Centre for Policy Development's Blog, page 128

Miriam Lyons | The Drum ABC News 24

Miriam Lyons joins Annabel Crabb, Chirs Berg (IPA) and Dr Nijmeh Hajjar to chew over an eventful week in politics both here and abroad. From the spreading calls for democracy across the Arab world, to calls for more or less than a carbon tax here, the re-emergence of multiculturalism in the political lexicon and the recent backflip on the youth allowance, tune in online to hear what CPD has to add to the debate.

Watch here online on ABC's The Drum here.

Eva Cox | Hands up who wants a 30 hour week

Eva Cox remembers when we talked of more leisure time. So how  did we end up  with our over-worked, growth-focused society? She has some seemingly radical ideas to do less paid work and share all other life experiences more fairly.  And she thinks it would save energy!

Read Eva's article in The Punch here.

Kate Gauthier | Asylum policy debate: we're being conned

Kate Gauthier examines the asylum seeker 'debate' only to find that there isn't really one going on between our major parties. Instead she finds both the ALP and Coalition are seeking a race-to-the-right approach, and it's punishing those who are seeking protection. Kate Gauthier pulls apart their tired arguments and outlines an alternative approach.

Read Kate's article in The Drum Unleashed here.

John Menadue | Private hospitals duck cost test

Chief Executive of Australian Private Hospitals Association, Michael Roff's recent note that private hospital costs are significantly lower than public hospital costs doesn't quite add up, according to CPD's John Menadue. In Menadue's letter to the Australian Financial Review, he points out the various inconsistencies in Roff's calculations. Here's what John had to say:

I am at a loss to understand how Michael Roff, Chief Executive, Australian Private Hospitals Association can claim in his letter of 15 February, that according to the Productivity Commission … 'Private hospital costs were 32% less than public hospitals.'

The draft PC Report, page 83, acknowledges that 'comparing the costs of public and private hospitals has been one of the most challenging parts of this study.'  It goes on that 'the Commission's experimental cost estimates suggest that, at a national level, public and private hospitals had broadly similar costs per casemix-adjusted separation in 2007/08. However, significant differences were found in the composition of costs ..'  It then elaborated on the differences.

In the Financial Review of 17 February, Mark Fitzgibbon, in an opinion piece, was more cautious and said only that the Productivity Commission 'calculated that almost three fifths of surgery in public hospitals had an average cost at least 10% higher than in private hospitals.' That is meaningless if he leaves out the other two fifths. His figure, drawn from page 102 of the PC Report, makes clear that private hospitals are specialised in certain areas, particularly minor surgery. We have always known that the hard jobs are invariably left to the public sector.

The ultimate test of whether private hospitals are more efficient overall is why they don't jump at the opportunity to treat public patients in private hospitals on a casemix basis.  Years ago Jeff Kennett made an offer to the private hospitals to treat public patients on this basis, but they declined.

John Menadue

Director, Centre for Policy Development

First published in the Australian Financial Review on Monday 21 February.

Jennifer Doggett | Is this real health reform or more of the same?

CPD health policy expert, Jennifer Doggett refutes Kevin Rudd's claim that the re-vamped COAG hospitals agreement constitutes 'major national health reform'. She finds the 'in principle' COAG agreement abandons most of the central reform features of the Rudd blueprint. So is changing and what is staying the same for our ailing health system?

Read Jennifer's article in The Punch here.

Ben Eltham & Ian McAuley | What The Insurance Companies Don't Tell You

Two CPD Fellows, Ben Eltham & Ian McAuley, scrutinise our national insurers: an industry where sensible public policy takes a back seat to rent-seeking. Our summer of catastrophes has shown up the injustice of Australia's powerful insurance industry.

Read how Ben and Ian think the system could be improved in their article in New Matilda here.

John Menadue on re-distribution of doctors

How an auction might help fix medico maldistribution

John Menadue, a key figure in establishing our system for universal health care, has had much to say about the direction of health policy in recent years. Now that health reform is back on the agenda, we're pulling out some policy gems from the archive.

In August 2008, John challenged the belief that we have a doctor shortage. He shares his ideas to address the problem of distribution of doctors, and how we encourage doctors to work in rural and remote areas where they are most needed.

In Australia, we don't have so much a shortage of doctors as a maldistribution of doctors. Auctioning provider numbers could be an effective way of addressing this problem of maldistribution whereby affluent parts of Australia are generally well-served with medical services, but remote areas are badly served. There is also, of course, a strong case to increase the delivery of health services by nurses, pharmacists and allied health professionals.

Continue reading what he had to say in his article for Crikey here.

Ian McAuley | What about the real reform issues?

Ian McAuley responds to Gillard's health policy announcements asks about the real health reform issues?

Understandably health administrators are saying "the devil is in the detail". They have a huge task, particularly relating to the determination of standard costs for items of service.

Political pundits will see this as a success for a government still seeking to establish its legitimacy.

In terms of hospital funding it should achieve much of what the Rudd reforms were designed to do; we should see efficiency gains over time. Some economists may be puzzled that states were unenthusiastic about the Rudd reforms. States' health care costs have risen from 22 percent of their budgets to 26 percent over the last ten years and are still growing; in that fiscal context the GST clawback looked attractive for the states. But that is to ignore other issues to do with the way powers are shared in a federation.

Continue reading what he has to say in Croakey, Crikey's health blog here.

Jennifer Doggett | Honey, I shrunk the health reform agenda

Jennifer Doggett takes a look at the government's health policy developments over the weekend. She finds that Kevin Rudd's bigger-than-Ben-Hur plan to revolutionise our health care system has ended up as Julia Gillard's 'Honey, I shrank the health reform agenda'.

Read her piece in The Drum here.

Ben Eltham | Showtime in Canberra

Tears, 'sh*t' and an Abbott brain reboot. One day into the 2011 parliamentary season and with the media treating it as a great pageant, our leaders are ready to put on a show, writes Ben Eltham. It has been a seemingly dramatic start to the political year, but can the image grab for television be any replacement for a lengthy and informed debate?

Read what Ben thinks of all the media Ho-Ha in his piece for New Matilda here.