'As Turnock points out, the largest number of beneficiaries of public health can never show up at a public hearing and can never write a letter to the editor praising their health department because they have not yet been born. The public health movement is constantly working to make sure the world our children inherit is a decent place. But often theirs is a thankless job.'
Rachel's Democracy and Health News, 13 April 2006; Bernard Turnock's Public Health — What it is and how it works (3rd Edition).
WORLD PROBLEM: The public health system is in crisis.
TRENDS SUPPORTING THIS VIEW AND ATTEMPTS TO FIND A SOLUTION:
- Emergency services spokespeople say they can no longer guarantee help to people in an emergency situation because there is not enough staff to handle the demand.
- Doctors and nurses complain of insufficient beds and funding to support the population in public hospitals. When election time comes around, miraculously the public hospital system is given an injection of extra funds to keep the health professionals quiet.
- In times of excess stress in the public hospital system, the stress of handling the growing population (which in itself is also facing stress or is choosing to live it up too much without thinking about the consequences) increases and puts a toll on the aspiration of many young would-be doctors and nurses while those already in the profession are considering early retirement. This is the time when the government starts to make excuses that there is not enough doctors to solve the health crisis instead of admitting the population is way too high for true sustainability and not enough people are looking after themselves.
## SPECIAL UPDATE ##
13 January 2004
Reports of patients in Australian public hospitals being quietly euthanised just to free up beds for other patients have started to emerge and become investigated by the police.
## SPECIAL UPDATE ##
15 November 2004
It would appear many governments of the world don't want to acknowledge high profits of businesses is part of the fundamental issue in this debate on the health crisis. For example, there has been talk of the Royal Australasian College of Surgeons in Victoria controlling the number of surgical training positions and in which hospitals these future surgeons can work in. The reasoning behind this ludricrous approach is quite simple: it is because the top surgeons in the country can maintain their very high salaries and/or earn extra money by imposing high fees on public hospitals for their services. This may be to partly offset the high cost of insurance to protect themselves from litigation by their patients. But it is also because they see the value of creating a low-supply in a high-demand situation as required to maximise their own profits by keeping the numbers of surgeons helping the Australian community to a low level.
## SPECIAL UPDATE ##
15 November 2004
Under considerable pressure from the State Labor Government to balance this profit-mentality of the top surgeons with the moral and social obligation they must show to help the health of the general public (especially in times of high population levels as we are seeing today because of the need by local, state and Federal Governments to earn extra tax revenues from the people and while the business community prefers to see people have less time to look after their own health by working overtime for the sake of extra profit), the Royal Australasian College of Surgeons will now offer 30 more surgical training places just to appease the State Labor Governments.
Other changes include allowing trainee surgeons to train and work in the state in which they had been trained if they so choose. This would put an end to the silly national ranking system which had denied experienced NSW doctors wanting to become a surgeon from working in NSW and Victorian trainee surgeons being forced to move into NSW and fill the positions instead.
The college will now work closely with the Australian Consumer and Competition Commission (ACCC) to ensure its selection process is transparent and fair.
The college has warned that extra health funding will be needed to pay for the 60 new positions in the next couple of years assuming of course the salaries of the new surgeons remains where they are today. Given how the Federal Government fought tooth and claw to minimise health spending, this warning will place even greater demands on taxpayers.
Or perhaps the Federal Government might wish to consider the funding to Defence a low priority and worthy for redirection to help improve the health of all Australians for a few years?
Yes, we can only dream on...
NOTE: Doctors do seem to have a lot of control at hospitals, the few that do exist. Yet it should be a decision made by the patients (if conscious and in sound mind) and/or the nurses. Doctors are there to mend the bodies the best way they can. Patients and nurses should decide for themselves how treatment should be served.
## SPECIAL UPDATE ##
1 February 2005
The definition of elective surgery has been extended to include surgery for people who are not experiencing a "life threatening" health problem and therefore considered the lowest priority. This includes hip-replacement surgery and abnormally large growths on the surface of the ear or face. Even if the person's health problems will create severe psychological trauma or seriously reduce the quality of life of someone (eg. it forces him/her to be permanently house-bound), the shear numbers of people requiring surgery has forced doctors to categorise more and more surgery as elective, leaving only the most serious cases to handle. While those who must attend a hospital for trivial things such as giving birth to a baby are forced through the system as quickly as possible like a bunch of cattle.
Until people take responsibility for their health and think about their actions and the population levels are reduced, the hospital system will soon reach the point of total collapse and with it the economy in its present form.
- The Government has to demand an increase in the cost of Pharmaceutical Benefits Scheme (PBS) medications for the average person on the street to pay. In other words, where expensive life-saving drugs were previously subsidised by the government to allow people to survive, now the Government has seen the opportunity to save money by reducing the subsidies and asking people to pay more for their drugs. As Annette Ellis MP, Australian Federal Member for Canberra and Parliamentary Secretary to the Shadow Minister for Family and Community Services, said:
'The Coalition [Liberal (Howard)] Government attempted to increase the cost of PBS medications by 30% in the May [2002] Budget. Labor voted against this increase and the Bill was defeated in both Houses.
'While we believe there is no doubt that the funding of Australia's health system must be reviewed, raising funds by charging the elderly, the sick and families is just not fair.' (1)
- The Government sees the public health care system as a bottomless black hole where any amount of money thrown at it would disappear without getting back much for the investment. This attitude changes dramatic just prior to an election before returning to the previous attitude after the election.
## SPECIAL UPDATE ##
20 November 2003
The Australian Federal (Howard) Government has decided to go for what must be described as a desperate Mark 2 Medicare reform to get the Australian public to see how the Government is trying really hard to fix the health care system (spew!). A boost in funding will certainly go a long way. Unfortunately it has taken until now for the Government to suddenly see the benefit of spending A$2.4 billion over four years (instead of the meagre $917 million in extra funding over four years in the Government previous package known as A Fairer Medicare) to prop up the declining Medicare system.
