Lesley Russell

Lesley Russell has worked as a political advisor on health to Democrats in the US Congress and the Labor Party in the Australian Federal Parliament. She is an Adjunct Associate Professor at the Leeder Centre for Health Policy, Economics and Data at the University of Sydney.

Lesley's recent articles

Prevention – putting health into healthcare

Prevention – putting health into healthcare

Health outcomes are about more than access to healthcare services: they are highly dependent on the social and economic determinants of health. Despite lip service to the importance of these factors and preventive health actions, the Australian healthcare system is relentlessly focused on treating sick people, with subsequent economic and social costs incurred by governments, society and individuals.

Expensive dental care worsens inequality. Is it time for a Medicare-style Denticare scheme?

Expensive dental care worsens inequality. Is it time for a Medicare-style Denticare scheme?

Theres growing awareness public dental programs are unable to meet the demand for services. Private dental care is increasingly unaffordable, and millions of Australians go without the treatment they need.

Dental care must be on the election agenda - it's time

Dental care must be on the election agenda - it's time

As the federal election looms so too does a crisis in affordable access to dental care. The pandemic has served to further widen the socio-economic dental divide and there are consequences for healthcare costs, productivity and social inclusion.

For 21st century primary health care, we need bold and brave leadership

For 21st century primary health care, we need bold and brave leadership

Its long past time to implement primary care reforms but whose voices are being heard in the discussion?

Upturn: A better normal needs a focus on health, not just healthcare

Professor Paul Torzillo discusses the lessons for healthcare in Upturn: A Better Normal After Covid-19. The volume of essays would have benefitted from a more comprehensive analysis of what a better normal in health, rather than just healthcare, would look like. But the plea for ensuring the humanity of medicine will resound.

David and Goliath battle over community alcohol harms is under way in the NT

There is a David and Goliath battle being waged in the Northern Territory as health and social welfare organisations and Indigenous leaders battle business behemoths and the Territory Government over the issuance of new liquor licences.

What is the fate of the MBS Review Task Force and its work? (Croakey Dec 21, 2020)

Five years in the making, the Final Report of the Medicare Benefits Schedule (MBS) Review Task Force was quietly released last week.Associate Professor Lesley Russell outlines the wide-ranging findings and how they are likely to shape the future of the MBS.

Social prescribing links workers

Social prescribing acknowledges that the provision of holistic, patient-centred healthcare must move beyond a medical model and consider the wider social determinants of health. Link workers can provide personalised support to help patients identify and achieve health and wellness goals and linkage into appropriate community services.

Tackling substance abuse in the coronavirus pandemic

The social and economic impacts of the coronavirus pandemic are driving more people to substance abuse while also limiting access to prevention, treatment, support and rehabilitation - services already in short supply. Without immediate actions, the consequences will be felt for years to come.

Australias health care after coronavirus is there a silver lining to the pandemic?

What have we learned from the coronavirus pandemic that can inform and drive reforms to Australias health care system?

LESLEY RUSSELL. The Next Community Pharmacy Agreement

In normal, pre-coronavirus pandemic times, we would have expected to see the details and funding for the 7th Community Pharmacy Agreement announced in the May federal budget. But the new agreement, expected to cost some $20 billion over five years, is being negotiated behind closed doors and out of public view.

LESLEY RUSSELL. The Hidden Death Toll from the Coronavirus Pandemic

As deaths from the coronavirus pandemic climb relentlessly, it is already becoming clear that the official toll is an under-estimate and that significant numbers of deaths caused directly and indirectly by the virus are not being recorded as such.

LESLEY RUSSELL Coronavirus Highlights American Inequalities and Trumps Inadequacies

In the United States there are serious problems with the adequacy and appropriateness of the health measures to control coronavirus and its impact.

LESLEY RUSSELL. Tackling the Emergency Department crisis: Some what if? scenarios

The crisis in Emergency Departments is causing harm to patients and staff, and transformative health system re-design is urgently needed.

JENNIFER DOGGETT, LESLEY RUSSELL. The Private Health Insurance dilemma: a product in search of a role (Croakey 22-10-19)

Medibank has announced that it will become Australias first private health insurer to make potential out-of-pocket (OOP) costs publicly available in a move to shore up public trust, after winning a Shonky award from consumer group Choice for junk policies that cost more and deliver less.

