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The National Health and Hospital Reform Commission report for Australia is based on three important tenets that in a nut shell summarizes the findings and recommendations of the report. It seeks to address the traditional underlying health services inequality among the citizens. Realign the national health programs in a way that would best tackle present challenges and agitate health sector growth and reforms in the private sector as well (Bennet, 2009). The commission report is a culmination of other two reports that were done earlier.
In general the hallmarks of any health reform policy should include four basic concepts. One it should seek to increase health care coverage area by diversifying the range of services that are offered by both the public and private sector. Two, an effective health care policy should encourage market growth by inviting private and other stakeholders within the industry in order to match population demand. Three, It should facilitate training of healthcare practitioners in all major disciplines so as to prevent a short fall of health professionals. Finally a very important feature of a health reform plan pertains to it cost (Holvorson, 2009).
Health care services should be affordable to majority of the population, thus it cost should be as low as possible without compromising in anyway its health services quality (Taylor, 2003). Underlying all these ideal features of an effective health reform is the cost. Ultimately the cost and funding that goes towards implementing and financing a workable healthcare plan very much determines if the healthcare plan would be successful.
Australia Health Care Reform Policies
The National Health and Hospital Reform Commission report summarizes a list of not less than one hundred recommendations from the public and stakeholders (Bennet, 2009). The recommendations so far compiled seek to introduce new aspects to the current health care plan as well as change others. The recommendations that the commission has put forth will require over whole in the way the current health care is being done in Australia. The National Health and Hospital Reform report has therefore come up with three key areas that must be addressed by the new health care system.
Foremost the health care plan should tackle the factors that hinder free access to healthcare by the majority of the population, in doing so it must also address healthcare inequality in the current healthcare system. Secondly, the healthcare plans should consider current emerging issues and challenges that which it must incorporate within it frameworks. And finally the healthcare plan should strive to come up with a system that would meet the needs of the peoples in every possible way (Bennet, 2009). These three aspirations are the tenets of a model of a healthcare plan that dictated the way that Australia healthcare reforms were approached, and which are also used widely elsewhere in the world to design healthcare reforms (Garey, and Lorber, 2008). More importantly they acted as the values that the new healthcare system will uphold.
One of the many recommendations that the commission made to the government regarding the Australian healthcare reform is contained within the Healthy Australian Accord (Bennet, 2009).
This accord is a combination of several recommendations that pertains to healthcare funding responsibilities within the government. Healthy Australia Accord specifically defines the role that each government institution must play to implement the healthcare system (Bennet, 2009). It focus is on funding and it outlines in details the funding obligations between the federal government and the state.
The approach that the accord has taken in this regard is a system where both the commonwealth government and the state must contribute towards financing the healthcare reforms. In these arrangement healthcare services funding has been shifted to the commonwealth government for implementation as well as funding. The healthy Australian Accord clearly identifies the health sectors that the commonwealth government is accountable for, i.e. primary health care, elderly care, dental care and financing health care for Torres Straight Island residents as well as the Aboriginal people (Bennet, 2009).
In addition the commonwealth would provide full funds required to finance these sectors contained within the Australian healthcare reforms. Another point that the Healthy Australian Accord covers regards public hospitals and healthcare services. Towards this end the commonwealth government is also required to take up responsibilities for financing healthcare services and hospitals as well (Bennet, 2009). The accord suggests that the commonwealth government should consider carrying out reductions in grants or funding towards other agencies within the state so as to meet these financial obligations.
Besides this the accord major suggestion requires that the healthcare system be revised in such a way that would consolidate healthcare services within a central location.
The idea therefore is a "one health system" that is financed and managed from a central point of location which is nationally, that applies devolution model of healthcare services to the grassroots level. The Healthy Australian Accord will be our major focus in this paper which we shall analyze in details so as to us understand the benefits and the challenges that implementation of the accord would mean.
We shall also examine other implications that the accord presents in its recommendation and how it relates with other policies contained in the report. In order to understand the recommendations as outlined within the Healthy Australian Accord let us briefly examine the Australian government structure: particularly the commonwealth government and the state. While keeping in mind that the accord mainly seeks to transfer control and implementation of healthcare reform to the federal government. We shall also identify the traditional roles that each level of government namely, commonwealth government and the state has always undertaken.
Australian government structure is made up of three levels, the federal government also commonly referred as the commonwealth government, the state and the local government (Our Government, 2009). There is usually a fourth level referred as the territory government which is regarded as special form of state. Basically Australia is governed from two levels the federal governments and at the state levels, between these two governments the Australian constitution accord them equal powers.
Commonwealth government is the central level of the Australian government and is considered the level where the most power are vested (Quartly, 2002). It is the level that controls the three vital arms of any government i.e the legislature, executive and judiciary.
The federal government is responsible for implementing national policies and in passing directives for the entire nation. The authority of the federal government is not limited by the state boundaries but applies to every citizen. However state government powers are defined by the states boundaries. It is a form of power devolution from the central federal government to the state level.
