Australian Social Policy - Literature review Example

Heading: Australian Social Policy Your name: Course name: Professors’ name: Date Introduction Australia has various social policies some of which include education, health, employment, and family. The focus of the paper is on the Australian health policy, which is one of the largest concerns of the government. The policy seeks to provide universal, quality, affordable, accessible, equitable, responsive, coherent, and flexible health services to all Australian citizens. Additionally, the paper intends to provide an overview of the policy, and to examine key policy issues. Lastly, it seeks to evaluate the policy in its historical, political, and social context, as well as the government responses to the policy issues. Identification and overview of the policy The social policy focused in this paper is the Australia health policy. According to the Center for Policy Development (2007), the policy encourages the state and federal ministers, as well as their departments to move to a universal, single insurer. It also campaigns for emphasis on program delivery in basic healthcare centers that provide integrated variety of services, as well as engaging citizens in healthcare to check the powerful service providers’ lobbies. Additionally, it supports the rationalization of user reimbursements, and the attainment of efficiency and equity in resource allocation. Furthermore, it calls for them to offer and fund serviced based on therapeutic needs. It also calls for retention of Commonwealth responsibility of financing and standard setting, as well as focusing on ministerial concern on health instead of healthcare. The policy also advocates for organizing healthcare plans around the users’ needs. The policy has a number of principles including universal, coherent, flexible, equitable allocatively efficient, technically efficient, responsive, and designed subsidiarity basis (Barraclough, 2007). Issues of Australian Health Policy Australian health policy stakeholders have various issues that the health policy should address. To start with, they advocate for health for the indigenous Australians. Some of the problems faced by these individuals include domestic violence, substance dependence, diet, lifestyle-related illnesses, and inaccessibility of primary care. A large group of indigenous people, especially in the rural areas requires high-cost hospital care with related incomplete or slow recovery, infection risk, or separation. However, lower-cost and timely primary care would help in the avoidance of hospitalization (McAuley & Menadue, 2007). Secondly, Center for Policy Development (2007) says that stakeholders require the health policy to handle the mental health of the people in the country. Here, some of the common problems include lack of incorporation among service providers, such as, private psychologists, emergency wards, psychiatrists, and mental health crisis groups. Another challenge regards little understanding of mental health by a majority of the medical professionals, as well as unavailability of Medicare funding for several important services. In as much as Commonwealth handles these issues, it is crucial to take more measures. Another issue of the Australian social policy relates to access, affordability, and equity. These problems are closely related, but distinct. In terms of access, problems relate to waiting periods for elective processes. This is an issue of access from user’s point of view, but a workforce concern from the system’s perspective. When some individuals experience easy access as compared to others, an issue of inequity arises. For the people requiring high service levels, the quality and suitability of the care may be subject to the personal inclination of general practitioners, who, via their referrals, are caretakers of medical services, and who possess a logical standpoint towards healthcare therapies. In terms of affordability issues, a common problem involves the difficulty of getting bulk-billing practitioners and the prescription and non-prescription costs of pharmaceuticals. The ones with high-cover personal insurance attain free access to dental and other subsidiary medical services, whereas those with their taxes subsidizing personal insurance depend on their own resources to attain the services (Center for Policy Development, 2007). Another main issue of the policy involves complexity of services. This implies that there are various eligibility means for distinct government plans. Healthcare and aged care plans have artificial and sharp demarcations. There are conditions to obtain access to particular services via distinct avenues. Various service providers have varying records; hence, misinformation. Complexity yields delayed treatments, and thus, unnecessary events of adverse conditions developing prior treatment (McAuley & Menadue, 2007). In addition, perverse incentives amount to another concern of the Australian health policy. There are many incidences related to these including the design of the Medical Benefits Scheme reimbursements that encourage short consultations and procedures more than other services. There is also little Medicare coverage of health services like psychology and physiotherapy, as well as general motivation to offer insured and high cost services instead of uninsured and low-cost services. The policy also seeks to address matters of safety and quality. This is because of the high degree of stoppable morbidity and death, especially in the hospitals, due to lack of incorporation between service providers and utilization of obsolete information