The Government has also given it a new name for the latest package of reforms. It is now known as MedicarePlus. By changing the name, it is hoped the Government can give the impression to average Australians it has done enough to fix up the health crisis while at the same time make it difficult for the Labor Party to make expensive promises or to have anything substantial by way of good policies to use at election time in 2004.
The Band-Aid solution to Medicare by the Government will include a reasonably generous A$5 bonus per consultation for doctors to bulk-bill concession-card holders and for children up to 16 years old. Nothing like a bit of appeasement with the larger proportion of the Australian population consisting of low- to middle-income families and the less well-off if it can mean a chance to earn a few more extra votes at around election time!
Another change has been to offer a safety net for out-of-pocket medical expenses amounting to 80 per cent of the medical costs paid by the government for low-income patients paying more than $300 and $700 for all other patients. Health Minister Tony Abbott described this policy as "iron clad" as part of his government's election commitment to the Australian people. In his own official words:
'That is an absolutely rock solid, iron-clad commitment.'
However, the ultimate aim for the Government is to eventually see Medicare collapse after 2008 through massive blow outs in the budget so that the health care system can be turned into the US-style of privatised health care system where doctors can charge any amount of money it likes and the Government can sit back and do nothing for the people, forcing the rich to get richer and the poor to get poorer and hopefully die quicker. In that way, it is hoped the population will return to a more self-sustainable level where everyone will hopefully have a job designed to support the Australian economy and in return give people a better chance to afford the cost of health care, no matter how expensive it becomes.
## SPECIAL UPDATE ##
20 November 2004
It has taken the Federal (Howard) Government just two weeks before the polls on 9 October 2004 to capitulate to the health demands of the State Premiers with a promise of massive multi-billion dollar extra funding to this sector. This has angered the State Premiers when only last December the Federal Government was crying foul about the lack of money in the coffers for health. The truth is, the Federal Government needed its money from taxpayers to help pay the cost of the blunder in Iraq and to afford major election promises in areas of health and education during this month. In other words, Mr John Howard is trying to buy votes from the Australian people.
## SPECIAL UPDATE ##
14 April 2005
The supposedly "iron clad" election promise from Health Minister Mr Tony Abbott last year has suddenly looked decidedly flimsy today after the government's admission that the safety net was not economically sustainable nearly 5 months after the election. Funnily, for a government that claims it has good economic management skills, it could not predict the budget blowout of the new safety net policy of MedicarePlus estimated to be about A$1.2 billion even though outside observers consisting mainly of health care experts, the Australian Democrats and reporters had warned the government prior to the election of the developing blow out due to increases in the doctors' fees among other known issues at the time. Even Mr Abbott conceded the government knew the cost was blowing out just prior to the election, but kept it a secret claiming the government needed more time to see what would happen. Now Mr Howard has allowed Mr Abbott to take a well-earned rest as the Prime Minister took the brunt of questions from the media, saying:
'I understand people will be critical, and I regret this, I am very sorry that it has occurred. We had a difficult choice to make. It's either let the thing drift to an unsustainable position or take these painful, but necessary, steps now [while] still retaining a generous safety net.' (The Canberra Times: Quotes of the week. 16 April 2005, p.B6. & Metherell, Mark et al. PM, Abbott sorry about Medicare: The Sydney Morning Herald. 16-17 April 2005, p.4.)
Some people have welcomed the changes made to the Medicare safety net. As Troy Cox of Docklands in Victoria said:
'John Howard has made the right decision on Medicare. We must prepare for the consequences of an ageing population. It is sensible to make small adjustments to health care now rather than bigger, more painful adjustments in the decades ahead.' (The Sydney Morning Herald: More of that mean spirit in safety net changes (Opinion & Letters). 16-17 April 2005, p.38.)
It is a pity such an attitude to changes is not reflected well by Mr Howard when it comes to the environment and promoting renewable energy sources.
But why wasn't the cost of the safety net calculated or, if it was, calculated accurately based on actual trends such as the increasing doctors' fees? The calculation should have shown it was unsustainable, in which case what's the purpose of introducing the safety net in the first place if it is not going to greatly benefit the Australian people?
Was this meant to be Mr Howard's way of buying extra votes from the Australian public at election time? Or did Mr Abbott and Mr Howard have the calculations roughly written down on a piece of parliamentary toilet paper and called it a health policy? If so, it is certainly not worth the paper it is written on! Either way, it doesn't look good for the Federal Government.
To rein in the runaway costs of the Medicare safety net, the government will increase the threshold to $500 and $1,000 for low and middle/high-income patients respectively (and so effectively curbing around 400,000 Australians, mostly low-income earners, from qualifying under the program) before paying the 80 per cent safety net. A hard blow indeed for low-income patients and an unmistakable show of deceptive and misleading behaviour by a government that is more interested in political self-preservation than the preservation of the health and financial circumstances of its own people.
As opposition leader Mr Kim Beazley said:
'This is a class A, rolled gold, world-best practice piece of deceit...' (Cronin, Danielle. More Medicare changes possible: PM: The Canberra Times. 16 April 2005, p.3.)
Deceit is the right word. Prime Minister Mr John Howard may have been able to get away with breaking another election promise (among numerous others including the one he claimed that interest rates would not rise under a coalition government, and another in not sending more troops to Iraq. Not so with the safety net election promise. By breaking the safety net election promise, the Prime Minister does not have the luxury of claiming he had no knowledge of what was happening. People have been telling the Prime Minister (and Mr Abbott) about the budget blow out for some time (including an official report published in the Sydney Morning Herald as early as September 2004 stating the blow out will reach A$1 billion). Mr Howard had figures showing this was happening according to his Health Minister, yet he chose to ignore it and did not make or show accurately the calculations needed to confirm his figures, in stark contradiction to his usually strong economic management principles.
As Robyn Prygoda of Nowra in NSW said:
'The Howard Government trumpets its economic management skills yet it consistently underestimates the budget surplus and, if it is to be believed, couldn't predict from November to this month the cost of the Medicare safety net.