LESLEY RUSSELL. Where is the Focus on Rural Health (Redux) Looking at You, National Party

The impacts of drought and climate change on health and wellbeing are threatening to increase the growing gap in health status between Australians who live in metropolitan and rural areas. Yet the Morrison Government and its National Party partners have lost focus on rural health, they have failed to focus on a national drought strategy and are international laggards in climate change action. Rural families and communities are suffering as a result.

LESLEY RUSSELL. Where is the Focus on Rural Health?

It is unfair and poor public policy that mortality and morbidity rates in rural Australia are significantly worse than those in metropolitan areas. There is an urgent need for a National Rural Health Strategy, accompanied by a sustained increase in funding, workforce and other resources, to address this growing health and healthcare disparity.

KELSEY CHALMERS and LESLEY RUSSELL. The National Strategy to Reduce OOP costs: will price transparency work?

Reducing patients out of pocket (OOP) costs is a major issue for the health policy agenda. But what are the chances that solutions to provide real relief for patients will emerge?

LESLEY RUSSELL. Restraining the Free Market That is Specialty Medicine

The past week has seen a series of media articles about how some people must fund raise to cover the cost of expensive brain cancer surgery and a paper released from the Actuaries Institute, How to Make Private Health Insurance Healthier, that highlights (yet again) the needed reforms to Australias private and publicly funded healthcare. Together they highlight the need to reign in the free marketplace that is specialist medicine in Australia and that is costly to both Medicare and private health insurance.

LESLEY RUSSELL: The Budget as an Election Campaign Document

This years Government budget documents and the Oppositions response are budgetary in name only they should be seen as election campaign commitments. As such, they provide a telling story about the parties focus on health and healthcare and the underlying political ideologies.

LESLEY RUSSELL. Can Primary Health Networks (PHNs) Drive Needed Primary Care Reforms?

LESLEY RUSSELL. Can Primary Health Networks (PHNs) Drive Needed Primary Care Reforms? A strong primary care system is essential to the equity, efficiency and effectiveness of the healthcare system and for improvements in health outcomes. However, the structure and funding of primary care has not kept pace with changes to disease patterns, the economic pressures on the healthcare system, workforce needs and evidence about the impact of social factors on health. In a paper recently published with my colleague Dr Paresh Dawda, we analyse the current operations and funding of Primary Health Networks and explore whether they are fit-for-purpose...

LESLEY RUSSELL. The recommendations from the MBS Review for reforms in primary care: who will ensure these proposals are properly considered?

Hidden in a pack of draft reports from the Medicare Benefits Schedule (MBS) Review Taskforce that were released by the Morrison Government without fanfare just before Christmas are a series of recommendations that, if effectively funded and implemented, could begin the long and difficult task of reforming Australias primary care system.

LESLEY RUSSELL. ACSQHC Third Australian Atlas of Healthcare Variation 2018.

The 2018 version of the Australian Atlas of Healthcare Variation was released on December 11. This is the third such annual atlas, which examines differences in healthcare use according to where people live within Australia and is produced by the Australian Commission on Safety and Quality in Health Care in partnership with the Australian Institute of Health and Welfare. This year it looks at healthcare use in four selected clinical areas: paediatric and neonatal health; cardiac tests; thyroid investigations and treatments; gastrointestinal investigations and treatment. Specific recommendations for improvements are made. There are interactive features available.

LESLEY RUSSELL: Time to make dental care an election issue

The Victorian Governments election commitment to a $395.8 million program to provide free dental care to schoolchildren will be welcome in a state where affordable and timely access to dental care is increasingly difficult. Its time for a concerted campaign to ensure that improved access to dental care and better prevention initiatives are on the agenda for the upcoming New South Wales and federal elections. Governments must be persuaded that their failure to see oral health, dental services and caries prevention as essential components of health care is a false economy.

LESLEY RUSSELL.Tackling the wicked problems in health - by building bridges with social services.

None of the wicked problems in health obesity, mental illness and suicide, chronic illness, ageing will be solved with just hospitals, doctors, nurses and prescription pads. They all require resources beyond those provided by the health care system. Thats not news; there are very few health professionals who deny the impact of the social determinants of health on health outcomes and health care costs and the importance of linking into social services. The challenge is how to achieve this. In essence how do we move the focus from general practice and primary care to primary health care?...

LESLEY RUSSELL. The dental divide and the decay of public dental services (ABC News, 21.08.18)

The noisy public debate about patients' out-of-pocket costs and their consequences reaches a crescendo when it comes to oral health and dental care.

Ending the medical / dental divide (redux).

