1. Health Care Expenditure v Expenditure on Early Intervention & Prevention
The World HealthOrganizationdefinespreventionas'approachesandactivitiesaimedatreducingthe likelihood
that a disease or disorder will affect an individual, interrupting or slowing the progress of the disorder or
reducing disability'
If we are to cope with the challenges of a greying Australia ….we must also put more money into prevention
stopping people needing medical treatment in the first place.
Much of the burdenof disease and associated costs are preventable, making disease prevention an important
approach for improving the public’s health and to control health care costs
Spending on prevention
For the financial year 2011–12, $2.23 billion, or 1.7% of total health expenditure, went to public health
activities,whichincludeprevention,protectionandpromotion.This amount does not include spending in non-
healthsectorssuchas road safety,the environment,andschools.Immunisation,healthpromotionactivitiesthat
encourage a healthy lifestyle and reduce health risk factors, and cancer screening programs, were the major
areas of public health spending (AIHW 2011, 2013).
Between2000–01 and2010–11, governmentexpenditureonpublic health activities grew at an average rate of
3.8% per year. Much of the growth resulted from implementing the human papillomavirus vaccination (HPV )
program in 2007–08.
While public health expenditure estimates are subject to data quality issues that affect international
comparability, comparisons suggest Australia spends less on prevention and public health services than most
other OECD countries, ranking in the lowest third in 2010–11.
(Source: AIHW 2014)
Further readings:
National study proves prevention better than cure (8/0/10)
https://www.vichealth.vic.gov.au/media-and-resources/media-releases/national-study-
proves-prevention-better-than-cure
Prevention is always better than cure (24/12/12)
http://www.smh.com.au/federal-politics/political-opinion/prevention-is-always-better-than-
the-cure-20121223-2btf5.html
Is prevention really better than cure? And how much does it cost? (25/7/12)
http://tasmaniantimes.com/index.php/article/is-prevention-really-better-than-cure-and-how-
much-does-it-cost
Focus on prevention to cure the growing health budget (14/5/13)
http://www.ausmed.com.au/blog/entry/focus-on-prevention-to-control-the-growing-health-
budget

2. 4/29/2015 The government is missing the point with its health pricing ideas
http://www.brisbanetimes.com.au/comment/the­government­is­missing­the­point­with­its­health­pricing­ideas­20150215­13egnz.html 1/2
The federal government's focus so far on the use of a "price signal" to reduce its health spending entirely misses the nature of the problem with current
and future health costs in Australia – and the obvious options for improvement.
Without an aggressive focus on reducing the risks of preventable illness and improving the management of chronic diseases, government fears of the
increasing health costs of the growing and ageing population will become a certainty.
Australia's health policies, funding and service models are failing about one in four people living in Australia. Preventable diseases and chronic
conditions, like diabetes, heart disease and stroke, affect a substantial and growing proportion of people living in Australia, and this lies at the heart of the
current health cost debate.
Our funding and service models are principally geared towards treatment rather than prevention; to be chronically ill seems to be an acceptable state for
some people in our healthcare system, and it would seem access to preventative healthcare is an optional extra for some Australians. Reducing the risks
of preventable illness for everyone would deliver huge benefits on a population scale; it would address the very real fear of escalating health costs and a
growing, ageing and increasingly sick population.
This idea is not new, and it is certainly one the current government has acknowledged as a real problem. In its 2013 election policy statement, the
Coalition said: "The challenges facing the Australian health budget and Australian health services are well known to be the increasing prevalence of
chronic disease, demographic changes with an increasing and ageing population, and the tyranny of distance faced by many rural and remote
communities."
Given this, a focus on reducing funding for primary care services in isolation demonstrates a remarkable lack of understanding of the available evidence
of how best to address these challenges.