'Look out for budget cuts to essential services this year and next and then, surprise, surprise, a budget windfall to fund another round of promises which will be broken within six months of the election.' (The Sydney Morning Herald: More of that mean spirit in safety net changes (Opinion & Letters). 16-17 April 2005, p.38.)
The Prime Minister knew by pleading ignorance it would give him a political advantage over his opponents in the election, as opposed to choosing to be honest to his people by admitting he made a mistake in his budget analysis.
Perhaps all promises in the future should be made legally binding statements and in writing to ensure all governments of the day really think about what they are saying to the Australian people before committing themselves to the promises. Not such a bad suggestion. As Anne Brown of Bowral in NSW said:
'I was watching the news on Thursday night abouyt the Government's alteration to the Medicare safety net and I thought perhaps it would be an idea to make all politicians' pre-election promises legally binding statements. In other words, wouldn't they think twice before making statements that they would be legally held responsible for?' (The Sydney Morning Herald: More of that mean spirit in safety net changes (Opinion & Letters). 16-17 April 2005, p.38.)
- Insurance companies and the Australian Federal (Howard) Government has to increase the cost of premiums for such things as health and property because of the number of claims from people in an ever-expanding population. And it isn't so much a profit motivated action by the insurance companies. According to Private Health Insurance Administration Council chief executive Hayle Ginnane in Australia:
'Generally, the entire [private health insurance] industry is operating on very tight margins — 90 cents in every contribution dollar goes out again in benefits.
'Estimates benefits paid for contributors will exceed A$7.5 billion this year. Increases in contribution rates are necessary to meet these increased benefits in a mainly not-for-profit market. The 30 per cent [government] rebate [estimated to provide $2.4 billion] provides support in meeting the costs of contributions.' (2)
The main cause for an increase in health insurance premiums is said to be (i) an increase in the number of people entering private hospitals, and (ii) the higher costs of treatment. As for property insurance premium hikes, it is primarily large numbers of people claiming for lost or damaged property which is said to be the real cause.
## SPECIAL UPDATE ##
Higher insurance premiums could also be an issue of greed by some claimants wanting to receive money from the insurance companies for any reason (a problem with the way Western society emphasises money as more important than anything else).
## SPECIAL UPDATE ##
December 2005
With yet another increase in health premiums across many health funds — in some cases rising 40 per cent compared to four years ago and for some people paying an extra A$200 or more for their premiums — chief of health insurer MBF, Mr Eric Dodd, argued most funds are probably not performing well and believes there should be greater transparency and accountability of all health funds before asking for a premium hike. He summed up the situation with a telling quote:
'If you wanted it to be, the CEO of a health fund could be the most fantastic job in the world. You could play golf five times a week.' (The Sydney Morning Herald: Incompetence and kickbacks — just another year at the office. 7-8 January 2006, p.28.)
## SPECIAL UPDATE ##
7 January 2006
The Federal Government is not entirely innocent of the higher insurance premiums. Gordon Burns of New Lambton, NSW, writes:
'Upon receipt of my annual insurance premiums I notice that government charges constitute a nifty 42 per cent. Included in this is GST on the fire service "levy". No doubt such double taxation is enabled because of the sneaky use of the word levy instead of tax, but such government dishonesty and duplicity should not be allowed to pass unnoticed or unrecorded.' (The Sydney Morning Herald: Stung twice (Opinion and Letters). 7-8 January 2006, p.20.)
## SPECIAL UPDATE ##
24 February 2006
The Australian Federal (Howard) Government has approved health insurance companies to raise health insurance premiums for families by A$160 every year to allegedly cover increasing treatment costs, new technologies and the added burden on private hospitals to treat extra patients.
As Australian Health Insurance Association chief Michael Armitage said:
'Premium increases...will cover the additional use of private hospitals, new and expensive technologies and increases in treatment costs.' (O'Malley, Sandra. Families' health bill goes up by $160 a year: The Canberra Times. 25 February 2006, p.3.)
The only option for Australian people to minimise health insurance costs at the present time, assuming the current capitalist system is maintained, is to visit http://www.iselect.com.au/. This web site will help you to choose the best and lowest health insurance premium for your needs, assuming you can still afford the premiums.
## SPECIAL UPDATE ##
25 February 2006
Young Australians feel tempted by the idea of deserting their private health insurance funds in droves owing to the high premiums with very little in return or benefit. Some have actually done something about it by letting their insurance premiums lapse.
Old-age people are contemplating a similar move because of their low incomes (unless you are an ex-company director) except their situation is a little more complicated in that the older you are, the more you need health insurance to pay for the slightly more regular hospital treatments and hefty medical bills.
Those aged somewhere in the middle will hopefully have well-paid and fairly permanent jobs to be able to afford the cost of hefty premiums without complaint.
This general observation is supported by statistics claiming since 2001, 477,000 people (or 2 per cent) aged up to 54 years had left private health insurance, while 445,000 aged over 55 years had joined.
In focussing on the total numbers who are with private health insurance funds, the Federal Health Minister Mr Tony Abbott claims people are sticking with private health insurance because the products and services are getting better. Interestingly it is not because the cost of the premiums are going down. Mr Abbott adds:
'The Commonwealth Government has carefully scrutinised all applications [from the six largest health funds for premium increases] to ensure the premium adjustments are the minimum needed.' (O'Malley, Sandra. Families' health bill goes up by $160 a year: The Canberra Times. 25 February 2006, p.3.)
This may explain why the increase this year will average out across the six largest health funds at 5.68 per cent higher than last year's premium costs for the 8.8 million Australians with health cover compared to nearly 8 per cent last year from the previous year, 7.58 per cent in 2004 and 7.4 per cent rise in 2003. Possibly last year's rise was in anticipation of a slightly lower rise for 2006.