There are a total of six states within Australia each run by the presiding state authorities. In many instances states are allowed to enforce laws within their jurisdictions that are different from those of the federal government, on condition that the laws to do not in any way contradict the federal laws (Quartly, 2002). The state level three arms of governance, judiciary executive and legislature must draft laws that are in line with federal laws. Between the three levels the federal government has more funds and more clout in all matters that pertains to governance and policies. Needless to say the commonwealth government would be more effective in implementing policies that are of national importance such as the Australian health care reforms plan, for many good reasons.
According to recommendation written on the Healthy Australian Accord the federal government is to pay full cost towards outpatient in all public hospitals up to a certain figure that is preset for each hospital facility. It should also meet 40% of the cost for all hospital admission that occurs at public hospitals (Bennet, 2009). With time the accord suggest that the federal government should move towards acquiring and controlling all public hospitals and thereby also meet the full costs of patient admissions in public hospitals as well (Bennet, 2009).
Indeed the accord has gone a long way towards putting the healthcare reforms implementation and funding squarely in the door of the federal government and I believe for good reasons. Health care financing is traditionally undertaken by both the commonwealth government and the state. In this arrangement each partner has always contributed undefined amounts that went towards healthcare financing that varied each time. Therefore long term plans on healthcare services cannot be undertaken since future budget is impossible to be accurately quantified or even relied upon.
The results are that healthcare services budget keeps shifting now and then so as to meet the available funds each season. The accord addressed this challenge by having the federal government commit to predefined regular funds which will allow long term healthcare plans to be implemented since resources can be guaranteed in advance (Bennet, 2009). The main advantage of having a central form of a healthcare reform policy is that national wide healthcare reforms can be achieved rapidly through implementation of directives that cut across the healthcare board.
More importantly it enables coordinated healthcare reforms that are in tandem with every other state within the country. This way upgrading of let's say, hospital facilities and training institutions is done uniformly in every part of the country because each state or hospital institution is given equal amount of funding. Besides the healthcare reform within the country is systematic for all states in the manner that priority sectors are first addressed before next sector of health care reform is agreed upon. Transferring health care reforms to Federal government would also mean that healthcare programs would be implemented directly from the central level.
This would require the government to invest in human resource to manage the broad array of services that makes up healthcare system. Meaning the federal government would not pay a casual interest to healthcare services as it has usually done when only funds were necessary to disburse. Increased participation by the federal government would therefore translate to quality healthcare programs and services. In shifting the health care funding, the Healthy Australian Accord would put to rest a dance in circles that has gone on for far too long between the commonwealth government and the state, at the same time it will reduce the bureaucracy within the health sector.
Essentially what happens is that commonwealth government disburses money to all states that are earmarked to be used for various projects. The state government after receiving the money goes on and funds its various projects with the funds including healthcare programs (Bennet, 2009). If the federal government was to inject this fund directly to existing healthcare projects, would mean reducing the time taken and the cost in terms of human resource that goes towards funds distribution. The other point is that this funds that are given to states as grants are usually surrounded by controversy.
The state government usually funds the priority projects using the money since it is never enough, in doing so states generally omit covering patients care services which is left to the federal government, in what the commonwealth governments claim to be covering through the allocated state grants (Bennet, 2009). And this is not the only problem that arises out of this arrangement federal government claims that the state's healthcare services are not up to the task and therefore the patients most of the times get referred to commonwealth funded hospitals.
This ends up undermining the logic behind the whole arrangement where the idea is to diversify and decongest federal healthcare institutions through strengthening the state health facilities through grants.
If the current healthcare system seems ineffective and underfunded then it is equally confused and uncoordinated. There are no clear guidelines that exist which can be referred to by the partners which would outline the functions of each government in providing healthcare. The health care structure itself is confusing as well and patient including other people in general have no idea which government level is supposed to provide what services. Therefore it becomes hard for the people to petition the state or the commonwealth government to provide quality healthcare since both stakeholders would just shift keep shifting the healthcare responsibilities.
This arrangement also means there is no sense of leadership within the sector due to the fact that healthcare institutions are so much defragmented without any form of consolidation (Evans and Gil-Soo, 2006). In the same way the healthcare sector management is not defined in any way since healthcare services are not run from a central point. Lack of central management of healthcare services also results to similar programs being implemented by different actors in the sector that are waste of taxpayers' money (Miller, Vandome, and McBrewster, 2009).
However in the same way that centralizing healthcare reforms implementation has its advantages, then the existing healthcare system has its advantages, but it benefits have been far outstripped by its drawbacks.
Among its advantages is the fact that two sources of funding are important since one source can step in for the other in case of shortfalls (Gee, 1994). However federal funding of healthcare services would certainly provide enough finances to ensure the reforms are implemented undisrupted. Besides federal funds are more stable than state sources since it has the capacity to seek loans from international monetary institutions in case of any shortfalls. Perhaps, the only advantage that the current healthcare system has is in the way that it can be customized to meet the unique aspects of it residents. Nevertheless, the benefits of seceding healthcare services to central government have many advantages and are the practice in many countries worldwide.
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