The Australian healthcare system is complex, loosely organized, and technically sophisticated. However, the task of health reform in Australia has always been slow and grueling. Even so, the country has undergone numerous health reforms since the 1970s. This paper will highlight some of the major reform efforts made to Australia's health system including the impressive figures who drove these initiatives.
In 1972, Gough Whitlam's Labor government pressed for a national healthcare system of which it named Medibank. This initiative was meant to offer free public hospital care and to fund other medical services. The Liberal party, however, attempted to block the implementation of the Medibank bill, but the Australian constitution forced the two parties to develop joint legislation. The Medibank bill was passed in 1974, but it still sparked a lot of controversies. The Australian Medical Association encouraged doctors to hike their rates which created a widening gap between the doctor's fees and Medibank reimbursement. The result was widening deficits that led to a financial crisis (Boxall & Gillespie, 2013). The Labor government was voted out in 1975 due to voter concerns about the economy.
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The Fraser government took over and constantly undercut the Medibank legislation by reforming it. The government decided to levy tax on this system, although individuals who bought private insurance were exempted from paying the tax. In April 1981, the Medibank legislation was repealed. The Fraser government was criticized over its health insurance policies because they did not have any consistent or coherent objectives. Two years later Bob Hawke came into power and wasted no time to restore the national health insurance system, dubbed Medicare. This time the government ensured it backed the program with a levy on the income tax. The Medicare legislation sailed through smoothly that the Howard government which came into power in 1996 did not attempt to undermine the program. Howard made several reforms many of which were meant to restore the role of the private sector in the healthcare system. The Medicare levy surcharge was implemented in 1997 and later in 1999 the Insurance Rebate Scheme was initiated.
The next significant reforms in the Australian healthcare system came after 2007. The Australian health system had been experiencing significant challenges during the years leading to 2007. The Rudd labor government expressed its intention to execute significant structural changes to Australia’s healthcare system. By April 2008, the government had established the National Health and Hospitals Reform Commission to offer counsel on a long-term strategy (Bennett, 2013). In April 2010, the Australian government signed the National Health and Hospitals Network Agreement which involved all state, territory and federal governments, except for Western Australia. Another much-anticipated reform made was the creation of the Australian National Preventive Health Agency in 2011. This program focused on effectively preventing tobacco use, obesity, and excessive consumption of alcohol. The government also made an effort to establish new channels for public reporting on the status and performance of the healthcare system to inform the public and policymakers. In conformity with the National Health Reform Agreement, every state in Australia enforced stronger devolution of governance to local hospital networks. For the first time since 2001, the Turnbull government made reforms to private health insurance that increased the maximum excess consumers could choose under their health insurance policies (García-Goñi, Fouda, Calder, & Paolucci, 2018). This would allow many consumers to diminish their premium increase by 2019.
The Australian healthcare system has undergone numerous reforms, but still, major challenges remain. The healthcare system is plagued with significant structural weaknesses in governance and funding that continue to undermine health care delivery in the country. A lot of effort still needs to be made to reform the Australian healthcare system. This will only be made possible by good political leadership and active collaboration with the community and healthcare sector.
References
Bennett, C. C. (2013). Are we there yet? A journey of health reform in Australia. The Medical Journal of Australia, 199, 4, 251-255.
García-Goñi, M., Fouda, A., Calder, R. V., & Paolucci, F. (2018). A new funding model for a chronic-care focused healthcare system in Australia. Health Policy and Technology, 7, 3, 293-301.
Boxall, A.-M., & Gillespie, J. (2013). Making Medicare: The politics of universal health care in Australia . Sydney, NSW: UNSW Press.