management. Some experts worry about the low and inconsistent quality in medical services (Center for Policy Development, 2007). The policy also advocates for work practices and efficiency in the health systems. Most of the people that deliver direct services especially in the hospitals mention poor management, rigid work arrangements, unnecessary bureaucratic conditions, unreliable and primitive record systems, overall poor utilization of information technology, and inflexible demarcation matters, as a major cause of ineffectiveness. These issues are unlimited to public or private but many result from lack incorporation between various service providers. Other issues addressed by the policy include lasting cost pressures, imbalanced resources, unsuitable program structure, politicization, lack of coordination or incorporation between programs, work dissatisfaction and pressure, and wide labor force issues among others (McAuley & Menadue, 2007). Evaluation of the Australian health policy within historical, political, and social context Health policy is among Australia’s most contentious political subjects and has been a critical at each Commonwealth elections ever since 1940s. The key reason for the controversy is that main stakeholders have conflicting and varied interests. Health providers need huge income and profits, consumers want to able to get quality services at a reasonable price and governments need to keep control concerning the money they spend. Since it is impossible to achieve these goals at once and this reality causes serious conflicts (Gray, 2005). In addition, there is a powerful ideological cleavage (liberal party), and the coalition partner (National Party), have usually taken a liberal individualist position, favoring least government involvement in health policy, with a big role for private insurance and private medicine. On the contrary, the Australian Labor Party recently took a social liberal stance, asserting that health needs public funding in order to attain equity and access objectives. The Australian policy oscillation pattern between private and public insurance systems is distinctive among OECD nations and motivated by political party contest (Gray, 2005). According to Gray (2005), health is the leading industry in Australia, over five times bigger than defense, and it provides opportunities for an immense financial benefit. According to the Australian Institute of Health and Welfare statistics, health spent 9.5% of GDP between 2002 and 2003, 1% more than the average of OECD. Additionally, health care costs have a tendency to multiply faster as compared to other prices, largely because of the introduction of modern technologies and enhanced utilization. Different from the usual assertion, the old populations has little influence. Governments that are liable for huge percentage of expenses in the OECD nations, thus, look for ways of moderating health inflation. Private providers of healthcare, as well as health professionals seem to defy restrictions on their money in order to oppose government attempts to restrict the rising expenditure, unless they get other ways ensuring that customers make for the loss through copayments or private insurance premiums (Willis, Reynolds, & Keleher, 2009). Nevertheless, Gray (2005) maintains that the challenge with the private insurance premiums and the copayments entails the flat rate levies; hence, not considering the potential to pay. These payments cause hardship to the low-income individuals; hence, creating financial obstacles to access, as well as defeating the reason for which the governments engage in health systems. In 1940s, health funding became a serious political matter when the Commonwealth initially got in the field. The initiation of a prepaid hospital system took place in 1946 under the Chifley Labor government, but efforts to initiate modern health service were unsuccessful due to lack of cooperation by the medical profession. The incoming government of Menzies neglected the prepaid hospital system and started a publicly subsidized personal health insurance in 1950s. This plan faced serious criticism due to its expense, complexity, high user charges, as well as lack of coverage. In its response, the Labor created plans for national health insurance system known as Medibank, introduced by the Whitlam government in 1975. Nonetheless, Fraser Coalition government dissolved Medibank, and the voluntary health insurance plan replaced it (Gray, 2005). As Gray (2005) says, in 1983, Labor initiated a national health insurance plan called Medicare that started its operations in February 1, 1984. The Health Insurance Commission has the responsibility of administering the new insurance plan. The plan is beneficial in the provision of the prepaid health services to all Australian citizens and compensation at 85% of the program charges for out-of-hospital healthcare services. This implies that if medical professionals decide to bulk-bill, then there are no patient charges during services. The new plan also offers repayment of 75% of the agenda charges for medical services given to private patients. Territories, states, and Commonwealth share the cost of the scheme, the Australian Health Care Agreements governs the arrangement, and negotiations take place after five years (Baeza, Bailie, & Lewis, 2009). It is worth noting that during the initial 12 years, there was no controversy regarding Medicare operations. The number of persons with private insurance slowly decreased to 30.6% in 1998, when people started relying on the already established system (Baeza, Bailie, & Lewis, 2009). At the same time, bulk