Curing an ailing system

The balance is also about solutions for our major health issues. Balance between, for example, technical solutions and those that require changes of our environment and changes of our behaviours. A good example is obesity - do we wait for the obesity pill or do we invest in universal programs (education, social marketing, regulation, amenity provision, public transport) to increase physical activity and improve nutrition?

Fair

Although we continue to enjoy healthy improvements in our life expectancy, there are major inequalities in the way life expectancy is distributed across Australia. The most disadvantaged are Aboriginal Australians, and life expectancy can vary by up to ten years across different suburbs in Sydney and Melbourne. So the system also has to work at “levelling up” - bringing those with the poorest health up to those with the best health, which requires changes in income distribution, and investment in education and employment. This is why we should cherish our progressive tax system as fundamental to a just society, where it is seen as a positive contribution to our own well being, and to that of others, not money “stolen” from us by governments.

Simple

This is the monster that we don’t seem to be able to deal with - federal versus state versus local governments - multiple layers of services disintegrating under the weight of an arcane, but seemingly immutable system of government. Simple means fewer, better integrated systems for funding and running preventive, primary and tertiary care services. Simpler for providers and for punters.

When we look to the future we should be ready to learn from other countries. And we shouldn’t automatically look to the US, but start having a much more in depth look at the northern European and Scandinavian experiences. Take, for example, the recent UNICEF report, An overview of child well being in 21 OECD rich countries. It examined 40 indicators of child well being and found that Netherlands, Sweden, Denmark, Finland, Spain, Switzerland and Norway had the highest level of well being with UK and US the lowest. (Australia could not provide enough data over all the dimensions to be included!).

We have to ask the question whether the top countries do better because they take fairness more seriously, and have more inclusive social policies, greater social cohesion, and more equal distribution of wealth and amenity?

In my darker moments I wonder if we are still committed to fairness in Australia. I sense that we have become meaner over the last ten years, less interested in the “fair go” although we still promote it as an essential Australian value.

So come election time look for the policy that is the smartest, the most balanced, the fairest and the simplest. It’s also likely to be the most affordable.