Chapter 3: Future of Health – The health system

The trends reshaping health and the future implications for the Australian marketplace.

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The Future of Health – The Health System continues the discussion on the Australian health ecosystem.

We have been very fortunate in this publication to have editorials provided by two of Australia’s thought leaders in the sector on their insights into the current health system, some of the emerging system challenges and the Future of Health.

Mr Mark Fitzgibbon, the Managing Director of ASX listed nib provides his observations on the health system and some of the key decisions we will need to make as a community as the level of expenditure continues to grow over time.

An aging demographic, growing population, a rising prevalence of chronic disease and changing consumer expectations such as those driven by technology are all placing increasing pressures on the level of economic expenditure as a % of GDP for health.

In Mark Fitzgibbon’s editorial he outlines that healthcare expenditure in western societies has been increasing at GDP ~+2% p.a. for the last 50 years.

He also poses the key question that we as a community face, that being one of how and who funds this increasing cost? Although Australia’s Health System expenditure compares favourably against our global peers (e.g. ~10% of GDP in Australia vis a vis ~18% in the US) approximately two thirds of this expenditure of ~$170bn is currently being borne by taxpayers.

Given the aging population and the reduction in working aged taxpayers to support the health tax obligations by the middle of the century there will be insufficient tax payers to support the health system.

Mark presents a case in his editorial which is similar to the case for superannuation reform that occurred in the early 1990’s that the obligation will increasingly shift towards individuals to fund lifetime care supported by a level of higher government support for those that are at risk of being left out because of higher medical needs or lower economic means. In this emerging environment data and information that enable consumers to benchmark and make more informed choices, together with personal health insurance play an increasingly important role.

Providing an alternative perspective is Professor David Peiris. David is Director, Health System Science at world leading Australian health research organisation, The George Institute. He is also Professor of Medicine at UNSW and a practising GP.

In his editorial, David outlines a landscape where whilst Australians are some of the longest living people in the world we are spending nearly 11 years of our extended life expectancy in ill-health, the highest rate in the OECD.

The rising tide of chronic disease attributed to non-communicable diseases such as cardiovascular disease, chronic respiratory disease, diabetes and their accompanying risk factors is now the leading cause of death, illness, disability and death in Australia.

There are already signs that our health system is beginning to struggle with these threats with Australia having some of the highest out of pocket costs across OECD nations.

In the editorial, David isolates the key question for all of us to consider. It isn’t if the health system of tomorrow will look different than it does today; the question is how?

The editorials together with the three case studies included on the emerging Health Industries South Australia Ecosystem, the Dialysis Project and the Stroke Helmet which highlight the importance of innovation and disruption to the solution and the evolution of the health system.

For full analysis, download the report: