The National Health and Hospitals Reform Commission chief Dr Christine Bennett seems to have embarked on a series of media briefings to gee up interest in the Commission’s forthcoming report.

This earnt her a nice splash in the Weekend Australian’s health section which rang with praise at the “boldness” of the Commission’s work to date.

Interesting because I’ve heard some health policy experts using quite different adjectives. Timid, being one that springs to mind.

But, assuming we’re happy to run with the Commission’s advertising campaign, it’s worth taking a moment to contemplate the virtues of “bold”.

Every health library’s shelves are groaning with the “bold” recommendations of endless reviews, reports, and inquiries. Surely it’s time we moved beyond documents that simply make visionary recommendations and require them also to propose practical implementation strategies with some effort to build in accountability mechanisms. Such strategies need to be broad-ranging, not only addressing legislative and policy issues but also the politics, both partisan and professional.

The historic failure to do this means that many bold recommendations for change have remained just that: recommendations.

The other notable aspect of Adam Cresswell’s piece was his observation thing that “Bennett seems particularly animated when discussing option C”, – one of three potential options for changes to the governance of health care put forward by the Commission’s interim report.

This option is:

Commonwealth to be solely responsible for all aspects of health and health care, establishing compulsory social insurance to fund local delivery. transfer all responsibility for public funding, policy and regulation to the Commonwealth, with the Commonwealth establishing:  a tax-funded community insurance scheme under which there would be multiple, competing health plans for people to choose from, which would be required to cover a mandatory set of services including hospital, medical, pharmaceutical, allied health and aged care.

Interesting because a few people have now mentioned to me their impression that Bennett seems to be favouring this option. We shall see.


Health economist Ian McAuley, a Centre for Policy Development Fellow and lecturer in Public Sector Finance at the University of Canberra, has sent in the following comment on my post above:

Option C – the Nanny Corporation

Cresswell is right on one point at least, when he says “Bennett seems particularly animated when discussing option C”.

The Commission tries to define Option C as “social insurance”, but it’s nothing of the sort.  Rather, it’s makework for private health insurers, who would somehow transform themselves from financial institutions into care coordinators.

Just to make sure we don’t sensibly reject the notion that we need a financial institution to cream off funds, every Australian would have to “enrol” with a private insurer.

Conscription with the option of choosing a platoon.

Whether we need a care coordinator or not.

Even if we’re one of he majority of Australians who make very light use of health care and manage our own needs, without the intervention of a financial bureaucracy – the nanny corporation.

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