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CoAG: smiles all around « Previous | |Next »
February 11, 2006

Everybody is singing the praises of yesterdays CoAG meeting between the states, territories and the commonwealth. This human capital reform agenda has been mostly driven by the Bracks' Government in Victoria and the line is that the COAG meeting would look to unlock the power of "human capital" in a new wave of reform.

Though they were unable to reach an agreement on how to pay for the reforms the commonwealth, states and territories have signed up a national reform agenda aimed at lifting productivity through better education and health, increased infrastructure investment, and cutting business red tape in exchange for a qualified promised from the federal government when they meet specific targets.

Yet the approach to the shortage of doctors and the need for medical reform is this:

CartoonUSParker.jpg
Jeff Parker

One of the reforms is for an extra 60 students to start medical training over the next four years — but only if they can afford to pay up to $216,000 for a degree. That is why I'm a little sceptical about the health care reforms.

Most of the CoAG empahsis was on improving productivity and skills through increased investment in "human capital" by improved education and skills training, and by attacking health problems, such as diabetes and mental illness which hold back workforce productivity and participation. More skilled and healthier workers makes for a wealthier Australia. Small investment now, big dividends latter is the argument.

Most of the spin has been about the new sense of co-operation between the states and the commonwealth and the way the politics of federal-state relations have changed. It has been seen as 'historic' because it signals the end of buck passing and duck shoving between the commonwealth and the states.

My interpretation is that there was broad agreement on the need for a new wave of national reform to fix some of the worst aspects of the health systems (mental health and aged care) and training regimes (national recogniition for vocational qualifications and skills accreditation) and the overhauling of infrastructure regulation.

However, the vision of CoAG is more one of making people healthier so they can stay in the workforce longer. It is more about and keeping Australia competitive with the rest of the world than a reform of the health care system to shift its emphasis away from hospitals to prevention and primary health care. You can help to solve the hospital problem by reducing the demand for hospital services through primary care prevention. Since most health funding is spent on curing the sick, and only a small portion is spent on preventing people from getting that way, then that does means structural reform, not just tinkering at the margins.

That means displacing the emphasis on high-tech and high-cost hospital care for primary health care. CoAG continues to see hospitals as the epicentre of health and it failed to to give chronic illness and disease prevention and treatment a much greater share of the funding.So the talk about health care reform remains talk.

| Posted by Gary Sauer-Thompson at 8:34 PM | | Comments (0)
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