If you want to understand the world's most powerful industry, then find people strong enough to tell you the truth

Here are four health industry experts that you may not even know about, who tackle the tough issues that lazy bureaucratics and career politicians often avoid

Healthcare is one of life's' essentials. It's as basic as power, the internet, transport and banking. Yet despite swinging between public control and private outsourcing, costs continue to soar, technology is resisted, hospitals remain in the 19th Century.

How do we bring this vital but archaic industry into the modern world?

Start by reading the works of these tough talking experts.

Jeremy Sammut

A research fellow at the Centre of Independent Studies (Sydney, Australia) where he has written extensively about ageing, technology and the sustainability of Australia's current health system.

He discusses wasting health dollars by the billions, bureaucratic roadblocks to reform and the dangers of promoting health services as being 'free' instead of a valued resource to protect.

Since the turn of the century, real combined federal, state and territory government spending on health (adjusted for inflation) has increased by 80%...

In 2010, 13.5% of the population was aged over 65; by 2050, this proportion will increase to 22.6%...

Almost $1 in $10 in the economy each year is now spent on health, and 70% of these health dollars are locked up in the inefficient public health system...

Bureaucratically-run public hospitals are not under-funded: The real problem is that current funding and administrative arrangements permit vast sums of taxpayer dollars to be wasted paying for bureaucrats rather than for beds.

...chronic disese is...responsible for 80% of the total disease burden... Projections suggest that by 2020 the rising cost of treating chronic disease will consume 80% of total health spending.

Medi-Mess: Rational Federalism and Patient Cost-Sharing for Public Hospital Sustainability in Australia

Saving Medicare But NOT As We Know It

The Future of Medicare: Health Innovation in 21st Century Australia

Real Choice for Ageing Australians: Achieving the Benefits of the Consumer-Directed Aged Care Reforms in the New Economy

MEDI-VATION: ‘Health Innovation Communities’ for Medicare Payment and Service Reform

MEDI-VALUE: Health Insurance and Service Innovation in Australia - Implications for the Future of Medicare

Health Innovation

How! Not How Much: Medicare Spending and Health Resource Allocation in Australia

Politically-Feasible Health Reform: Whatever Will It Take?

Lessons from Singapore: Opt-Out Health Savings Accounts for Australia

The False Promise of GP Super Clinics: Part 1: Preventive Care

The False Promise of GP Super Clinics Part 2: Coordinated Care

Why Public Hospitals Are Overcrowded: Ten Points for Policymakers

No Quick Fix: Three Essays on the Future of the Australian Hospital System


Stephen Duckett

An economist, Fellow of the Australian Academy of Health and Medical Sciences, program director for the Gratten Institute.

Like Jeremy, Stephen is blunt about wasting up to one third of the health budget on unnecessary tests and treatments, red tape and an over emphasis on hospitals, at the expense of cheaper community care.

Private health insurance premiums could be cut by up to 10 per cent if private hospitals were made more efficient and stopped over-servicing.

Over-regulation has created a complacent (health insurence) industry that is over-reliant on direct or indirect taxpayer subsidies.

Australia could save $1.5 billion a year on health spending by improving the safety of patient care in hospitals.

Seventy per cent of Australians want to die at home yet only 14 per cent do so... Dying in Australia is more institutionalised than in most countries.

Australia’s Pharmaceutical Benefits Scheme pays at least $1.3 billion a year too much for prescription drugs.

Saving private health 1: reining in hospital costs and specialist bills - Report
Private health insurance premiums could be cut by up to 10% if private hospitals were made more efficient.

Saving private health 2: Making private health insurance viable - Grattan Institute
The only way that private hospital insurance can survive as Australia’s population ages is to make insurance cheaper for younger, healthier people.

The history and purposes of private health insurance - Grattan Institute
Australia’s private health insurance industry fears it is in a death spiral. Read the Grattan Institute working paper on private health insurance

Filling the gap: A universal dental care scheme for Australia - Grattan Institute
Australia should introduce a Medicare-style universal insurance scheme for dental care, so all Australians can go to the dentist when they need to. It would cost $5.6 billion a year and should be phased in over 10 years.