In a piece published in the Medical Journal of Australia in December 2014, I called for an end to the artificial medical/dental divide. At the same time, writing in The Conversation, I outlined six first steps towards the better integration of dental and medical care to improve health outcomes and contain overall health care spending. My thoughts then are applicable today, especially in light of additional data and information that has emerged over the past three years.

LESLEY RUSSELL. Ageless At Altitude

Residents of Colorados most picturesque mountain towns in Summit, Pitkin and Eagle counties live longer than anyone else in the United States. Recent data collections, research and comparisons with the so-called Blue Zones those few places where people live longer and healthier than anywhere else on earth highlight why the Colorado Rocky Mountains offer such great health outcome and what needs to be done for this area to truly become an American Blue Zone for every who lives there.

LESLEY RUSSELL. Who cares for the carers?

Governments have yet to create a coherent strategy to help the almost three million Australians providing informal care.

LESLEY RUSSELL . How knee replacement surgery highlights issues of access, affordability and best practice in Australias two-tiered healthcare system - Part 2

Part 2 Best practice and improved surgery outcomes As the population ages, total knee replacement surgery is becoming commonplace. It is one of the most expensive surgical procedures. Most replacements are performed as elective surgery in private hospitals. Those patients who must rely on the public system are waiting longer than ever. In Part 1 of this paper, the variations in frequency of knee replacement were considered. Given that most such procedures are cnducted in the private sector, the dependence on private health insurance creates disparities in access. Little information is available on preferred prostheses. ...

LESLEY RUSSELL. How knee replacement surgery highlights issues of access, affordability and best practice in Australias two-tiered healthcare system - Part 1

PART 1 Access and affordability As the population ages, total knee replacement surgery is becoming commonplace. It is one of the most expensive surgical procedures. Most replacements are performed as elective surgery in private hospitals. Those patients who must rely on the public system are waiting longer than ever.

Private Health Insurance: focus on premiums ignores the cost of using it

Last weeks announcement from the Turnbull Government purported to be about making private health insurance simpler and more affordable but in fact delivered more for health insurance funds bottom lines than for Australians budgets and highlighted the contorted, confused and controversial logic that underpins the governments push requiring taxpayers to contribute to the financing of both tiers of a two-tiered healthcare system.

LESLEY RUSSELL. Private Health Insurance - a low-value proposition?

Private health insurance has been allowed to undermine the universality Australian healthcare to the extent that international experts now downgrade the Australian system in comparison to those of similar countries because it is two-tiered. Growing public concerns about increasing premiums, unexpected out-of-pocket costs and inequalities have led to a focus on whether health insurance provides value for money. The focus should be widened to investigate the extent to which private health insurance supports low-value and low-quality healthcare services.

LESLEY RUSSELL. The impact of private health insurance on equity and access in specialist healthcare

Most specialists charge fairly and reasonably, but there is clearly a need to name and shame those who are over-charging and over-servicing to ensure a level playing field for the good guys and to protect, respect and care for their patients.

It is disingenuous of the Coalition to claim it has no intention of privatising Medicare.

The election campaign battle over Medicare should come as no surprise. It echoes disputes during previous campaigns and have their origins in ideological divides that date back to well before Medicare was founded and have persisted through the subsequent political disputes. Labor sees the health of Australians as a matter of sufficient national importance that it requires government intervention; the Coalition sees it more as a matter of personal responsibility and individual choice.   The compromises struck in order to enact Medicare have meant that Australias healthcare has been a blend of public and private systems, with precise...

Lesley Russell Too high: the impact of specialists fees on patients health

In todays health care debates around the centrality of primary care, moving towards patient-centred medical homes, improving care coordination for people with chronic illnesses and whether private health insurance provides value for money, there is one element that is almost always missing the role and the costs of specialist services. In 2014 over 28 million specialist services were billed to Medicare and 21 million of these were for out-of-hospital services. Only 30% of these services were bulk billed, and the average out-of-pocket cost for the remaining 70% of services was $70.89. However gaps of several hundred dollars are...

Lesley Russell. The debate we're yet to have about private health insurance.

The six previous papers in this series highlight the poorly defined role private health insurance plays in the funding and delivery of Australian health care, and how the Abbott government might allow this role to expand. But major changes to Australias iconic Medicare system should not happen by stealth. They require full analysis and debate about whether a more integrated public-private system is a feasible option that fits with Australian values and can improve efficiency in health care financing. Successive governments of both persuasions have failed to convincingly articulate why Australians need what is increasingly a duplicate health...

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