As Abbott said:
'This is the lowest increase across all private health insurance funds since 2001.' (O'Malley, Sandra. Families' health bill goes up by $160 a year: The Canberra Times. 25 February 2006, p.3.)
Or if Australians didn't have the nearly 8 per cent rise last year and instead had 7.5 per cent increase, then the rise for this year would be 6.18 per cent. Would Mr Abbott continue to claim it is the lowest since 2001? Nothing like putting a positive spin by reducing the rise this year to 5.68 per cent.
In total, the rise since 2001 has been between 33 and 40 per cent depending on which private health insurance fund you are with.
However the Australian Consumers Association health policy officer Ms Viola Corczak believes no continuously rising health costs are sustainable. Eventually something must give. Either the health system is properly fixed including getting people to become healthier or people will have to get out of the health insurance system altogether leaving only the richest people to pay the highest amount for their premiums.
As Ms Corczak said:
'This rise shows that the private health insurance system is unsustainable.' (O'Malley, Sandra. Families' health bill goes up by $160 a year: The Canberra Times. 25 February 2006, p.3.)
Ms Corczak further adds:
'Consumers are not getting value for the money — they are paying more, but still receiving roughly the same benefits.' (Pollard, Ruth. Health fund fees up 33% in five years: The Sydney Morning Herald. 25-26 February 2006, p.5.)
She suggests the 30 per cent private health rebate should be removed and the money used to fix up the public hospital system and assisting with preventative care for individuals in the community.
The most the Federal Government can do in this situation while it keeps a surplus of $A15 billion for its election year and spends phenomenal amounts of money on Defence to support the war in Iraq, is to spend a few tens of millions of dollars in television advertising convincing young children to get outdoors and exercise more. Now a recent stdy has found the money is wasteful in that it isn't the exercise being the problem, but rather the amount of consuming of junk foods in the name of profit for the food giants which is the issue.
Actually this is not quite correct. The Federal Government has agreed to give an extra A$1 billion to state governments to improve the public health care system. After that, it is dreaming the the problem will be fixed.
## SPECIAL UPDATE ##
29 April 2006
Federal Health Minister Tony Abbott believes the best way to lower health insurance premiums is to sell off Medibank Private. But as Stephen Jackson of Gulgong, NSW, said:
'Tony Abbott says that a privatised Medibank Private would result in lower premiums ("Medibank benefits warning", April 28). Is that in the same way that privatised green slips would reduce premiums? A privatised Commonwealth Bank would reduce fees? A privatised Sydney Airport would reduce costs? The list goes on.
'Pull the other one, Mr Abbott.' (The Sydney Morning Herald: A litany of hopes lost in privatisation (Opinion & Letters). 29-30 April 2006, p.32.)
## SPECIAL UPDATE ##
1 July 2006
Apart from a 30 per cent rebate to people who join private health insurance, the Federal (Howard) Government used clever marketing techniques to make the health insurance under Medibank Private look cheap. Through carefully-crafted television advertisements, the cost of the health insurance appears to be only A$1.13 per day or a tad under A$400 per year, remarkable considering the average premiums from other funds is twice this amount. But if you look carefully at the advertisements, it is from A$1.13, meaning it is the most basic health cover you can get. To get a useful health cover, be prepared to pay a lot more. The Government is advertising in this way to help attract young people back to health cover.
## SPECIAL UPDATE ##
23 February 2007
The latest situation in this continuing saga of trying to improve the health system and lower insurance premiums has seen Australian Health Minister Tony Abbott approve a 4.5 per cent increase in premiums on average. This is roughly A$2.00 a week more for families in private health cover.
Mr Abbott put a positive spin on the change saying it is the lowest increase in 6 years and families benefit from the 30 per cent rebate saving around A$1,000 per year. Mr Abbott added:
'Over the last two or three years, we have seen consistently more people coming into private health insurance.
'I think we've had five or six consecutive quarters of substantial growth in the numbers of people with private health insurance and I certainly think that with an even lower increase this year, we're more likely to get more people into private health insurance and not less.' (Cronin, Danielle. Government gives health funds nod to up premiums: The Canberra Times. 24 February 2007, p.5.)
Mr Abbott is certainly playing the positive spin doctor today. Perhaps more of him might be welcomed in the public health system.
Unfortunately Mr Abbott cannot skate around the fact that fees have increased by 50 per cent since the Federal Government claimed in 1999 there would be no significant increase in the costs to Australian families over time. The small increase today is likely to be offset by significant increases in the coming years. And we wouldn't be surprised if Labor is to blame for it should they win this year's Federal elections.
As for people joining private health funds in greater numbers, it is likely this is because the population is aging and some people who are getting rich need a reliable health care system to support them in their old age as a form of security.
If reelected, the Federal (Howard) Government plans to sell off Medibank Private. So while the Government argues all it likes about how much they are helping people on private health insurance through the 30 per cent rebate, the Government can also blame health insurance premium hikes on greedy business professionals.
But as President of the Faculty of Public Health Medicine at the Royal Australasian College of Physicians George Rubin, and his colleague Stephen Leeder (a councillor) said:
'...There has never been a public debate in this country about the public subsidy of private health insurance. The overall bill to taxpayers arising from the 30 per cent rebate increases annually with the fee increases granted to insurers. In turn, this adds to the percentage of GDP spent on health care. Yet there is little evidence to suggest that the investment leads to improved health outcomes.
'Is the rebate where taxpayers want their taxes to go? If so, how much? Could the money be better spent improving other areas of health care? The federal opposition [under Kevin Rudd] has not signalled any changes to the policy at this stage, suggesting that it may be comfortable with Medicare progressively becoming a safety net for the poor.
'We are constantly told that Medicare has provided Australians with one of the best health systems in the world. In this election, we should be hearing our politicians fostering debate on health care costs and co-payments and articulating policies that provide for universal health care coverage at the point of service delivery.' (The Weekend Australian (Letters to the Editor): Why no debate on health?. 26-27 May 2007, p.18.)
