Liberalism,+the+way+toward+better+population+health+for+Australia

Tutor: Coleen Niland
**“The Liberal Party of Australia believes in the idea that government should only do those things which the private sector cannot… the individual matters most and an emphasis on the individual and enterprise is the political philosophy best able to meet the demands and challenges of the 21st century.”** - //The Liberal Party of Australia Federal Platform (2010).//

**Cultural Artefact** ==== This cartoon from the ‘CartoonStock’ collection is representing the choice that the people in Australia face when dealing with our health care system. Do they go with the private system and pay for their own health care and have choice over the doctor and hospital which provide the services they need, when they need them or do they go with the public system, which may mean that they are put onto a long waiting list to receive treatment and get no choice over which hospital and doctors they receive this treatment from? Which is better for the people of Australia a user-pays system or a system provided that by the government? ====

**Public Health Issue** The public health issue that this artifact is representing is the choice that people in Australia are facing when dealing with the health care system currently in place. They have to choose between paying for their own health care in the form of acquiring private health insurance, or choosing to go with the public system. Does a user-pays system of health care, provide better services and care to all people in Australia or does the Medicare system, work best to meet the health care needs of Australia and its ageing population?

The Liberal approach, suggests that a user-pays system of health care is the best for all people, by rewarding Australians for paying for their own health care.

**Critical Literature Review** ==== When looking into the health care systems of Australia, there are two main issues to consider, these are what effect has Medicare had on the health care system in Australia and why a larger emphasis on the user-pays system of health care Australia currently has would be the best way in achieve better population health. Since the introduction on Medicare in 1984 the Liberal Party of Australia have altered their policy and values toward public health care to suit the greater population, whilst still providing benefit to and rewarding those who continue to take out and use private health insurance. ====

==== Private health insurance offers and covers policy holders for private hospital visits as well as if they choose cover for ancillary or ‘extra’ services, such as dental visits and optometry costs. People that think that private health care and insurance is too expensive for them would be surprised to find that over 80% of privately covered services have no gap involved, meaning that you pay no more than your premiums for the insurance (Liberal Party of Australia, 2011). Private health insurance also means that users have access to health care without the extended waiting periods experienced by those using the public health care system. The Australia Institute for Health and Welfare (AIHW, 1998) reported that 20% of people in the public system experienced extended waits (longer than what is defined as desirable) for their elective surgeries. This was during the time the Liberal Party of Australia was in government. Compare these to the figures released by the AIHW for 2009-2010, which showed that this figure had risen to 50% of people waiting for elective surgeries on the public health care system. This wait ranged from 27 days in Queensland, to over 73 days in the Australian Capital Territory. During this time frame the Australian Labor Party had been elected into government and had implemented their policies, which focus on a national health care system, rather than a user-pays or private system of health care. It can be seen clearly that a national health care system is not working for the people of Australia. ====

==== This increase in time patients spend on waiting lists in the public system has seen the number of people with private health insurance rise (Australian Bureau of Statistics, 2010). In 1998 the Australian Bureau of Statistics (ABS) reported that only 38% of all Australians had some form of private health cover, this was a serious decrease from the 48% of people covered before the introduction of Medicare in 1984. In 2010 the ABS found that the figure for the number of people with some form of private health cover had increased to 53% of all Australians. When asked why they took out the private health insurance 54% of people said they had invested in the policy for security, protection and a piece of mind that when they needed medical treatment they would receive it much sooner than they would in a public hospital. Of these people 23% stated benefits for ancillary services and shorter waiting times as other reasons for choosing the private health care system. If people don’t trust the government funded public health system, it is showing how this system is not effective in looking after the health needs of all Australians (Liberal Party of Australia, 2010). ====

Since the first of January 1999, all Australians who take out or hold private health insurance have been given a 30% rebate from the government.
==== “The private health insurance rebate was aimed at restoring the balance in our health care system. A balanced system will ease the burden on Medicare and the public health system and give more Australians greater choice and access to private hospitals. The Commonwealth 30% rebate makes private health insurance more affordable…encouraging more Australians to take up private health insurance.” (Australian Government: Senate Select Committee, 2003, p. 145). ==== ==== The rebate did exactly this, with the number of people with private health insurance increasing to 51% of all Australians (ABS, 2005) from the previously documented level of 38% in 1998 (ABS). The aim of reducing the burden on public hospitals was achieved to an extent, with over 50% of overall treatments such as chemotherapy (50% of all treatments), cardiac procedures (56% of all treatments) and mental health treatment (65% of all cases presented) being performed in private hospitals (Australian Health Insurance Agency, 2003, as cited in Australian Government: Senate Select Committee, 2003). Despite the decrease in utilization of public hospitals for many services the waiting times for patients in public hospitals continues to rise as shown previously. This shows that a public health system is unable to cope with the demands placed on it and showing that a private system of health care could prove to be beneficial for Australia. ====

**Cultural and Social Analysis** ==== Liberalism gives agency to individuals (Stanford Encyclopedia of Philosophy, 2010). Encouraging individuality and independence are strengths of the liberal philosophy and the Australian Liberal Party encourage Australians to take responsibility and be independent of the government funded public health care system in the form of having private health insurance //(Liberal Party of Australia, 2010).// If paying for the services that you used in the health care system was compulsory for all people, benefits would be seen by all in the reduction of taxes, due to the decrease in funding required to upkeep the public health system //(Liberal Party of Australia, 2010).// ====