Medicare is one of three critical funding sources for health care in Australia – the others include private health and public hospital funding. Pulling one
lever, to deliver savings in one area of the system, without considering the other two, will have unintended consequences for the other two – and for
people and their healthcare, including the healthcare costs incurred by consumers – currently 16 to 17 per cent of all health expenditure.
These three levers are operated by three players – the federal government, state and territory governments, and private health insurers – but none of
them act alone. Two of each are coupled in the delivery of the funds and of the services that are funded.
The complexity of our federated system and the funding contradictions that are created, coupled with rising health costs, an ageing population and the
growing impact of preventable chronic diseases, means that unless we make changes, health will continue to be a blinding headache for governments
and individuals alike.
For Australia's health budgets and health services to begin to meet these challenges, policy and funding must be based on the evidence of what works to
meet these challenges. We need to re­orient Australia's health policy and funding to a network of healthcare services located across Australia. There is
strong evidence that this system of healthcare delivery is most effective when delivered locally by primary care providers – both general practitioners and
other health professionals.
Similarly, it is very well known that the care of chronic and complex conditions, whether lifestyle or age­related, is most effective when provided through a
range of health services at the primary and community care level.
Encouragingly, the 2014 budget's introduction of primary health networks goes some way towards potential improvement in the alignment between
health services and how they are funded by different levels of government. This offers the potential to better align GP primary care services that are
funded by the Australian government with hospital acute care services funded largely by state and territory governments.
High­cost health services ­ primarily acute hospitals ­ are increasingly overwhelmed by the continuing rise in the incidence and burden of chronic disease
on the Australian population across all ages.
Reduction in funding to primary care services – the services of general practitioners and other health professionals – in isolation from other measures to
improve preventative health and chronic diseases care can only accelerate these pressures.
2:09PM Wednesday Apr 29, 2015 1917 online now Do you know more about a story? Real Estate Cars Jobs Dating Newsletters
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Unless we focus on reducing preventable illness and improve how chronic diseases are managed, we will
never address the root of our escalating health costs.
Rosemary Calder
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The government is missing the point with its health pricing
ideas
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3. 4/29/2015 The government is missing the point with its health pricing ideas
http://www.brisbanetimes.com.au/comment/the­government­is­missing­the­point­with­its­health­pricing­ideas­20150215­13egnz.html 2/2
n
The federal government has recognised the significance of the pressures emerging from the traditional roles of governments within the Australian
federation and has initiated a discussion about federation. The health measures that the government wants the Australian public and health
professionals to consider need to be considered in that context.
The federation discussion offers Australia an excellent opportunity to construct an effective and efficient national health system – one that maintains and
sustains the best of its traditional capacities whilst better focusing available funding and resources on prevention and early intervention as well as
treatment – to reduce the risk of avoidable diseases and better control the growing impact of chronic diseases on high­cost health services.
The 2014 federal budget included a little recognised commitment to establish a national health commission. Little if anything has been said about this by
the government, yet it offers a critical opportunity to work with state and territory governments, and with health system experts, to work collaboratively on
"the challenges facing the Australian health budget and Australian health services."
Instead, the entire political debate has focused on how to limit access to GPs – with a predictable furore from health professionals and health consumers
alike.
The national health commission should comprise all governments as members, the federal, state and territory governments, with independent experts
from the health sector including consumers, to enable an Australian health system to finally be the focus of health policy and funding arrangements.
Realignment of the work of primary care practitioners through funding and service arrangements should be considered in tandem with the role and
funding of hospital services – they are both central to the care of people with chronic diseases.
Rosemary Calder is director, Health Policy of the Mitchell Institute for Health and Education Policy, based at Victoria University in
Melbourne.
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4. Activity: Squares, Triangles, Circles
On completionof the research,studentslist:
Practice HSC Question: Identify reasons for the differences in health care expenditure and health promotion
expenditure in Australia. (5 marks)
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4 things that “square with my thinking”
3 angles theydisagree/agree with;or 3 things for whichI
need more information
1 question “circling”
in my head