- The Government and businesses have to reduce spending on health and social services because they claim it is costing them too much. (3)
NOTE: With the war in Iraq going at full swing, government funding for Defence has gone up. It seems fighting terrorists has a higher priority than looking after the health and well-being of all citizens and living things on planet Earth.
What if all military spending was redirected towards improving health, education and the environment? Where would we be in 5 years time?
- Doctors and nurses cry out for more funding and other resources while working long hours, but the government does not want to emphasise the problem in the hospitals by establishing an honours system for health professionals for their important role in the community. As M.J. Dickenson of Ngunnawal, Canberra, said:
'Jennifer Saunders (CT Letters, February 17) is spot-on in calling for an overhaul of the honours system.
'I proposed my daughter, thinking she might get some small recognition after almost 40 years of dedicated nursing in public hospitals, whilst at the same time raising a family. My proposal was rejected. Now had she been a public servant, an MP, an Olympic gold-medal winner, well...' (4)
- Carers, the unpaid nurses of society, are rarely if ever acknowledged for the free services they provide to look after the health and wellbeing of members of the community. In Australia alone, it is estimated that carers in totality save the governments around $20 billion a year in caring for people at home.
- A classic example of how poor the public health system is currently at, talk of a highly contagious airborne flu evolving from the dreaded bird flu and affecting humans would see the health system collapse within days. For a start, the number of people experiencing bird flu symptoms would fill the corridors of every hospital and there isn't enough nurses and doctors to attend to every one of the patients. Next, the businesses and government don't have a plan to create enough anti-flu virus shots designed to tackle the bird flu for the entire population. The size of the population is not sustainable for the current health system.
What makes it ludricrous is the amount of money governments will spend on defence compared to the health system. Where are the priorities in society?
- The grim scenario has been extended to bioterrorism. Knowing how much State and Federal Governments are focussing on anti-terrorism measures, what happens if a major terrorist attack occurs? Will the health care system cope with the potentially large numbers of casualties reaching the public hospitals? In Australia, public hospitals in Sydney are struggling even to provide neo-natal care for new mothers. In a recent story of a Sydney woman on 7 May 2007, three hospitals had to transfer the woman who was on the verge of giving birth to twins until she reached a hospital in Wollongong where the facilities she needed were available. How can the public hospital system cope in the event of a terrorist attack?
A leading hospital administrator and chairman of the Department of Medicine at Sydney Hospital, John Graham, said Sydney hospitals are so cash-strapped, understaffed and so run down that if a terrorist attack would occur or a bird flu epidemic hit the city, the health system would not cope. It doesn't have the resources to look after 500,000 let alone the over 2 million people living in Sydney.
Dr Graham said:
'I am the canary down the coalmine and I am asphyxiating. It doesn't matter if I fall off my perch, but it matters if the heal-a-million who come into the Sydney CBD every day have their health jeopardised. I, for one, am not prepared to let the NSW Health Department sit back and do the wrong thing.' (Snow, Deborah. Bioterrorism alert: hospital cutbacks leave city exposed: The Sydney Morning Herald. 22-23 April 2006, p.5.)
And this doesn't include the lack of commitment by the Federal Government as of 2006 to restrict advertising of junk food to children on television and elsewhere or at least force food giants to promote healthier foods. Because as childhood obesity gets worse, the burden on the public health system will increase.
People either take responsibility and look after everyone properly, or we all pay the consequences.
- Another major contributing cause to an overburdened health system are the overuse of antibiotics to combat bacteria. The more humans use antibiotics, the more resistant the bacteria gets over time.
Encouraging signs are emerging in the world of science (and how important it is to invest in good quality scientific research and development no matter how radical and creative it might be seen by the State or Federal Government of the day) where a new naturally-occurring substance has the power to revolutionise the antibiotic industry thanks to excellent work by Dr Jane Whitley of the Institute of Animal Science in Melbourne, with assistance from Dr Jianghui Wang and research team leader Dr Ben Cocks. It began when Dr Whitley came up with the brilliant idea of testing the anti-bacterial qualities of Tammar wallaby milk. As Dr Whitley said:
'When you look inside the mother's pouch, it's such a horribly dirty environment for the baby, and the mum if always poking about in there. It's not very hygienic.
'That's where the idea for the research project came from, because the milk seemed a logical place to look for something that would protect the joeys against infection.
'Their immune system doesn't develop for 100 days after they're born, and during that time they're relying totally on their mother's milk to fight any infection. It seemed pretty obvious that there had to be something in the milk.' (Beeby, Rosslyn. Wallaby milk's curing quality uncovered in war against deadly superbugs: The Canberra Times. 29 April 2006, p.B2.)
As a result, Dr Whitley and her colleagues have realised there is a chemical in the milk (possibly AGG01) considered 100 times more powerful at fighting e-coli, salmonella and golden staph among many others than the strongest forms of penicillin.
Dr Whitley believes this is a classic example of creative thinking achieving a worthwhile goal for society. Dr Cocks has announced the news in late April 2006 at an international science conference in Chicago, USA. Funnily enough, the same announcement made in June 2005 by Victoria's Minister for Innovation John Brumby apparently didn't cause a stir in the scientific community or the media. It took a scientific conference to really get international scientists excited at the prospect.
This new discovery opens the door to testing the milk of other mammals such as platypus, possums and other marsupials.
Now if only we don't cause the extinction of all these animals and also protect the natural environment and maybe there could still be hope for humanity after all, and at the same time save the health care system.
- A rare event in the history of Australian politics was unveiled today where State Premiers finally agreed with the Australian Prime Minister John Howard on something. This time it is over the training of doctors and nurses — the new deal will see a boost in their numbers (just so long as some rural communities will benefit from it rather than the continuing exodus of doctors to the cities). Well, to be precise, nearly all the states got the extra medical school places they wanted except for NSW which received one-tenth of the places requested. The agreement has been described as a landmark Commonwealth-state co-operation.
