Australian Social Policy: Health
Australian Healthcare Policy: Fluctuations between Private and Public Systems
In Australia, one of the most politically divisive and publically discussed social policy domains is that of health. It has been an issue under discussion by political candidates at each Commonwealth election over the past seventy years due to the politically engrained differences in how the political parties have conceptualized managing the Australian healthcare system. These political divisions are in addition to the stakeholder positions that are usual to any healthcare system, with patient, provider, research, and insurance interests often having vastly different goals and motivations. Health policy in Australia is indeed reflective of the plurality of political parties and ideologies core to the Commonwealth's legislature (Gray 2003). The political tensions around health are no small matter, either, with the healthcare industry being the largest industry in the Commonwealth (Duckett 1999).
In light of the political fluctuations and their impact upon policy development and change, a key resource for understanding the priorities and activities of the Australian government's health initiatives is through the Australian Institute of Health and Welfare, which publishes over 100 policy and action briefings each year (Australian Institute of Health and Welfare 2011). Issues of access have remained central to the concerns of the nonpartisan Institute of Health and Welfare which handles public health, medical health, medical economics, bioethics, and health management aspects of the Commonwealth's policy and action plan. One of the main subsections of the Institute's website covers the issues of "Services, workforce, and spending" within the Commonwealth's health plan and policy (Australian Institute of Health and Welfare 2011). In a report published in 2010, the Australian Government reported the following long-term trends with regard to per capita health expenditure (this should be seen as distinct from reporting on public health expenditure):
"Australia has been one of the first countries to adopt a newly developed international standard, the System of National Accounts 2008. The new System has increased the scope of production activities included in the measurement of GDP. The changes have increased the size of Australia's GDP, which has had the effect of reducing Australia's health to GDP ratio, particularly in comparison with other countries that have not yet adopted the new standard. Health expenditure grew from $48.4 billion (7.8% of GDP) in 1998-99 to $112.8 billion (9.0% of GDP) in 2008-09. In 2008-09 prices, this was a change from $66.5 billion in 1998-99 to $112.8 billion in 2008-09. (Australian Government 2010)"
These trends in Australian per capita health expenditure reflect that despite political tensions surrounding how much the Australian government 'should' be spending on per capital healthcare-related costs, the rate of expenditure nearly doubled in the decade between 1999 and 2009. This period of time saw a great deal of change and fluctuation in Australian healthcare policy, starting with a series of revisions to the Medicare policy and culminating in Australia's response to the global recession and rising healthcare costs. The historical context of the political fluctuations within Australia and its impact upon the healthcare infrastructure and the policies of which is comprised is essential to the understanding of how the healthcare industry has become the largest and most controversial industry in the Commonwealth.
The Australian Labour Party has been the face of nationalized social medicine policy in the past several decades, operating from a perspective that healthcare is a protected right, for which the government is obligated to provide basic access. The platform position of the Australian Labour Party has been that publically funded healthcare is central to ensuring equitable access for all Australians. The other end of the political spectrum is represented in the Australian Liberal and National Parties, which function as a coalition with regards to healthcare policy position. The coalition favors a more libertarian stance on health policy development in Australia that minimizes the public sector in favor of privatized care (Palmer and Short 2007). The political pendulum has swung between these political parties and their respective political agendas, often influenced by social, cultural, and particularly economic factors. The resulting pattern of Australian healthcare policy reflects multiple changes in direction from a philosophical perspective, with social benefits related to healthcare coverage having changed multiple times in the past several decades (Gray 2003).
A chief example of the oscillation of Australian healthcare policy development is historically situated in the early postwar era. When a national hospital system was created in 1946, it collapsed with a lack of participation from Australian healthcare providers. By the early 1950s, with a new, more conservative administration...
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