The debate was convened to encourage creative ideas on how scarce healthcare dollars were allocated to meet competing demands and service needs.
Griffith University researcher Rachael Krinks argued that so-called Citizen’s Juries could be used to generate greater community input into health funding decisions.
“Complex decisions about how scarce health dollars are spent should not be made by politicians, clinicians and economists alone,” she said.
“The public’s view and their values need to be part of the discussion and getting the opportunity to tick a ballot box every three years and ad hoc tokenistic consultation mechanisms are not enough.
“Citizens’ juries show promise in this regard: citizen jurors absorb complex information and can be the source of bold reform ideas that do not necessarily require additional resources.”
CEO of the Wesley Research Institute Christian Gericke said the most important change that needed to be made was in the way the health system was governed.
“We have to move away from a NHS-style command and control system to a self-organising system in which money follows patients, so patient choice becomes the ultimate power in the health system and not the bureaucrats. This works well in a number of continental European health care systems, including in Federal systems such as Germany or Switzerland.”
According to the Academic Director of AusHSI, Professor Nick Graves, one option is to establish an independent non-political authority to make the hard rationing decisions in healthcare, as they do in the UK and some European countries.
“We let the RBA make decisions about interest rates and monetary policy independent of politicians so why not let an expert authority make health-related decisions independently of political influence?” he asked.
“Unfortunately many rationing decisions in health are not based on evidence, rather political imperatives win out. We want to move toward a system that will give us explicit and evidence based rationing,” said Professor Graves.
Professor John Fraser, Intensive Care Unit Specialist and Director of the Australian Critical Care Research Group said that as the population ages the challenge of using the health budget more efficiently would only become more acute. He made a strong push for greater investment in health promotion and disease prevention.
“We could save an enormous amount of health resources by investing more in preventive approaches. Reducing obesity and cutting down the smoking rate will save more lives than any acute services hospitals could ever hope to achieve.
“It’s not all about the doctors and hospitals. Poorer communities have worse health outcomes, more obesity and less access to fresh food. We could reallocate cash to subsidise cheaper food in these areas; improved, age-relevant research and reduce more than 50 years of obesity per child.
“Exercise for the sick and healthy dramatically improves outcomes but politicians are too scared to be radical. They should be neutered in the health debate, and a group of “even greyer men or ladies” should be allowed to budget and spend the dollar.
“An independent group wouldn’t have to worry about being re-elected. We need to really be radical otherwise our state and our country will move from being ‘beautiful one day, …..too fat , too old and on dialysis the next’.”
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