This remarkable event occurred on 14 July 2006.
- Social policy may have reached the crossroads. The increasing weight of people living a wealthy and sedentary lifestyle; less time away from work to exercise, eating healthy foods, and do a variety of different and more creative things for the mind and body; the convenience of buying low-cost and fast fat-filled take-away food with more sugar than you find at a Queensland sugar plantation; staying home after work and dropping on a couch in front of a TV or playstation; people wanting to become single because of pressures at work and the high cost of living; people dying alone in apartments; greater social isolation; more risky sexual practices; depression for L-brain people; increasing problems of childhood type 2 diabetes and so on is seeing some health professionals look towards a new social policy.
The solution is simple: all work and no play makes for a dull boy. The overemphasis on supporting the nation's economy and get filthy rich as emphasised by the Australian Federal (Howard) Government's new industrial relations reform is destroying the social fabric and health of Australian society.
It is time society reverses this trend.
- The best the Federal (Howard) Government can muster following the May 2007 budget is a one-off payment of A$600 per patient for every full-time carer. As for businesses selling unhealthy products, choosing a peaceful solution to conflict, and reducing population levels, there will be no changes here. The economy and enough people consuming is more important than the health of the population and the hospital system.
- The Federal (Howard) Government has been undercutting funding to the public health system by A$1.1 billion every year as State Premiers have discovered. It shows the priority health has for the Federal Government.
- The election has been called by Australian Prime Minister John Howard, with the day set for 24 November 2007. As Peter Costello immediately released his tax plan and reveals a A$34 billion slush fund has been collected over the past 4 years to spend on substantial tax cuts for people in employment and then urges opposition leader Kevin Rudd to come up with his own tax plan, Rudd counters with a tax plan to help families, education and the health system. Then suddenly, Costello says he just happens to have more in the slush fund to pay for health and education.
So over the past for years the Howard Government has effectively withheld money to the health system (and education) so the Prime Minister can sway the Australian people to vote for his government at election time with all these financial sweeteners. It occurs at a time when stories of women are forced to give bith to babies in hopital toilets and closets because there isn't enough doctors and funds to support them.
The more the government reveals it can spend the money on social services but hasn't, the more the Australian people will resent the two-faced hypocritical bastard the government is.
This R-wing Howard government is happy to spend big bucks for Defence and the troops in Iraq and at the same time reduce spending to education, health and everything else just to force people to suffer or somehow get a job, and then suddenly say it has the money to support the social and educational services needed by the population at election time. This could end up becoming the biggest downfall of the government simply because it cannot be honest and do the right thing by all the people.
- Australian employers are attempting to tackle the obesity problem of employees by paying people to exercise. It is up to the employees to find the time to exercise and prove they have done so. This is the latest decision as of 2 January 2008.
As for the health funds, they are providing a discount for people who take up a gym membership.
These are considered the easy option without sacrificing the economy or business profits.
- A survey of people living in Sydney in January 2008 has revealed obesity levels are highest among people with low incomes and less education in the Western suburbs than the higher affluent areas of the eastern and northern suburbs. NSW Premier Morris Lemma thinks the solution is encouraging people to get out more and exercise.
That's not the only reason. When people have less money, it takes longer to pay off the bills and mortgages. People tend to work long hours earning little money or are unemployed. By the time people get away from work, there is little time except feed the children and relax.
Price of food and the quality of the food is another factor. Major supermarkets (Woolworths and Coles) have been found to provide more of the cheaper junk foods and lower quality fresh foods to poorer suburbs. This move by supermarkets may be understandable as expensive food items are rarely bought by poorer members of the community. But it should not result in supermarkets selling poorer quality fresh foods such as fruits and vegetables and/or more junk foods.
Supermarkets must take responsibility to supply healthy foods to the entire population at the lowest price possible. Milk, water, fruit, vegetables and fish should be priced to be cheaper. If necessary, governments or supermarkets should impose a food tax on junk foods to help offset the higher prices for healthier foods.
For example, soft drinks such as Coke should be priced as more expensive than milk and water. If necessary, raising the price slightly for soft drinks can help to reduce prices for healthier water, milk and certain types of fruit juices (ie. low in suger).
THE SOLUTION:
All world problems have a simple solution. Solving world problems really depends on:
1. The type of people involved (eg. R-wing/L-brain or L-wing/R-brain).
2. How much listening and gathering of information we do to understand a problem.
3. The careful balance of R-brain and L-brain skills when searching for a solution.
4. Choosing a solution that takes into account the feelings of those people and other living things that will be affected by the solution.
5. Applying the solution.
When we face the issue of health as a world problem to solve, there are essentially three solutions available to us: (i) maintain the current economic system with all its warts and flaws and forever be forced to put more and more funding into health as population increases and/or ages and businesses keep selling unhealthy products to the people (which eventually means less and less money available for other services unless we all pay more taxes through clever techniques such as introducing a consumption tax or quietly implementing tax bracket creeps); (ii) be more efficient in how the health system is implemented; or (iii) undergo a radical and creative overhaul of the entire health and economic system.
At present the authorities have chosen (ii) (with a little bit of (i) thrown in for good measure) as the best so-called "creative" solution one can muster after decades of looking at the health care system. As Michael Fearnside, a neurosurgeon, said:
'The public system is just so swamped by emergencies now, it is just so difficult to get your elective patients in.' (Pollard, Ruth. The Sydney Morning Herald: Radical surgery: Why hospitals face the knife. 10-11 December 2005, p.27 (pp.26-27).)
The efficiency plan will involve (i) reducing duplication in surgery work throughout all the major hospitals by having community health centres specialising in a particular field; (ii) having more nurses employed and performing more tasks commonly reserved to doctors; (iii) perform the right surgery to get people out of hospitals quickly; and (iv) promoting a better and more healthier lifestyle for everyone.
However if we are truly serious about solving the health problem on a permanent basis then clearly the best solution has to be (iii). It is time for a radical overhaul of every aspect of society, including our economy, and not just the health care system.
