Comments on: Treasury’s role in health and other interesting insider insights http://blogs.crikey.com.au/croakey/2009/05/14/treasurys-role-in-health-and-other-interesting-insider-insights/ Thu, 19 Nov 2009 01:13:48 +1100 http://wordpress.org/?v=2.8.6 hourly 1 By: Luke S http://blogs.crikey.com.au/croakey/2009/05/14/treasurys-role-in-health-and-other-interesting-insider-insights/comment-page-1/#comment-263 Luke S Sat, 04 Jul 2009 10:10:20 +0000 http://blogs.crikey.com.au/croakey/?p=428#comment-263 Gavin is correct but I would go further. The elephant in the room is the mindless surrender of governments and the polity to market-driven economic ideology over the past 3 decades, especially in the anglo-sphere. That the inequality that these policies cause is the structural cause of so many of these problems (obesity, depression, smoking...) is an issue that most 'public health' experts and politicians are reluctant to touch. It's becoming clear, however, that the next big advance in health will be created in the socio-economic (dare I say ideological) space, far removed from the bio-medical research labs. Fran Baum's piece in the recent SA Bulletin is excellent and almost goes as far as fingering these underlying structural causes for our current public health problems. Gavin is correct but I would go further. The elephant in the room is the mindless surrender of governments and the polity to market-driven economic ideology over the past 3 decades, especially in the anglo-sphere. That the inequality that these policies cause is the structural cause of so many of these problems (obesity, depression, smoking…) is an issue that most ‘public health’ experts and politicians are reluctant to touch.

It’s becoming clear, however, that the next big advance in health will be created in the socio-economic (dare I say ideological) space, far removed from the bio-medical research labs. Fran Baum’s piece in the recent SA Bulletin is excellent and almost goes as far as fingering these underlying structural causes for our current public health problems.

]]> By: Gavin Mooney http://blogs.crikey.com.au/croakey/2009/05/14/treasurys-role-in-health-and-other-interesting-insider-insights/comment-page-1/#comment-168 Gavin Mooney Sun, 17 May 2009 11:31:13 +0000 http://blogs.crikey.com.au/croakey/?p=428#comment-168 Interesting and useful discussion but still not getting at the real evil - the industry that produces the obesity-inducing food. The fat profits of this industry are the problem. I also can't get too worried (as Mike Daube is) about the fact that only 2% of the health care budget goes to prevention. If we are to spend more on prevention would it be best spent in health care? I doubt it given the social determinants of health. Robyn McDermott is right - we need many more cost effectiveness studies but not just in GP land. When was a new tertiary hospital (such as the Fiona Stanley in the West) ever subjected to economic evaluation? There is an inequity about where such studies are called for by government - in public health, Aboriginal health and community care. I can also understand Steve Leeder's concerns but it is not just 'public health types' who want prevention. Citizens' juries in my experience give a higher priority to prevention than to acute care. Prevention needs to be led by the values of the informed public. Experts have their role in prevention policy but their values do not. Interesting and useful discussion but still not getting at the real evil – the industry that produces the obesity-inducing food. The fat profits of this industry are the problem. I also can’t get too worried (as Mike Daube is) about the fact that only 2% of the health care budget goes to prevention. If we are to spend more on prevention would it be best spent in health care? I doubt it given the social determinants of health.

Robyn McDermott is right – we need many more cost effectiveness studies but not just in GP land. When was a new tertiary hospital (such as the Fiona Stanley in the West) ever subjected to economic evaluation? There is an inequity about where such studies are called for by government – in public health, Aboriginal health and community care.

I can also understand Steve Leeder’s concerns but it is not just ‘public health types’ who want prevention. Citizens’ juries in my experience give a higher priority to prevention than to acute care.

Prevention needs to be led by the values of the informed public. Experts have their role in prevention policy but their values do not.

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