Earlier this week, Croakey posted an article on the demise of the Australian National Preventive Health Agency (ANPHA). In the post below, republished with permission from the Power to Persuade blog, Professor Brian Howe, who was Health Minister in the Hawke Labor Government, discusses the risks to the role of the Australian Institute for Health [...]READ MORE
Jennifer Doggett writes: Which regions of Australia have the highest rate of low birth-weight babies? Are males in regional and remote areas more at risk of mental illness than those in cities? Where do children in ‘jobless’ families live? Do women in the most disadvantaged areas have lower rates of breast screening than those in [...]READ MORE
Recent articles at Croakey have highlighted efforts to decolonise healthcare practice and HIV research. How might policy-making be different – in both process and outcomes – if efforts were made to decolonise what remains a heavily colonised system? This and other questions are raised by Dr Tim Senior’s sixth Wonky Health column, which examines the Forrest [...]READ MORE
In the wake of International Overdose Awareness Day (August 31), UnitingCare ReGen’s Donna Ribton-Turner says the taboos surrounding deaths from alcohol and other drug overdose magnify the burden for grieving families and increase the risk for all of us. She looks at how we are improving, or not, with public awareness through the media coverage [...]READ MORE
A recent seminar at the University of Sydney examined the legacy of the Australian National Preventive Health Agency (ANPHA) in an event also billed by some as “a wake for preventive health”. In the article below, Stephen Leeder, Emeritus Professor of Public Health and Community Medicine at the University of Sydney and Editor-in-Chief of The [...]READ MORE
On 22 August the Senate Community Affairs Committee released the report of its Inquiry into Out-of-Pocket costs in Australian health care. This is a comprehensive document, which comprehensively addresses a long-neglected area of health policy and highlights the inequity and inefficiency of our current approach to out-of-pocket costs in the Australian health system. The Committee (minus the Coalition members who put in a dissenting report) made a large number of recommendations, which have already been covered in Croakey and elsewhere. The main thrust of these recommendations is that no new out-of-pocket costs should be introduced until major changes are made to the way in which out-of-pocket costs are managed within our health system.
Senate Inquiries can often feel like a fruitless exercise and there are many examples of where sensible and well-supported recommendations are shelved and ignored by governments for short-term, political reasons. However, this Inquiry demonstrates the important role these inquiries can play in highlighting and addressing longstanding gaps in public policy. Despite the fact that direct payments have a significant impact on how consumers access health care and which forms of care they access, out-of-pocket costs have been ignored by both sides of politics. Labor introduced an entire health reform agenda without including out-of-pocket costs as an issue (the National Health and Hospitals Reform Commission Report covers health funding in great detail but barely mentions direct consumer payments). The Coalition has gone a step further by proposing sweeping new payments, without any understanding of how current costs are impacting upon consumers.READ MORE
Jennifer Doggett writes: It’s a scenario familiar to anyone used to attending health conferences and workshops: a presenter gets up and talks about a problem they are trying to solve in their city-based health service or program. Inevitably, after the presentation a hand will go up at the back of the room and someone will [...]READ MORE
Who should we be listening to in the debate over co-payments in the health system? Why do Governments take advice from unions, such as the AMA, with clear vested interests, rather than from expert researchers and consumer groups? In the following piece, Anne Cahill Lambert builds on Marie McInerney’s work on the co-payment to question the role of ‘expert’ in the health policy arena. She writes:
I am intrigued about the latest furore about the $7 Medicare co-payment. Aside from the fact that I don’t agree with it, I have been fascinated about who has been consulted or whose views have been reported.
Dealing with my disagreement first, the major claim is that a free public health service is unsustainable. Of course, Medicare is not free. It is a universal health system that is predominantly supported through a levy on taxpayers. I think many commentators, including our Health Minister, are muddling the terms universal and free. The beauty of our Medicare system is that all citizens are covered. It is the centrepiece of Australia’s health system of which I am extremely proud.READ MORE
The debate about the relative benefits and disadvantages of Caesarean Sections versus vaginal births is one of the most complex and contentious in the medical and health sphere. In this fascinating piece, Hannah Dahlen, Professor of Midwifery, University of Western Sydney, approaches this issue from a microbiological and epigenetic perspective and discusses the evidence for a causal link between labor and birthing processes and diseases later in life, such as asthma and diabetes. These fields of research are relatively new and not without their skeptics. However, if proven to be correct this research could potentially have major implications for birthing practices in countries, like Australia, with very high rates of Caesarian sections, and provide important insights into the cause of the ‘chronic disease epidemic’ facing our society today. Professor Dahlen writes:
In 1915, when caesarean section was rare, Kendall proposed that microbes, which colonise the baby’s gastrointestinal tract following vaginal birth, ‘may be protective’ He said, “Very shortly after birth bacteria make their appearance in the mouth of the newborn, and organisms appear in the meconium from four to twenty hours post partum (Kendall, 1915 p 209). Colleagues of Kendall had previously undertaken experiments sterilizing the environments (including undertaking caesareans) and foods of newly born/hatched animals, observing that development became affected under these conditions. This led Kendall to conclude that these bacteria may be protective under ‘ordinary conditions’.READ MORE
Viewing the global community’s response to the outbreak of the Ebola virus in West Africa in its historical context, Alexandra Phelan argues that it forms part of a pattern of treating infectious diseases as ‘the other’. She believes that this view has impacted upon the lack of pro-active action from the developed world to fix [...]READ MORE