Putting a stethoscope to the patient

Is our current health system terminal? Do we need to significantly change the way we deliver health care? According to the Government, the answer is no.

Unfortunately we do not need to look far to see that our health system is cracking under the strains of a growing mismatch between its capacity to deliver quality healthcare and the changing needs of our communities.

It is true that by international standards the health of Australians is enviable. Overall life expectancy is high; as is the number of years we live without reduced functioning due to ill-health. And infant mortality is low.

But numerous inquiries, reports and expert commentary have long highlighted the lack of value for money, enormous waste and escalating costs which make health care inefficient and unfair.

The Federal Parliament alone has conducted three major inquiries into health funding and Medicare, while the Productivity Commission has produced many reports on health-related issues such as the health workforce and medical technology.

There’s a remarkable degree of agreement on what the problems are.

Duplication, cost shifting and buck passing between the Commonwealth and states and territories is legendary and known to be detrimental to patient care.

There is too much emphasis on hospital care and too little on prevention and primary care. There is also too much fragmentation and compartmentalisation between health programs and services.

A chronic shortage of medical staff has been aggravated by turf wars between professions, and an outdated Medical Benefits Schedule (MBS) system that is doctor oriented and rewards more expensive diagnostic procedures and interventions over cheaper preventive and early intervention activities.

Incentives for private health insurance are undermining universal access and pushing up prices for everyone.

Australia also suffers from too many health inequalities and they are growing - nowhere is this more marked than between Indigenous and non-Indigenous Australians.

It would be almost impossible to remain ignorant of the 17-year gap in life expectancy between Indigenous and non-Indigenous Australians or of the much higher rates of chronic health conditions. Infant mortality is also two to three times higher for Indigenous Australians than for non-Indigenous Australians.