Safer care saves money: How to improve patient care and save public money at the same time - Grattan Institute
Australia could save $1.5 billion a year on health spending by improving the safety of patient care. Safer hospital care doesn’t just reduce harm to patients, it saves money for taxpayers and frees up beds so other patients can be treated.

Mapping primary care in Australia - Grattan Institute
Primary care policy needs an overhaul to ensure all Australians, especially the poor and the elderly, get the best possible health care. Many poorer Australians can’t afford to go to a GP when they need to or a dentist when they should, and people in rural and remote areas find it too hard to get to…

Building better foundations for primary care - Grattan Institute
Simple reforms to Australia’s health system could help save more than $320 million a year on avoidable hospital admissions and provide better care for people with diabetes, asthma, heart disease and other chronic conditions.

Chronic failure in primary care - Grattan Institute
The Government spends more than $1 billion every year to encourage better prevention and management of chronic disease, but our health system is still failing patients. The way we fund and organise primary care needs to change.

Blood Money: paying for pathology services - Grattan Institute
Taxpayers spend more than $2.5 billion a year on pathology services, but they’re not getting a good deal. Changing the way government pays for testing would save money without cutting services to the sick.

Dying well - Grattan Institute
Seventy percent of Australians want to die at home yet most die in hospital and aged care. New policies could help many more people to die comfortably at home. As the baby boomers grow old, it is time to discuss a subject we might dislike but cannot avoid.

Unlocking skills in hospitals: better jobs, more care - Grattan Institute
A better match between hospital workers and their skills could improve jobs for doctors and nurses, save public hospitals nearly $430 million a year and fund treatment for more than 85,000 extra people.

Controlling costly care: a billion-dollar hospital opportunity - Grattan Institute
A new pricing system for hospital treatment could end unjustified cost differences among hospitals and free up $1 billion for more and better health care.

Australia’s bad drug deal - Grattan Institute
Australia is paying more than $1.3 billion a year too much for prescription drugs. It is time to get tough with drug companies and take the politics out of price-setting.


Norman Swan

Producer and presenter of the Health Report on ABC Radio National. Previously qualified as a medical Doctor. He discusses new health research and treatments, out of pocket costs for private patients, over servicing and avoidable errors.

Millions of Australians fork out big money for private health insurance believing it will give them their choice of specialist and Rolls Royce service. Yet many, at a time of great personal crisis, are saddled with bills for treatment, leaving them thousands of dollars out of pocket and wondering why they bothered paying for insurance at all.

When we head to the GP most of us assume "the doctor knows best". But the truth is, many of the scans, tests and procedures ordered by medical practitioners are wasteful, unnecessary and potentially harmful.

Mind the Gap
Our investigation tells the story of your out of pocket medical expenses.

Wasted
The unnecessary testing and treatments choking the health system and making patients ill.

Cancer treatment in the private sector
A personal story about private sector cancer treatment


Michael Armitage

His work history includes Minister of health for the South Australian Government and CEO of Private Healthcare Australia.

When working at PHA Michael Armitage commissioned a comprehensive report into the quality of Australia's private hospitals. When the results came back listing a number with high error rates allowed to continue to practice, he made his frustration known.

"There are a whole lot [of hospitals] that are C-triple-minus," Dr Armitage said. "And we just keep backing up the truck full of gold bars" to pay them.

Private Healthcare Australia who commissioned this detailed report, wanted to ban private hospitals where care was rated C— leaving patients with dangerous infections or needing their treatment redone completely.

The unpublished hospital research was based on figures from 2004 to 2007 using the 25 million "data points" insurers gather each year. The work was completed in 2009. Since then the PHA has been fighting to get the findings into the public domain. It lobbied politicians from both sides and even sought advice from the Privacy Commissioner. Dr Armitage said the advice was that the PHA would be sued.

The vast majority of people with private cover would have no idea that this report even exists. Thanks to Australia's cowardly politicians on both sides of politics, private patients continued to be damaged by unsafe hospitals, their error rates kept hidden by this report.

‘C-triple-minus’ hospitals can cost arm and leg
‘C-triple-minus’ hospitals can cost arm and leg


The blunt reality is that healthcare is full of vested interests who are making too much money, while delivering an uneven and sometimes dangerously unsafe service.

Giving these tough talking experts free rein to deal with these groups would give us a head start, along the road to reform.

© Wikihospitals June 2015