The creative approach would involve drastic changes:
- to the way we contribute to society through the work we perform for others (ie. the type of healthy things we produce for others, how long we should work for, and whether we should perform work we are not able to enjoy and stay healthy);
- to the tremendous wealth generated by society for the things we have sold to others by putting a cap on being rich, and forcing better products and services to be produced at a low cost and is better for the health of everyone concerned;
- to improving the environment for the sake of better air quality, fresh water supplies, adequate fresh and natural foods at a low cost, and ensuring the natural ecological systems permit these resources to be forever recycled and maintained;
- to the size of our population and how important it is to keep them at a manageable and sustainable level;
- to solving terrorism and treating other nations well in order to stop the risk of bombings that could maim and kill scores of people because of the failure of world leaders to negotiate with the terrorists and their nations; and
- in learning to look after our own health and the health of others by showing our responsibility for this important issue.
Let's face it. Our population is growing and growing fast and there are people wanting to sell unhealthy products for the sake of becoming rich. Also some people are going around invading other nations only to increase the risk of a terrorist attack on civilians in the nations doing the invading. At some point no amount of efficiency will permanently and sustainably solve the health problems in the long-term. Why? It is all a question of resources: there is only so much to go around, so little money, and not enough trained people to help one another.
Unless we are prepared to train every single human being in society to become their own doctors and nurses (let's leave the bedroom scene out of it for a moment) and have the skills to create their own medicine, the increasing age and population levels of those people more concerned about getting rich and having what they want by doing anything must eventually put increasing stress on the public health system, if not now then certainly in the next 20 years. And what then? Will governments pay robots to become the most highly efficient doctors and nurses in the world? Certainly beats having to pay health care professionals a salary given how expensive the health care system is to the State and Federal Governments.
There must be a limit to how much efficiency you can achieve. It is time for a radical overhaul of the entire system of society and the economy. And it is better to do it now, not in 20 years time.
And what if we don't change now but one day find ourselves forced to consider this new radical new health care system? In that case, how would the radical new health care system work?
Should there be too many unhealthy people burdening the public health system at a critical time, the new radical health care system will suddenly get implemented. And its approach will be nothing short of shocking to most people. The new health care system will work on the basis where each individual must take responsibility for his/her own health. For example, if a person chooses a healthy diet, regularly exercise, and employ whatever low cost method is available to keep healthy and fit, it would be extremely difficult to burden a health system with problems. But even if something should go wrong (eg. an accident or caused by genetics), the individual who does the right thing to the best of his/her abilities will be given a higher priority in the public health care system compared to someone who chooses not to look after their health at all.
Forget about paying hefty premiums to private health insurance companies. It costs too much and you don't get much value from it (in fact, not many people will be able to afford it at the time the new radical health care system is implemented). Let the onus for protecting one's health lie squarely at the individual. It is time for the individual to take responsibility for his/her own health and society must abide by it. All society can do is provide advice and then let the individuals find ways to improve their health and live life to the full.
The radical change is tough for those who deliberately abuse their bodies and mind irrespective of the advice medical professionals provide them. Perhaps people do it because they want to be rich and/or enjoy life's pleasures, which is understandable in a modern life seen by many as stressful and somewhat unemotional. But if a person was told by a doctor that smoking will damage his/her lungs and yet fails to adhere to the advice and change their lifestyle, then treatment to repair the damaged lungs at some point in the future should be curtailed and the resources applied to other people who are willing to do the right thing.
But this will require doctors, the legal profession, and businesses to accept death as a natural medical solution under the new radical health care system just as much as saving people's lives is.
Euthanasia will have to be the cornerstone of the new radical health care system.
We now have the technology and knowledge about the human body to know what happens when we enter the moment of departing from our body and experiencing death. Death is not as bad as some religious people make it out to be, especially R-wing religious types who believe some people who support euthanasia will go to hell when they die. Nothing could be further from the truth. Death is the deepest form of meditation you can reach where you have no eyes to see and would therefore appear dark, but you sense the warmth and light around you. You are not cold and alone, but warm and feeling a part of the grander Universe just like when you close your eyes while sitting under a tree on a warm sunny day. You may not feel your legs and arms, but the freedom is different and more intense. It is something you have never experienced before. But getting to this state can be the hardest especially if there's the potential for pain to be involved.
Not anymore. Medical science has the knowledge and the technology to stop the pain, allowing people to die in a dignified way.
Death can be most dignified with no pain involved when in the hands of compassionate and caring health professionals rather than letting nature (or God in the words of religious people) do the job which we hope will be as peaceful as falling asleep if we look after our health, but could easily be a whole lot more painful, violent and/or take longer especially if we don't look after our health (eg. obesity leads to sudden heart attacks as one example). True, some people trained in the art of meditation can overcome pain to the point where it is possible to reach the moment of death. But not everyone is an expert in this field and there isn't time for enough people to learn. We have to be sensitive to the pain of others so we can act out of love the correct way to help these people.
There are religious types who disagree with this view. A classic example include the conservative Australian Federal (Howard) Government. But if religious people are so pro-life, then why does the Government pay so little to carers to look after everyone until the age of their natural death? Pro-life types should back up what they believe by paying people adequately to look after other people.
What makes it really bizarre is how society is prepared to send older people to 15 years jail to stop them importing illegal drugs that could end their lives in a dignified way such as Nebutal. But here's the irony: looking after someone in prison costs around $30,000 per year. Carers in the community are lucky to receive a fraction of this amount. In fact, most carers provide their services for free often at the detriment of their own health and surviving frugally with the person they are caring at home. If society is truly prepared to send older people to prison because this is what the law says just to stop them from ending their lives, why can't every carer get paid a salary of $30,000 per year to look after older people?
If we can't value carers enough to look after people properly by paying them for what they are genuinely worth in terms of the economic savings they are providing to the Governments of the day, it's a sad indictment of society and of the R-wing religious types who believe in pro-life according to their understanding of God.
