Today I attended an interesting lunchtime discussion (organised by the Melbourne Institute) with presentations by Peter Allen , a Victorian Government public official and Richard Scotton, recently retired from the Health Economics Unit at Monash. (An introductory talk by Anthony Scott on British Health sector reforms I found uninteresting).
Several interesting issues stood out. Scotton pointed out that Australia spent 5% of GDP on health in 1961 and that Commonwealth Treasury projects we will spend about 15% in 2050, about the proportion the US currently spends. Moreover although we don’t spend as much as the US our health gains have been substantial. Over the past 40 years, 50 year olds – men and women – have gained an average of about 7 extra years of life. Even ignoring lifestyle improvements through the associated improved health, this is a big gain.
Scotton out that the success of these health efforts meant that people would live longer which would increase health costs through aging. He advocated market-based reforms of the health system but was not specific.
Allen was an interesting bureaucrat who gave a good perspective of current politics. He talked about the National Reform Agenda (NRA) on health and the role of COAG. He supported Scotton by pointing out Australia had the second lowest mortality in the OECD. A major difficulty, he suggested, was in indigenous health which is improving but by less than the improvement of others – the gap between non-aboriginals and others is increasing. There are also worse health outcomes for the poor – health varies with socioeconomic status. Ok, all this is obvious but worth making explicit.
Allen pointed out the increasing role of chronic diseases (asthma, cardiovascular, cancer, diabetes, mental, neurological) often treated using community rather than hospital care.
The NRA recognised the correlation between health status and work participation and essentially saw health care as an investment rather than a maintenance cost. Thus workforce participation can be boosted by improving health.