmire that runs the system, or the lack of funds invested in the system, or the billions of dollars removed from the system in the form of profits. The lockdown has stopped the spread of COVID, but we can’t be locked down forever. There is no plan for a third or fourth wave, if they come. There is no plan for another, different pandemic, if one comes.
Many of these shortcomings could easily be remedied by greatly increased funding to existing services, particularly hospitals and mental health services, and by extending the range of free services with dental health as a priority. This would enable the health system to prioritise the provision of health care according to patients’ needs rather than their ability to pay and would greatly reduce the influence of the health insurance industry.
Defend and Extend Medicare Now!
Free Healthcare for All!
Free Dental and Mental Healthcare for All!