Writer
Stephen Duckett
Stephen Duckett, an economist, is an Honorary Enterprise Professor in General Practice and in Population and Global Health at the University of Melbourne, Chair of the Board of Eastern Melbourne Primary Health Network, and a member of the Strengthening Medicare task force.
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Commonwealth-State health reform: It’s time for a conversation about national priorities
The prospects for significant health reform looked good at the end of 2023. A mid-term review of the main Commonwealth-state agreement – the National Health Reform Agreement (NHRA) – had recommended that the focus of a new agreement, due mid-2025, should be broader than public hospital funding. States seemed to be on board and the Continue reading »
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Medicare turns 40: since 1984 our health needs have changed but the system hasn’t. 3 reforms to update it
Forty years ago, Medicare as we know it today was born. It was the reincarnation of the Whitlam government’s Medibank, introduced in 1975 but dismantled in stages by the Fraser Liberal government. Continue reading »
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Proposed new Aged Care Act leaves gaps in rights
The current Aged Care Act, dating from the Howard Government era and infused with its neo-liberal ideology, is set to be repealed and replaced by a new one, purportedly incorporating a ‘rights basis’ as recommended by the Royal Commission on Aged Care Quality and Safety which reported in 2021. Continue reading »
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Medicare is changing for the better
Last week another important suite of changes to Medicare came into effect. Since the election of the Albanese government, we have seen a willingness by government to introduce a range of policies designed to update and strengthen Medicare to position it better for the future. Continue reading »
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New data shows the Commonwealth Government is not pulling its weight on hospital funding
The Australian Institute of Health and Welfare released its latest health expenditure data last week showing the Commonwealth share of government public hospital funding has declined to 41%. This will fuel state anger and make negotiations for a new funding agreement, to take effect in mid-2025, that much harder. Continue reading »
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Health budget has big changes – reviving our worn-out Medicare fee-for-service system and boosting bulk billing
There were four major changes for health care in the 2023-24 budget: prioritising primary care, funding to strengthen Medicare, cheaper access to common medicines, and new funding to keep the digital health system going. Many of these changes were foreshadowed in recent weeks. Continue reading »
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What if Medicare was restricted to GPs who bulk billed? This kind of reform is possible
Australia’s health system is under significant pressure. The Labor government has inherited a system with declining bulk-billing rates for GP visits. These fell from almost 90 per cent of all GP attendances bulk billed in December 2021 to just over 80 per cent a year later. Continue reading »
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Reforms and more funding needed to save Medicare
The release of the Strengthening Medicare Taskforce report has re-ignited discussions about reform of Australia’s primary healthcare system. Continue reading »
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Commonwealth-State cooperation is essential for healthcare reform
The recommendations of the Strengthening Medicare Taskforce released last week, like almost any serious health reform in Australia, require joint Commonwealth and state action. Continue reading »
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Your Medicare card: the Whitlam government’s contemporary legacy
On December 2 we celebrate the fiftieth anniversary of the election of the Whitlam government. Health reform was one of that government’s signature achievements. It appears that the stars are now aligning to build on Whitlam’s remarkable legacy and create a new Medicare fit for purpose in the 21st century. Continue reading »
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Will 2022 be the year primary health care takes a step up?
One thing primary care has a lot of is reports about reform. But despite a significant investment in reviews, consultations, and paper over the last five years, not a single cent has been invested in transforming these words on paper into policies which benefit patients and practitioners. Even though the previous government’s ten-year primary care Continue reading »
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What I would do if I were the Minister for Health and Ageing in the next government
A new minister in any portfolio has two tasks: fix the past and fix the future. Continue reading »
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Even in a time of huge budget deficits, government must pursue policy reform
Elections are times for political parties to articulate their policy vision. And for the 2022 federal election, held in the third year of a global pandemic, a program of bold and well-designed policies is more important than ever. Continue reading »
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How to learn from our Covid history (no, not with a royal commission)
What we have learnt from decades of experience about analysing what to do when things go wrong in healthcare should be applied to public health too. Continue reading »
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Act now to overcome the Commonwealth litany of failure on COVID
The Commonwealth has learned nothing from this litany of previous mistakes and continues to ignore lessons learnt from overseas. Continue reading »
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NSW’s reopening plan is risky, and signals an end to a national approach
By abandoning the national plan, NSW’s gamble to go it alone on easing restrictions for fully vaccinated people further fractures federalism… NSW initially locked down too little and too late. Continue reading »
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Stakeholder voices in health policy
Formulation of COVID policy, as with other aspects of health policy, has involved stakeholders voicing their opinions about what’s in Australia’s best interest. Or at least, that is how their lobbying is framed. Continue reading »
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Opening with 70% of adults vaccinated, the Doherty report predicts 1.5K deaths in 6 months. We need a revised plan
One consequence of the escalating COVID outbreak in New South Wales has been increased political tension around the “national plan” for COVID reopening. Continue reading »
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When should mandatory vaccination be on the agenda?
