Health & Wellbeing

| May 31, 2007

Australians are now living longer than at any other stage in history. At the same time, our society has been burdened by a dramatic increase in chronic disease. In 2005, it was estimated that 77% of Australians are living with a long-term chronic condition.

Australians are now living longer than at any other stage in history. At the same time, our society has been burdened by a dramatic increase in chronic disease. In 2005, it was estimated that 77% of Australians are living with a long-term chronic condition.

Associated with this increase is a change in our understanding of the determinants of health. Public health has moved past viewing disease only within the confines of the germ theory and the age of antibiotics. Modern discussions are now dominated by the understanding of the impact of lifestyle behaviours as a major determinant of individual health and wellbeing.

Studies now show that the top 10 individual risk/lifestyle behaviours contribute to 40.7% of Australia’s chronic disease burden. Not only does chronic disease significantly impact an individual’s quality and length of life, it also: – results in significant cost to business and industry due to decreased productivity through absenteeism, presenteeism, shortened working life and early retirement; and – has lead to increases in total healthcare expenditure. If current levels of health care expenditure were to continue increasing at a constant rate into the future, this expenditure could not be met from the current funding sources (public and private) alone and a funding ‘gap’ would be the result.

It is through adoption of individual positive lifestyle behaviours that Australia can reduce its chronic disease burden. Ultimately, we all have a collective interest in a healthier, more productive society; and change at both the individual and systemic level is necessary to facilitate this.

What role should the individual, business, the health industry and Government play in getting individual buy-in to a collective positive ‘wellness’ approach to health?

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4 Comments

  1. olgabodrova

    October 15, 2007 at 3:28 am

    Australian Health Reform

    A discussion paper "Revitalising Health Reform: Time to Act", recently released by the Australian Institute of Health Policy Studies, argues that current health reforms are ineffective and that “unfinished business” remains from 2000. An improved health system could deliver $3 billion in productivity savings and lead to big improvements in health outcomes for all Australians. The paper advocates broader community participation in the development of health reform options through a national consultation dialogue on what Australians want from their health system.

    What benchmarks for success need to be set and how can the Government be held accountable for its performance? Why is it proving so difficult to translate good ideas and intentions into concrete action?

  2. stan.goldstein@mbf.com.au

    December 4, 2007 at 4:03 am

    Health reform

    We now enter a period of possibilities, with a new government and the promise of a new outlook for the future. However in other fora the comment has been made that there should be little hope for real change when the new Labor government has established itself on policies as close as possible to the previous one – the so-called "me-too-ism". Can we avoid more of the same?

    It is somewhat discouraging that the first comment about healthcare reform looks to consultation and a discussion paper as the solutions, as though we have not had discussions and consulatation in the last. What is more, that discussion paper seems almost to be advocating public sector monopoly as the secret solution that will solve our numerous problems.

    I confess to having the belief that Australia's health system is so much stronger than it would otherwise be having a mixed public and private appoach, and that the problems facing the system today warrant a more innovative solution than further consultation.

    Of course the community should be party to any change to the systems that provide for healthcare in this country! Unfortunately, however, the system is sufficiently complex that there are few in the community who have a broad overview of and sufficently detailed information about what does happen or what might happen, should change be allowed or encouraged. Broad discussion which is also well informed is difficult, but not impossible.

     Much of the suggested policy of both political parties seems to have been founded in suggestions from one or other of the major stakeholders in the provision of healthcare, without necessarily looking to innovative approaches to dealing with problems that only seem to have been worsening over time. Whether it is the promise of more funding and the motherhood promise of dealing with waiting lists, or providing GP super-clinics, or local management for hospitals, this still involves putting patches on a system that was developed by 1970 and hasn't really been changed substantially since. Certainly the response will be that the reduciing lengths of stay, the advent of Day Surgical facilities and Outreach services, are all evidence of systemic change. Yet the system has basically been one of a hospital centric outlook with unsupported GPs working largely isolated from the multidisciplinary care teams in those hospitals, and the default option being that anyone even a little complex goes to the Emergency Department and the further default is then hospitalisation.

    Isn't it time to relook at what could be done with a different structure and see whether there might be a better solution? If lengths of stay in Australia are still longer than in the UK, is it because Australians are more unwell, that we get better treatment that takes longer, or is it because it is more difficult to coordinate out-of-hospital options in our multi-payer fragmented service provider system? Are GP Superclinics the answer? As though there is nowhere in the country where GPs and allied health professionals have adjoining practices and try to work in concert.

    In another forum there is a call for a framework to support innovation. There could be no greater need for such support for major innovation than for our health services.

    Where can we discuss brave new ideas without having to battle against the established positions of the big stakeholders? Who are the champions of challenging the status quo (beyond those that advocate moving dollars from private to public)? Is anyone satisfied with the way things currently are? Please please start the discussion, because silence will only encourage more of the same.

  3. olgabodrova

    March 3, 2008 at 1:59 am

    Tony Abbott on the national health reform

    Here is Tony's take on the national health reform in Australia (from his exclusive interview with Open Forum):

    Tony AbbottTony Abbott: "Almost by definition, the health "system" will leave much to be desired.

    Patients want the best, immediately, for free. In practice, it will be the best immediately but won't be free; it will be the best for free but with a queue; or it will be immediate and free but not necessarily cutting edge. 

    Policy makers want a system that conforms to the best organizational logic. Even if such a system could be put in place, it would soon be ruined by the ad hoc compromises needed to keep it going.

    Health "systems" are recalcitrant because they comprise hundreds of thousands of quirky individuals and innumerable competing vested interests trying to serve very large populations with every single individual a potential expert in his or her own case.

    The benchmark for success should be: does the "system" or system of systems deliver high and rising life expectancies and low and falling morbidity rates at a cost commensurate with comparable systems around the world. On this score, Australia does pretty well. Health costs are about 10 per cent of GDP here compared to 8 per cent in the UK and 15 per cent in the US. We have more choice than the UK and more fairness than the US.

    Of course, we can always do better. Health is always a work in progress. Often, however, the best is the enemy of the good. We should be striving for improvement, recognizing that our structures, diagnoses and treatments are essentially provisional until something better emerges. Still, if the question is posed: "do the health services government funds or provides nearly always meet or surpass reasonable expectations?" I think the answer is: "yes they do".

    (Read the whole interview here)

  4. jay

    May 14, 2008 at 6:32 pm

    My uncle was diagnosed with
    My uncle was diagnosed with type 2 diabetes about 10 years ago, along with that he's had a number of blood transfusions and is now taking about 4 prescriptions a day, filling them hat the local rite aid or cvs has become so expensive i've started having them filled through a canadian pharmacy (http://www.pharmacy-online.ca/) it is almost 50% less than what he pays here and has helped him so much. It'd be nice to find a cure for it but for now i'll keep ordering from canada to save him money.

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