The Australian Health Care Agreements 2003-2008 (original) (raw)

The 2003-2008 Australian Health Care Agreements: an opportunity for reform

Australian Health Review, 2002

The Australian Health Care Agreements govern the relationship between the Commonwealth and States about public hospital funding. The incentives enshrined in the Agreements can shape policy priorities. Although they provide for the largest specific purpose grant a State/Territory receives, the current negotiations should not be seen as providing the only opportunity for reform of health care for the next five years. This paper argues that the negotiations should focus on two key areas where Commonwealth-State frictions are high but reform is feasible. Specifically it is suggested that the Commonwealth should contribute its funding of public hospital inpatient services on a casemix basis, and secondly, should fund outpatient services directly

The 2003-2008 Australian Health Care Agreements - an industry perspective

Australian Health Review, 2002

This paper presents a public hospital and health care industry perspective on the development of the 2003 - 2008 Australian Health Care Agreements. The Australian Healthcare Association conducted a national industry consultation exercise from June to September 2002 in the lead up to the development of the next round of agreements. While acknowledging that the size of the funding commitment from the Commonwealth to the states will be the central focus of negotiations, health industry representatives identified issues of equal importance. The AHCAs' linkages with other health programs need to reflect that health care has moved beyond the confines of the hospitals. Adjustments and output targets need to provide incentives to improve and reform the industry. The success of private health insurance policy has not yet translated into benefits for the public hospital sector, and any funding contingencies between the two programs cannot be justified at this time. Special priority areas ...

Healthcare reform in Australia and New Zealand over recent decades Part B - Australia

2011

Often policy and institutional reform proposals, developed through experience and learning transfers from other jurisdictions, encounter many veto points/players before they can be implemented. When New Zealand elected members by a first-past-the post voting system in single member electorates to a unicameral parliament it was relatively easy for the majority party to legislate their reform proposals. However, if reform legislation is not supported by the electorate it can be reversed just as easily by an incoming government of a different ideological persuasion. The situation is different in Australia because it is a federation and restricted by its constitution. It also has a bicameral parliamentary system that makes it easy for veto players, with ideologies opposed to that of the government, to reject policy reform proposals before they can be legislated into law. Despite these difficulties, some significant health care policy reforms have been enacted in both Australia and New Zealand during recent decades.

Federalism and Australia’s National Health and Health Insurance System

Asia Pacific journal of health management, 2006

While health reform in Australia has been marked by piecemeal, incremental changes, the overall trend to increasing Commonwealth involvement has not been accidental or driven by power-hungry centralists: it has been shaped by broader national and international developments including technological change and the maturing of our nation and its place internationally, and by a widespread desire for a national universal health insurance system. In many respects the Australian health system performs well, but the emerging challenges demand a more integrated, patient-oriented system. This is likely to require a further shift towards the Commonwealth in terms of financial responsibility, as the national insurer. But it also requires close cooperation with the States, who could play a firmer role in service delivery and in supporting regional planning and coordination. The likelihood of sharing overall responsibility for the health system also suggests there is a need to involve the States more fully in processes for setting national policies. This article draws heavily on a lecture presented at the Australian National University in October 2015. It includes an overview of Australia's evolving federal arrangements and the context within which the current Federalism Review is being conducted. It suggests Australia will not return to 'coordinate federalism' with clearly distinct responsibilities, and that greater priority should be given to improving how we manage shared responsibilities. There is a long history of Commonwealth involvement in health, and future reform should build on that rather than try to reverse direction. While critical of the proposals from the Commission of Audit and in the 2014 Budget, the lecture welcomed the more pragmatic approaches that seemed to be emerging from the Federalism Review discussion papers and contributions from some Premiers which could promote more sensible measures to improve both the effectiveness and the financial sustainability of Australia's health and health insurance system. The Commonwealth's new political leadership in 2015 seemed interested in such measures and in moving away from the Abbott Government's approach. But the legacy of that approach severely damaged the Turnbull Government in the 2016 federal election as it gave traction to Labor's 'Mediscare' campaign. In addition to resetting the federalism debate as it affects health, the Turnbull Government now needs to articulate the principles of Medicare and to clarify the role of the private sector, including private health insurance, in Australia's universal health insurance system. Labor also needs to address more honestly the role of the private sector and develop a more coherent policy itself.

