Health and security

Without any doubt the first duty of the  Government is to protect all its citizens.  As a famous Roman statement – salus populi suprema est lex - has it, “the welfare of the people is the supreme law”.

Few in Australia would disagree when it comes to “stopping the boats”, protecting our borders and country against terrorism, maintaining law and order and contributing to overseas missions designed to make the world a safer place. But such an approach takes a very traditional view of security.

Some would argue that the Government has a basic responsibility to go further and protect and maintain the health and wellbeing of all its citizens.

With little doubt people are the wealth of nations and it is not simply the number of people which counts or whether they feel safe from border incursions or terrorism, but also their education, skills, abilities and all aspects of their health status.

People are the critical human capital which the Government has a responsibility to preserve, protect and bolster, for a healthy, robust nation free from the threat of disease and ill health is the basis of a successful, innovative and caring nation.

In Australia today the question remains – how far can the  Government go to actually protect us, not only during times of crisis, but generally in everyday life, or are we forced to fall back on our own resources and manage our own health?

If so can we do this in a meaningful  and preventative manner?

Many would perhaps argue that our health is our own responsibility and would aggressively oppose the Government  intervening in many aspects of our lives. But I believe there is a pressing need to fully appreciate that security is people-centred and that health and population dynamics play an important part in Australia’s security.  

Looking back at the past 200 years there is little evidence of the Government  being able to adequately look after us during times of epidemic crisis, and evidence suggests that during such times ordinary people have shown little confidence in the Governments’ ability to do so. In consequence people were often forced back on their own resources.

But it is not simply during such times that the Government fails to protect all its citizens but also at a time when we are confronted  by a wide range of threats related to young children, ageing, disability, obesity, diabetes, dementia, cancer, hearing, the internet, free speech and terrorism.

So who should be responsible for our health?

Should it be the Government, employers, corporations, the media or simply us? 

But if the Government provides only basic health care, the onus falls back on us as individuals to protect our own health, and if health prevention remains the responsibility of the individual, we certainly need a better understanding of what prevention actually is.

Certainly our health system places considerable emphasis on prevention and the need to produce a wide range of lifestyle intervention and prevention strategies. But do we really understand what we need to do to protect our health?

If preventing poor health is primarily a responsibility of the individual, then the question remains as to how well are we managing our health?

To me there is a major disconnect between what we think we should be doing about our health and what we actually do. I suspect that well less than half of all Australians say that they are actively managing their own or their families’ health.

Many fall back on the belief that it is corporations like the food and drink industry that should bear some responsibility for our health closely followed by our national healthcare system. Others argue that the media has an important role to play in informing and helping produce change. But in reality we fall in the void between all these and our belief in health prevention is sidelined.

Currently we live in a healthcare environment where public hospitals are free, some GP visits are bulk-billed and a small amount is refunded for the cost of medical specialists. Given that 12 million Australians, including 1.8 million aged over 65, do not have private health insurance it is not a pretty picture.

But are we a healthy society when almost 350,000 are currently living with dementia and there are 1,700 new cases every week, 63% of all Australians are either overweight or obese, roughly 12% suffer from asthma and more than one million are living with cancer. And let us not forget the regular outbreaks of childhood infections like measles, chickenpox and whooping cough which should have all disappeared years ago.

Other aspects of our health also raise qualms, such as dental care and physiotherapy which remain the responsibility of the individual.

The status of our dental health in many ways sums up the problems of individual health care. A 2012 survey by the Australian Research Centre for Population Oral Health found that 58% of all children aged 14 had permanent teeth affected by decay while 24% of all people living in major cities had untreated tooth decay as well as 38% of those resident in more remote areas. In addition, 21% of all Australians aged over 65 had no natural teeth. 

Things can only get worse.