billing slowly increased and thus enhancing accessibility for most of the populations. As the GDP ratio, there were considerably stable medical services. In fact, the private sector had interests to check the reduction of private insurance, but the Labor government did not respond; hence, allowing Medicare to reinforce its stance as the common insurer. Even though personal insurance coverage reduced then, there was a considerable increase in work proportion. However, there was a massive change due to Howard government’s election during 1996. Even though the Liberal Party promised to uphold Medicare as a whole during campaigns, it proceeded to enforce a plan similar to the Fightback! Privatization plans that the 1993 electorate initially declined. The effective health policy in the country was the Lifetime Health Cover that enables personal insurance agencies to compel a surcharge on individuals aged over 30 years and have no personal insurance. Many people believe that fear instead of financial computation facilitated the effectiveness of the policy, as people feared that lack of insurance cover would make their hospital inaccessibility impossible (Gray, 2005). Later, controversies concerning the Lifetime Health Cover led to the introduction of another policy called the Medicare Plus. This plan’s has features including higher compensations and safety nets for doctors that bulk-bill children and concession cardholders. Imperatively, the Australian health system experiences certain challenges in the short term. Firstly, the effect of the user charges that in spite of safety nets, implies that low-income individuals citizens will constantly use inadequate services as compared to the required amount. For safety nets to be operational, Australians should have a lot of money, and money for pharmaceuticals (Palmer & Short, 2000). Secondly, there is challenge of a constant health inflation facing the Australian health system. According to the International Studies, single payer systems are more efficient in the control of medical costs and the country recently changed to a multiplayer plan. One of the concerns of health inflation involves the fact that the governments seem to react by transferring costs to consumers in form of user charges, and thus worsening the access problems. Thirdly, the Australian health system faces a challenge of acute shortage of health services and professionals in the rural parts of the country. The fourth problem with Australian Health sector regards the Pharmaceutical Benefits Scheme sustainability, which is a primary building obstacle to the health system. Many analysts assert that the government free trade consent and undermines the scheme (Gray, 2005). Internationally, the main long-term limitation to present health systems entails the means of ensuring that quality services are accessible to all citizens at low price. One of the privatization policies of the Howard government entails the 30% taxpayer financed personal insurance rebate, criticized by a variety of health professionals like Butler, Davoren, and Richardson. Some of the suggestions to improve this include introducing mechanisms of enhancing quality and reducing serious events, and thorough assessment of technologies and treatments. It is also imperative to have enhanced population health measures and basic medical services in order to prevent illnesses (Dugdale, 2008). Conclusion In Australia, one of the most important areas of the social policy entails health. In fact, health is the leading industry in the country, with both private and public institutions offering healthcare. The Australian health policy advocates for universal, responsive, equitable, affordable, efficient, coherent, and flexible medical services to all citizens. This implies that it advocates for effective, equal, and affordable health services to all people in the country, regardless of their diversities. Additionally, the policy is not without problems, and these include health fluctuation, politicization, as well shortage of health resources and professionals among others. Therefore, the government should introduce mechanisms of enhancing quality and reducing serious events, and thorough assessment of technologies and treatments. It should also enhance population health measures and basic medical services in order to check illnesses. References Barraclough, S. (2007). Analysing health policy: a problem-oriented approach. Marrickville, N.S.W: Elsevier. Pp. 1-50 Baeza, J., Bailie, R., Lewis, J.M. (2009). Care for chronic conditions for indigenous Australians: Key informants’ perspectives on policy. Health Policy, 92 (2–3), 211-217 Center for Policy Development, C.P.D. (2007). A Health Policy for Australia: reclaiming universal care. Retrieved on August 3, 2012 from http://cpd.org.au/2007/04/a-health- policy-for-australia-reclaiming-universal-care/ Dugdale, P. (2008). Doing health policy in Australia. Crows Nest, N.S.W: Allen & Unwin. Pp. 15-60. Gray, G. (2005). Health policy in Australia. APO.org.au. Retrieved in August 3, 2012 from McAuley, I. & Menadue, J. (2007). A health policy for Australia; reclaiming universal health care. Pp. 1-25. http://cpd.org.au/wp- content/uploads/2007/04/AHPFA_CPD_smallfile_0.pdf Mooney, G. (2000). Economics and Australian health policy. St Leonards, NSW, Australia: Allen & Unwin. Pp. 1-20. Palmer, G. & Short, S. (2000). Health Care and Public Policy. South Melbourne: Macmillan Education Australia. Pp. 1-30. Willis, E., Reynolds, L. & Keleher, H. (2009). Understanding the Australian Health Care System. Philadelphia: Churchill Livingstone/Elsevier. Pp. 130-150. Read More