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To The Polls

by | May 6, 2019 | Future Health, Health Care Costs, Personal Responsibility, Public Health, Screening, The Practice of Medicine | 2 comments

It's only fair to share…

Australia is about to go to the polls and as usual health is a “hot topic”. The turnover of prime ministers here has caused some bemusement. For those reading overseas, Australia does not elect its prime minister. To that extent we follow the UK system where the leader is elected by the party which has the most seats in the lower house. However, the terminology is like congress in the USA with a house of representatives and senate. And just to muddy things further, elections have increasingly become “Presidential” with focus on the leader rather than policies of the party.

In terms of health systems, we also sit somewhere between the USA and UK in that Australia has a balance of private and public without veering too far to either end. In fact, the system works best when the two work synergistically enabling the public system to cater for those unable to support themselves whilst those who can, get out of the public queue.

Last election we had the bizarre “mediscare” campaign where it was claimed that the government insurer (Medicare) would be privatised. Thinking about that for even one minute would reveal that such a move was impossible. Nobody and nothing would buy an entity where revenue covers only 15% of costs and costs are uncapped.

This time we are seeing a more conventional spendathon where parties vie to see who can throw the most money at the system. Much of the money is being directed at cancer treatments and diagnostics. This has merit but also serves to remind us that we have a disease system rather than a health system.

It is a lot more expensive to treat cancer, or heart disease or type two diabetes than to prevent them. Of course, there are no force fields so prevention is not absolute, but numbers could be reduced. Apart from cost savings to the system, there is massive human benefit if people are well rather than unwell.

The public health lobby argues for more funding. Yet most of this goes on “awareness campaigns telling people what they already know, in the case of not smoking or giving unhelpful information in the case of diet.

We saw both the health and shadow health ministers tell a press club function that they would continue to oppose vaping as tobacco harm reduction. This is in the face of clear international evidence that enabling smokers to switch to a 95% less harmful option can reduce the death and disease toll from smoking. This news was welcomed by the cancer council – go figure.

Regular readers will know the problems with dietary advice and the ongoing promotion of  low fat foods. The dietary advice coming from public health is not only not helpful, it has largely contributed to the problems of obesity and type two diabetes we see today. The health star system, like the tick before it, have been abject failures.

The disease system, like all insurance systems is about covering cost when things break down. Much like your home insurance will not cover general maintenance nor car insurance cover petrol (gasoline) disease insurance and the system will not help you be healthy.

So, what is the individual to do. Ultimately the solution is to be in charge of your own health. This is not as hard as it is claimed to be. Follow the eight pillars of health. Get fresh air and sunshine, drink mainly water, eat real food, be active, get adequate sleep, manage your stress and have relaxation time, maintain good relationships and have some fun and purpose in your life.

No political party can ever deliver this but you can!