The Australian health care system: reform, repair or replace?

Australian Health Review, 2008

A Festshrift gives us the opportunity to look both backwards and forwards. Ken Donald's career stretches back to his intern days in 1963 and has encompassed clinical and population health, academe, clinical settings and the bureaucracy, and playing sport at state and national levels. There has been considerable change in the health care system over the period of Ken's involvement in the sector with more change to come -where have those changes left us? This paper discusses Aust Health Rev 2008: 32(2): 322-329 these changes in relation to performance criteria.

Policy challenges for the Australian health care system

Australian Health Review, 1999

In contrast to the regular media reports decrying the so-called crisis in the health system, a number of academic commentators have identified areas in which the Australian health care system could improve. George Palmer has been one of those, and over the years has published a body of work identifying areas for improvement. This paper reviews the performance of the Australian health care system against the criteria of equity, efficiency and acceptability, and explicates the contemporary problem areas associated with each criterion.

A review of the Australian healthcare system: A policy perspective

SAGE open medicine, 2018

This article seeks to review the Australian healthcare system and compare it to similar systems in other countries to highlight the main issues and problems. A literature search for articles relating to the Australian and other developed countries' healthcare systems was conducted by using Google and the library of Victoria University, Melbourne. Data from the websites of the Commonwealth of Australia, the Australian Institute of Health and Welfare, the Australian Productivity Commission, the Organisation for Economic Co-operation and Development and the World Bank have also been used. Although care within the Australian healthcare system is among the best in the world, there is a need to change the paradigm currently being used to measure the outcomes and allocate resources. The Australian healthcare system is potentially dealing with two main problems: (a) resource allocation, and (b) performance and patient outcomes improvements. An interdisciplinary research approach in the ...

A comparative analysis of Australian health policy in the 1970s

Social Science & Medicine, 1984

In the decade of the 1970s there were some slgmficant changes to the Austrahan health system while the health systems of most other countries remained stable. By comparing the Austrahan health system with that of a number of other countries in the 1970s. the paper examines both the causes and consequences of these changes. The substance of the vartous Austrahan health system nutlatlves was a change from a voluntary to a mandatory health Insurance system and then. after a short period of 'catastrophic' health Insurance. a return to a voluntary system Most of these changes appeared to be motivated by political and ideological preferences rather than by a rational assessment of their likely efficiency or effectiveness. In any event. and despite claims to the contrary, these changes were minor when vlewed m the broad context of international systems of health care The conclusrons of the analvsls. while tentative. suggest that the health system changes had Me, If any, direct impact on health costs. service use and indicators of health outcomes.

Book Review: The Australian health care system

Australian Health Review, 2008

THIS IS THE THIRD edition of one of the seminal local texts on the Australian health care system. Over the last seven years, this text has proved a basis for helping students, casual readers and health professionals understand Australia?s sometimes difficult to understand health care system. The text is divided into ten chapters that deal with key aspects of Australia?s health care system, namely: � Frameworks for analysis � The Australian population and its health � Financing health care � The health workforce � Departmental and intergovernmental structures � Hospitals � Public health � Primary and community care � Pharmaceuticals � Policy challenges for the Australian health care system. There are several key reasons why this text has been widely used in the past and will continue to be of value well into the future. The author has been able to accurately describe the complexities of the Australian health care system in an easily digestible way. This is a feat in itself and worthy...

Daring to dream : the future of Australian health care

2001

The circulation of this paper was very limited, mainly because we did not consider it suitable for academic publication. A more fully developed and argued article was published in the Australian Economic Review, 4th quarter 1968. By this time, the appointment of the Commonwealth Committee of Inquiry into Health Insurance, headed by Mr Justice J.A. Nimmo and Whitlam's public formulation of his "Alternative National Health Programme" had been instrumental in bringing health insurance policy to the forefront of national political policy issues. In view of its seminal importance-both for national health policy and John Deeble's long career in health service research and policy formulation it seems quite appropriate to bring the original paper from archival obscurity by publishing it in this volume. A third of a century has elapsed since it was written, and a great number of pragmatic and not-so-pragmatic changes have been made over that time. Nevertheless (apart from the numbers!), the proposal was widely regarded as very radical at the time yet bears an uncanny resemblance to the present structure of Medicare and the associated arrangements covering public hospital services.