Australian Politics and Policy - Senior, 2019a

Health policy
Unless there is an increase in the supply of resources dedicated to providing
health care, the result of unmet demand will be ‘queuing’. People will find they
cannot make an immediate GP appointment and people with non-urgent needs
will be put on to hospital waiting lists while more important cases are attended
to. Although waiting times command media attention and political criticism (the
media often confuse queue lengths with waiting times), a health care system in
which everyone could be attended to immediately is neither practical nor affordable.
A waiting list allows scarce and expensive resources (medical specialists,
nurses, diagnostic equipment) to be allocated to those who benefit the most. If
there were so much spare capacity and those resources were underutilised for want
of demand, that would be wasteful.
Asweageweusemorehealthcare,andAustralia’spopulation,althoughyoung
by world standards, is ageing. Over the long term Australians are having fewer
babies, immigration as a proportion of the population is falling, and we are living
longer. It should be noted, however, that older Australians now are much healthier
than they were a generation or two ago. Some health care costs, such as those
associated with treatment of cancer, tend to beconcentratedinthelastfewyearsof
life, and if we live longer those costs are deferred.
Another driver of health care costs, often mentioned, is new technology. In
most industries new technologies result in unit cost reduction, and it is certainly
the case in health care, as in other industries, that information and communication
technologies have helped reduce administrative costs. But there is also a flow of
expensive technologies that offer new opportunities to diagnose or cure diseases
or to ameliorate their effect, particularly pharmaceuticals. Technologies based on
geneticmanipulationandbespoketreatmentforindividualsarejustemerging.
Some technologies that have developed and been refined in recent years, such
as magnetic resource imaging (MRI), allow for earlier detection of conditions
than would have been possible in times past. Early detection of conditions can
save lives, allowing for timely and low-cost interventions (such as the removal of
small cancerous growths) or can promote changes in lifestyle. But such diagnostic
improvements can also lead to excess treatment of conditions that pose little threat
in themselves, such as slow-growing tumours that would be overtaken by other
causes of death.
Achieving value-for-money in health care
Both in their own role in funding health care, and in their broader role in helping
people make well-informed decisions with their individual resources (a consumer
protection function), governments are concerned with achieving value-for-money
in health care.
A prime concern is to ensure that health care interventions – pharmaceuticals,
operations – are effective. Do they achieve what they are intended to achieve?
Clinical trials of pharmaceuticals are about establishing a new drug’s effectiveness,
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