Health a lower priority than gambling, pets
The Federal Government’s Budget cuts to Medicare rebates and hospital funding have been panned at a meeting of international health leaders amid warnings that governments worldwide need to invest in health in order to drive economic prosperity.
In the latest assault on the Abbott Government’s strategy to pare back Commonwealth spending and load more health care costs onto patients and doctors, experts addressing the H20 International Health Summit in Melbourne warned inadequate funding for health undermined a country’s growth potential.
The Summit, convened by the World Medical Association in collaboration with the federal AMA and AMA Victoria, was organised to help elevate health as an issue for major world leaders, including forcing it onto the agenda of the G20.
It was told that, since the global financial crisis, governments across the developed world have been cutting their health spending, increasingly forcing individuals and households to make up the difference.
Govt spending on health falls worldwide
Andrew Goodsall, Head of Health Care Research at UBS Wealth Management Australia, said that among Organisation for Economic Co-operation and Development governments, spending on health had stagnated or shrunk between 2008 and 2011, while over the same period spending by the private sector had grown 2.5 per cent and among individuals it had increased 1.4 per cent.
It was a development that AMA President Associate Professor Brian Owler and several other speakers warned would come at the cost of prosperity as well as health.
A/Professor Owler told the Summit that, particularly when it came to improving the prospects of the disadvantaged, such as Indigenous communities, better health was fundamental.
“Without improving health, education and employment will not follow. That is why investment in health must continue,” he said.
Professor Angang Hu, Director of the School of Public Policy and Management at Tsinghua University, said the strong link between health and economic growth had been explicitly acknowledged by the Chinese Government in its development plans for the world’s most populous country.
Professor Hu said targets regarding life expectancy, child vaccination rates, infant mortality and maternal health were integral parts of the five-year economic plans developed by the Chinese Government.
In its latest five-year plan, covering the period 2015 to 2020, the Government aimed to lift the immunisation rate to 95 per cent of the population, boost life expectancy to 77.5 years, and halve infant mortality to six deaths for every 1000 live births.
The Chinese Government’s ambition, Professor Hu told the Summit, was to lift the country’s performance on the main health indices above those of all other developing countries by next year, the on a par with middle-level developed countries by 2020 and to achieve results equivalent to those of the top developed countries by 2030.
This is because, he said, health was seen as “the foundation for comprehensive development – health is both a means and end of development”.
Health integral to growth
The economic importance of health was underlined by Australian Institute of Health and Welfare Chief Executive Officer David Kalisch, he told the Summit that, “a healthy population is integral to a healthy economy”.
“If the health of a people falters, there is a major impact on the productive potential of the economy,” Mr Kalisch said.
But speakers including A/Professor Owler and health economist Roger Kilham said this was a lesson that the Abbott Government was not heeding.
Health Minister Peter Dutton has defended the Government’s health cuts on the grounds that health spending has been growing unsustainably.
But A/Professor Owler said the claim was “rubbish”, and that what was masqueraded as health policy was actually driven by a desire to balance the Budget.
Mr Kilham said the Budget settings reflected the priorities of the Government.
“All these things are choices,” he told the Summit. “We spend a lot on public hospitals, but we spend more on legal and illegal gambling, [and] we spend more on pet care than we do on GPs.”
He said that many Government decisions about health care were taken within the “very narrow framework of costs to the Budget”, which he said was a totally wrong and inadequate way of examining the issue.
“You would never build a road if you were only looking at the costs and no the benefits,” Mr Kilham said.
Speakers at the Summit said the focus needed to shift from how much was spent, to how effectively it was used.
Dr Neil Soderland, Head of Health Care Practice at the Boston Consulting Group, said, “we should not be looking at health spending, but value of that spending”.
Dr Soderlund said the focus tended to be on how many procedures or other services were provided, rather than what the care was ultimately intended to achieve.
“The issue isn’t growth in health spending, but outcomes – value for money,” he said.
A/Professor Owler urged a change in the mindset of the Abbott Government away from viewing health purely as an expense to seeing it as an investment fundamental to fostering growth and prosperity.
He said to achieve the best value for its health dollar, the Government should work closely with medical practitioners.
“We can’t have poor policies, purely fiscal policies, developed in isolation [from] health, thrust upon the community such as we have seen with the blunt $7 co-payment proposal,” AMA President said. “If we want to get wise investment in health, then we need to have a process of collaboration and consultation for general practice. Engagement with clinicians is key. It can’t be token.”