Back in August 2020, when announcing that Australia had negotiated a deal to procure supplies of coronavirus vaccines, the Prime Minister was quizzed by Melbourne radio commentator Neil Mitchell about whether vaccination should be compulsory. The PM hedged his bets – he would ‘expect it to be as mandatory as you can possibly make [it]’. Continue reading »
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Financial penalties for avoidable hospitalisations.
The 2020-25 Commonwealth-state hospital funding agreement requires the Independent Hospital Pricing Authority to consider penalties for excessive rates of potentially preventable hospitalisations. The new penalty would sit alongside existing penalties on states with higher-than-expected rates of ‘adverse events’ in hospitals. Continue reading »
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Where next for private healthcare?
The future of private health in Australia – both private hospitals and private health insurance – is under challenge. The proportion of the population with insurance has declined over the past decade. The insured population is getting older, which is putting upward pressure on insurance premiums, which leads to more people dropping out, especially younger people, Continue reading »
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Prosthesis pricing is a dead parrot
Hidden in the 2021-22 Budget papers was an announcement that the government had squibbed an opportunity to reduce private health insurance premiums by ending a protection racket involving private device manufacturers and importers, and private hospitals. Continue reading »
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What do we get for the millions spent on COVID consultancies?
Australia’s COVID-19 vaccine rollout is not just a shambles, it’s an expensive shambles. The program is so bad that government has given up on setting meaningful targets and has now redefined target setting to when an activity starts, rather than when it finishes. Continue reading »
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The critics are wrong: Australia needs a universal aged care system
The Royal Commission into Aged Care Quality and Safety has envisioned a new aged care system that would ‘deliver an entitlement to high-quality care and support for older people, and ensure that they receive it’. It’s a call for sweeping change. Continue reading »
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Penny wise, pound foolish: the federal government must step up on hotel quarantine
Our biggest weakness in protecting the community from Covid-19 remains a hotel quarantine system that demonstrably is not fit for purpose. Here’s how to fix our quarantine system once and for all. Continue reading »
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No one else in the world has tamed a second wave this large like Daniel Andrews (The Conversation Oct 26, 2020)
If the past few months have been like a long-haul flight, Victorians are now standing in the aisles waiting for the cabin door to open, a little groggy and disoriented but relieved. They have every right to be. No other place in the world has tamed a second wave this large. Few have even come Continue reading »
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Residential aged care funding rules are unfair and inefficient
The Royal Commission into Aged Care Quality and Safety has highlighted the tragic weakness of residential aged care throughout Australia. Hundreds of older Australians have died prematurely during the COVID pandemic. For their sake, and ours, this tragedy must prove to be the wake-up call that prompts a major shakeup of the industry. Continue reading »
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Victoria should stay the course
Victoria is now facing a difficult choice: to continue stringent lockdowns in the hope of getting COVID-19 cases down to zero, or accepting the lesser goal of opening up once cases are in single digits. Continue reading »
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Australia’s COVID-19 response Part 2: The four successes and four failures
Australia’s response to coronavirus to date has been among the most successful in the world. After an exponential increase that peaked at more than 400 cases a day in late March, daily cases declined to about 20 a month later, with some states recording several successive days or weeks with no new cases. At the Continue reading »
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Australia’s COVID-19 response Part 1 of 2: the story so far
Australia’s response to the COVID-19 pandemic has been remarkably successful. After an exponential increase that peaked at more than 400 cases a day in late March, daily cases declined to almost zero a month later. Continue reading »
