Health Crisis!
Only Through Original Thinking and some Courage Can Real
Change Occur!
Our Health Crisis will Bankrupt the Nation
Recently Jo-Ann Miller QLD MP and member for Bundamba just
outside Brisbane publicly “floated” the idea of penalising smokers
and the obese for their unhealthy lifestyles by suggesting that
people who become unwell through their own poor choices be pushed
to the bottom of hospital waiting lists. She reasoned at the time
that the Health Budget was being pushed to breaking point and that
if current trends in obesity and “so-called lifestyle disease”
continued (along with the progressive ageing of the population) it
would soon “burst”.
She was of course shouted down at the time by both sides of the
political divide and even doctors who allegedly supported such a
concept in private were deafeningly quiet when the “debate” went
public. It would of course be political suicide to commit to such a
notion, after all 27% of Australian adults smoke cigarettes and
more than 50% of Australian adults are now considered obese. Try
winning an election anywhere outside of Burma (sorry Myanmar) or
Zimbabwe with those numbers.
But if we move the discussion out of the political forum
momentarily and take a look at what we have:
The Department of Health’s own website quotes that obesity rates
have doubled in the past decade alone, Some major health reports
have placed Australia at the top of the world for obesity levels
and a study published recently in the American Journal of Clinical
Nutrition has the growth trends in obesity amongst Australian women
as the highest in the world
In 2007/08 Australia spent 9.05% of GDP on health and this
figure has increased by around 5% each year for the past decade.
Health expenditure figures no longer include in-home aged care as
this is now considered welfare expenditure. So by 2030
the total expenditure on health will be approx 25% of
GDP an absolutely unsustainable trend and all without
factoring in the ageing population and unpredictable explosion in
type II diabetes!
In a document commissioned by the Commonwealth Department of
Health focused on strategies for reducing lifestyle disease it is
estimated that if the growth trends for type II diabetes continue
in Australia the annual health care costs for diabetes
alone will increase to $8bn by 2032 (preventative
health task force 2009).
I could go on but I can hear people nodding off so suffice to
say that:
“Doing nothing or continuing with the current approach has the
potential to bankrupt the country…….8 BILLION BY 2032 ON
DIABETES CARE ALONE!”
National advertising campaigns have failed miserably the most
recent of which is the “Measure Up” campaign which was a
spectacular failure. In fact no national campaign on this issue has
yet made the slightest dent in the problem you cannot hide from the
numbers.
So how does Jo-Ann Millers proposal stack up now?
Well for mine shuffling sick people to the bottom of a hospital
waiting list is a little cruel and un-palatable. However it is
certainly high time the nation stopped kidding itself and asked
those people that become unwell through the course of their own
behaviour to pay at least part of the cost of their own health
care.
This could be done a number of ways and sharper minds than mine
will one day make a decision on how such a system is brought into
existence. Direct models, indirect models (sometimes called taxes)
who knows? But at some stage such a system MUST be part of our
health care funding model.
How about this as a starting point for debate?:
- A progressive rollout of the system
to allow people to adjust and modify behaviour
- Funding to be made available to
assist people to assess their current health status and be given
support to modify their choices
- Private health insurers adopt a
system where health behaviours affect premium charges. Currently
most use ONLY age as a premium penalty
- Programs to commence with part cost
recovery where patients pay a proportion of the cost of care where
clear links between behviour and the treated - illness are
established. The self funded component could then increase over
time.
- Patient contributions be capped in a
safety net style of system
- A national register for identified
lifestyle diseases is established
- An income threshold is used to ensure
that the most disadvantaged in society never go without health
care
The above are all just ideas and each has limitations and
implementation complexities, some may even be downright impossible.
The debate however must be commenced there is too much writing on
the wall and it is all in Bold Print: We are heading for a national
health calamity!
It is high time for Australians to accept some harsh realities.
Ultimately obesity cannot be blamed on someone else or even the
government. If you are obese and/or morbidly inactive IT IS YOUR
FAULT. As harsh as that sounds it has advantages. At least when
something is your fault it’s yours to control only when we stop
blaming will true progress begin.
Nobody said it was going to be easy and nobody wants to
victimise those who fall ill despite near faultless healthy
behaviour which raises another compelling point: Why should the
care/resources for sufferers of such cruel diseases as MS or the
entire raft of auto-immune diseases (all of which have no current
plausible lifestyle link) be diverted to people whose illnesses are
self-inflicted? Surely we have the capacity as a nation to develop
a system that is both fair and compassionate.
The solution to a looming crisis will take visionary thinking
forward planning and real political courage. All politicians know
that health costs are spiraling out of control. They also know (I
hope) that a solution will require a generational shift in attitude
and tapping in to the only thing that has any realistic chance of
success…………The “Hip Pocket” strategy.
There is a need to act very soon on this issue delay will mean
even harsher decisions in the future. Essentially I am floating the
rather novel concept of accepting personal responsibility and
seizing control. I don’t believe for a minute that most Australians
will do this easily we have been spoilt for too long. I would love
to believe that an appeal to the heart and common sense would bring
the much-needed change, I know of course that an appeal to the
wallet is our only real chance!
I'd be interested in your thoughts.
Brian Cooke