Let's look at this from a more religious point-of-view.
God is meant to be loving, is he/she not?
When we look after ourselves and others, we hope God will be kind to us throughout life and at some point will let us die peacefully in our sleep. However at other times, whether through cancer or some genetic reason causing us to become obese or whatever, we may have to do the job ourselves on behalf of God. As Jesus Christ said, "Is it not written in the scriptures that you are gods?"
Don't play God when people want to live. And don't play God by assisting people to die. Make sure people have everything they need to be happy and live a fulfilling life, including the young who, if they are perfectly healthy, should never have to contemplate the issue of death. Life is too wonderful and great to be thrown away.
However, at some point, death will be inevitable and we know it because there is nothing science can do to help overcome death or even our own faith in God (irrespective of the story of the man being able to rise from the dead). If we can't afford to pay carers to do the job of looking after someone suffering in pain, then we must make the decision to help the person through the process in a painless and dignified way.
As the Apostle said, "These people are gods who come down disguised as him". It means everyone. We are all gods. The earth has been given to all life on earth. And we are the guardians of earth now that our knowledge and technology has reached a level capable of changing the world forever. So act like the sons and daughters of God by showing how much we love the people and all living things around us.
We follow God, or the truth of love, as closely as possible throughout life. We go to church, or make the world our church as we practice love. But the transition between life and death is something God and humankind can work together to ensure people do not have to suffer given the knowledge we now have. This is called love. Love is the fundamental law of the Universe for all living things.
We are never meant to be God as there can only be one God. Yet we have to be gods, or the sons or daughers of God, by helping God to bring love into this world through our knowledge in order to reduce the suffering we see around us. Incredibly we do it for our family pets without a word of disapproval from the religious types because somehow we all know it is a form of love, so why not do the same for people?
We are part of God. God's presence is within each one of us and in everything around us. We consult God by praying for a solution in our minds, talking to the people around us, and searching in our Universe for a solution that would hopefully solve the things that eventually lead us to our death. When all this is exhausted and there is nothing we can do, we must exercise our power to bestoy god-like acts as a sign of love so long as we align ourselves to the truth of God, which is love. Our actions must speak volumes of our love to all life on Earth.
If love means letting people have their wish to die as there is nothing we can do to help them, then do it. Or else get the priorities right by spending money on helping carers look after everyone else instead of on defence and other useless activities.
Hence in the new radical health care system, if we are genuine about the concept of love that we can allow people to decide how they wish to end their lives, then politicians — dare we say it, the R-wing christian types as well — will have to legislate that individuals facing the new radical health care system should be allowed to legally enforce any decision they make to ensure their own health is maintained and, if that is not possible, how they wish to die. If necessary, it should be legally written down somewhere to ensure the bitter debate between the traditional religious types and other people over a particular individual's medical condition such as what has occurred with Ms Terri Schiavo in the US in early 2005 don't rage and divide society as it has done.
In fact, by writing things down, you should not have to go through the suffering of starving to death as was the case with Mr Schiavo just because the legal system says any assistance by the hand of a compassionate doctor to shorten the life is an act of killing and traditional religious types say this is not God's will. And you also don't have people around Mr Schiavo suffer while he suffers until death.
If you decide certain medical conditions are so serious that the probability of survival is extremely remote and there is nothing society can do to help you (and even religious types with their faith can't be sure God can help you), a truly compassionate and loving society should be prepared to respect your wishes to die peacefully, painlessly and quickly without being forced to die a potentially long, painful and lingering death through the natural process because of a legal requirement or the view of certain religious types that it isn't "right". (5)
People create in their own minds their own religion about their likely purpose and meaning in life. And they must follow it because they believe it is right in the eyes of their own God as they understand it based on the principle of love. And while they have faith in their religion, there is a physical limit. As some point, people will know when their time comes to depart this world and move on.
Employers may decide how people should work and make a profit, governments may decide how people should pay their taxes, and traditional religious people may decide what is ethically the right thing to do for others in the eyes of their own God in which they understand it, but people must ultimately decide for themselves based on their own understanding of God how they wish to live and how they wish to die. You can only give so much advice. In the end, people must decide what it is they wish to do and it is up to us to respect those wishes as a form of love.
We should not interfere in the affairs of others.
So if the decision is to live and be healthy, then society must respect this decision no matter what. Thus a person who decides not to experience regular and stressful overtime work for people working for a profit-motivated employer which is leading to health problems, society should respect the decision and the employer must abide by it. This is especially true if a doctor says the work will lead to health problems and you choose to improve your health through reasonable health-related decisions, those decisions must be respected and legally enforceable. No employer should be able to sack you on the basis of your health decision.
This means further radical changes to the industrial-relations laws.
The funny thing about today's society is that it is prepared to legally enforce the right not to shorten a person's life for medical and/or religious reasons because it is seen as a form of killing another person. Yet society does not want to legally enforce the right for people to take any reasonable steps towards being healthy irrespective of the risk they could be sacked by their employers.
This attitude has to change.
The health issue has now become far too important for society to let employers, governments, and traditional R-wing religious types decide the future direction of everyone else in society through their focus on money, power or what some people think is ethical in the eyes of their own God all the time. Employers and all the individuals comprising our hopefully forward-thinking society must take responsibility to ensure themselves and everyone else are allowed to make their own decision about how to be healthy and fit or, when the time comes, how to die. Because a healthy individual (and a person that knows he/she is healthy without burdening the health care system) is a healthy society.
And a healthy society is truly the lowest cost and happiest society in the world.
Only then, when the individual and society are healthy and when the population is properly capped and made sustainable once again, can we afford to look after the health of everyone no matter what we do in this Universe. But until then, while the health system in its current form is in crisis (or will return to a crisis situation soon despite the efficiency methods), we have to make important changes to society and the economy now or face the harsh decisions that will come when the new radical health care system takes over at a critical time.
We have no choice in the matter.
