The Australian Bureau of Statistics revealed one thing very attention-grabbing about Australian well being final week: dementia is poised to turn out to be our greatest killer, forward of coronary heart illness. It’s already the most important killer of ladies, South Australians, Canberrans and folks in NSW, and can quickly occupy high spot throughout all classes.
Whereas a part of the reason being as a result of dementia deaths are rising, the broader story is an effective information one: we’re getting a lot better at stopping coronary heart illness, which for generations was our greatest killer, and Australians live longer. That features Indigenous peoples, regardless of the appalling actuality that they nonetheless die, on common, eight years youthful than non-Indigenous Australians. General, we now have the fourth-highest life expectancy on this planet.
That is opposite to the narrative that pervades the media about our well being system — one by which our “frontline” well being employees heroically battle to beat authorities neglect and insufficient spending, whereas the inhabitants is beset by numerous “epidemics” — weight problems, alcohol, illicit medicine. In actual fact, Australian longevity is so outstanding that in August The Economist printed a chunk merely titled “Why do Australians reside so lengthy?”
A key motive for our bettering life expectancy is that, like each different developed nation, we’ve lifted our well being and caring spending dramatically — as Crikey has repeatedly identified, our well being and caring sector is way and away the most important employer of Australians and is among the fastest-growing employers. Governments from each side have elevated each well being spending and spending in aged care and incapacity care over the past decade.
There’s one other narrative about our well being system — one more and more peddled by the enterprise press. It’s about how this elevated funding is a deadweight on the economic system as a result of well being and caring are labour-intensive and subsequently endure from poor productiveness, which additionally outcomes from their being government-funded and government-run. As well being and caring continues to develop, pushed by an ageing inhabitants, it’ll impose an increasing number of of a burden on the “market” space of the economic system.
“Pouring extra taxpayer cash into issues comparable to incapacity and aged care will solely serve to tug down dwelling requirements additional throughout the board,” the Monetary Assessment’s Michael Learn wrote in September, echoing the views of fellow neoliberal galah John Kehoe that “rich economies are shifting away from manufacturing to decrease productiveness companies comparable to aged care, healthcare, incapacity care and private companies comparable to therapeutic massage and sweetness. Labor needs to enhance the so-called ‘care economic system’. That gained’t be straightforward in a government-dominated and controlled sector.”
Curiously, nevertheless, for a system apparently stultified by the lifeless hand of presidency, Australia’s well being system far outperforms the free market-based US healthcare system, which spends practically twice as a lot per capita as Australia to ship far worse outcomes — together with Individuals dying 5 years youthful than us.
For that matter, Australia’s non-public healthcare suppliers are not any extra environment friendly and productive than the general public system. In a 2019 report for the Grattan Institute, well being economist Stephen Duckett discovered that, when evaluating like with like, affected person stays in public hospitals are considerably shorter than in non-public hospitals. In 2009, the Productiveness Fee (PC) concluded that there was no distinction within the effectivity of personal and public well being methods.
Regardless of the doctrinaire insistence of neoliberal economists and enterprise lobbyists that the non-public sector is invariably extra environment friendly and productive than governments, in our greatest using sector not solely is there no proof for that, the reverse often is the actuality.
In April the PC returned to the difficulty of healthcare productiveness and our worldwide efficiency. Its conclusions have been a direct rebuttal of the AFR line that well being and care funding is a few kind of productiveness catastrophe. The primary line is “opposite to prevailing views, new fee analysis means that elements of the healthcare sector have skilled sturdy productiveness progress lately.”
It goes on to conclude “not solely has Australia skilled sturdy productiveness progress, fee analysis additionally finds that our healthcare sector is among the world’s best. Australia’s healthcare productiveness ranks third amongst 28 high-income nations as soon as we account for behavioural and environmental danger components and the age of our inhabitants.”
How may or not it’s {that a} government-funded, government-regulated and sometimes government-managed system is world-leading in productiveness, and world-leading within the outcomes it delivers for Australians — and out-performing the non-public sector?
The outcomes are a vindication of the sturdy funding each side of politics on the federal and state ranges have made into well being — funding that neoliberals and enterprise regard as a burden or indulgence to be mitigated and pared again, as an alternative of a public sector success story. One, clearly, they’d choose to maintain quiet about.
