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Dispense with the misguided utopian myths about our health-care system.

By Peter Baume - posted Monday, 3 May 2004

The Australian health system is a mess.

The current system operates inefficiently between our many levels of government. I believe our politicians are leading a wrongly based debate. They espouse utopian values.

They promise what cannot be delivered, and Australia is supporting professional monopolies that are not good for anyone. Let me explain.


The constitutional power for administering health care in Australia lies with one level of government (the states), while “new money” lies with the Commonwealth. Much of the debate in health is about “blame shifting”, and much of the activity is about “cost shifting” between those two levels of government.

Some states' governments have tried to use area health services to deliver care. These are seen to be more effective because they are closer to the community.

So why is the health system in a mess?

Our system is unsustainable because we promise to our society what cannot be delivered.

Specifically, we promise to deliver, at public expense, all possible care to all people, all the time.

With that promise, admirable as it might be in theory, there is no absurdity in opposition politicians or media drawing attention to the failure of governments to meet that promise.


The reality is different and sobering.

Resources are finite. Resources are not sufficient to provide everything for everyone, and have never been. They will never be able to do that.

We cannot simultaneously provide, at public expense, using the available best contemporary knowledge, the services for procedural care, personal care, protection of the public health, and the prevention of future disease.

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About the Author

Professor Peter Baume is a former Australian politician. Baume was Professor of Community Medicine at the University of New South Wales (UNSW) from 1991 to 2000 and studied euthanasia, drug policy and evaluation. Since 2000, he has been an honorary research associate with the Social Policy Research Centre at UNSW. He was Chancellor of the Australian National University from 1994 to 2006. He has also been Commissioner of the Australian Law Reform Commission, Deputy Chair of the Australian National Council on AIDS and Foundation Chair of the Australian Sports Drug Agency. He was appointed a director of Sydney Water in 1998. Baume was appointed an Officer of the Order of Australia in January 1992 in recognition of service to the Australian Parliament and upgraded to Companion in the 2008 Queen's Birthday Honours List. He received an honorary doctorate from the Australian National University in December 2004. He is also patron of The National Forum, publisher of On Line Opinion.

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