==== When considering the health care system of Australia it is important to recognize that not all people have equal access to the facilities provided. Groups of people such as those living in rural and remote areas and people from lower socio-economic backgrounds (Australian Institute of Health and Wellbeing, 2011). These inequalities result in lower life expectancies and higher rates of mortality and morbidity (Australian Institute of Health and Wellbeing, 2011). This is a huge public health issue that Australia is yet to fully address in terms of health policy and the health care system, which they provide for the people of Australia. ====

==== The policy of the Liberal Party of Australia has in more recent years started to address some of these issues. One of the ways in which they are tackling the problems faced by people in remote and rural areas is by increasing their access to health care facilities and services (Liberal Party of Australia, 2011). By increasing the access to health care facilities, they are allowing people to choose whether they go to a to be treated as a public or a private patient in the healthcare system, even if they are being treated in public hospital. Previously people in rural were less likely to have private health insurance as they didn’t have the facilities to visit for treatment and medical help (Australian Institute of Health and Wellbeing, 2011). ====

==== Another issue that arises with a system of private health care is that some people may not be able to afford the insurance, which covers the costs involved in using private health care services. Since the introduction of the private health insurance rebate in 1999, there has been a marked increase in the number of people in the lowest income bracket of the population with health care. A Senate Select Committee was formed in 2003 to look into the Medicare scheme and see what changes should be made were presented with the following information from the Australian Health Insurance Agency (2003), “Over one million Australians earning less than $20,000 per year benefited from the rebate, allowing them access to private health care.” Providing this rebate is helping to increase the number or people of lower socio-economic status with private health insurance. ====

==== In Australia private health insurance represents a health care system that allows for choices (Australian Government: Senate Select Committee, 2003). As a patient in the Australian health care system, you potentially have three ways you can be treated if you have private health insurance (See Figure 1). The choices you are given are, being and Medicare patient in a public hospital, a private patient in a public hospital and a private patient in a private hospital. Without private health insurance you have no choice but to be a Medicare patient in a public hospital, with no choice of doctor or which hospital you will be treated at.====

==== The majority of Australians get the choice of private or public health care under the Liberal Party’s policy toward health care. Liberal Party of Australia acknowledges that some people will choose to only be covered by the government funded Medicare scheme, but they recognize that this is a valid choice and therefore continue to support Medicare. They do however believe that private health care is the system better equipped to cope with the health needs of a modern day Australia. ====

**Analysis of Cultural Artefact and Learning Reflections**

=
The cultural artefact presented earlier presents the issue that people in Australia are constantly having to make choices about health care; do they go with the public system, which may see them wait for months to receive treatment, or do they go for the private health care system, which requires having private health insurance. Having to make a choice like this can be tough for some people, yet for others it is as simple as having the knowledge that when you seek medical help and treatment, you will be able to receive this straight away, without having to sit in a queue. The Australian health care system has developed in the way that it has, to allow people to be able to make this decision so that is suits them and their situation at the time, however the decision has increasingly become one-sided, with many people choosing private health care. People are choosing private health care as they see the public system as being inadequately equipped to provide care to those who need it when they need it. The artifact is depicting this through the symbolism placed above each to the health care options on the wall behind the doctor. This symbolism is representing what people see our health care options as, as well as the idea of the Liberal Party that a private health care system is the best way forward for Australian population health. =====

=
In review of this assignment, it has become clear to me the state of the Australian health care system, and that it is in a state of disorganization and uncertainty. With both of the major political parties in Australia presenting vastly different ideas on what the health care system should be like, it is no wonder that so many groups of people are being overlooked and missed in our current system. From research done around this topic and the statistical evidence, I believe that our current health care system is working to an extent but it is not the most functional system; it will not be the health care system to achieve greater population health. In Australia I believe that we need a health care system that does focus more on private health care and making this accessible to all people, regardless of where they live and how much they earn to reduce the huge burden that is currently placed on the public health care system. We need a health care system that while focusing on private health care also retains the choice that people currently have over which system they utilize for their health needs. A Liberal health care system, would allow people to get the health care they need, whilst still maintaining their own agency. =====

**References**

==== Australian Institure of Health and Wellbeing. (2010). New report provides timely information on emergency department care and elective surgery waiting times. Retrieved fromhttp://www.aihw.gov.au/media-release-detail/?id=6442472376. ====

http://www.liberal.org.au/Latest-News/2011/05/04/Labor-s-health-changes-drive-up-family-costs.aspx.
**Learning Engagement and Reflection Task**

Lucinda,
==== I found your wiki post very interesting and a very thorough view on the topic of doctor-patient relationships. I found it particularly interesting reading about the research done on the power in these relationships and how it showed the power held by the doctor over the patient was disappearing. This is obviously great in terms of the health care that can be received by patients from their doctors, however I wondered to what extent the power still existed. In the example of a male doctor performing an invasive procedure like pap smear on a woman, is there a less of a power held by the doctor nowadays or do patients in situations like these still feel as if the doctor holds all the power in the relationship? ====

Suzie,
==== Great work on an interesting and very informative wiki! I found the comparison between countries and the rates of suicide in each one very eye-opening. What is it that causes such high numbers of people to take their life in countries like the Russian Federation, Lithuania and the Republic of Korea? Individualism as a determinant for mental illness was something that surprised me a little, but made me think would living in different culture like a collectivist culture reduce the effect of this determinant perhaps? ====