Read any health report these days and you can only agree with Fred Astaire when he told Gingers Rogers "There may be trouble ahead" because before long we're going to have to face the music of rising health care costs.
Whether it's cardiovascular disease, osteoporosis or the number of old people in nursing homes, there seems to be a formula that says this condition now affects X million people and costs Y million dollars, but in 2020 it will affect one in two Australians and cost half the national GDP.
An example is the treatment of cancers. This week the president of the Clinical Oncological Society of Australia, Bruce Mann, has asked where the money is going to come from to pay for the stream of new chemotherapy agents that are in the pipeline, just as Nicola Roxon announced Federal government spending $104 million on just one drug, lenalidomide, to treat a thousand people with multiple myeloma over the next few years.
As Bruce Mann says, the benefit to individual patients of cutting-edge therapies is unarguable, but "there are so many of these [new drugs] coming along. If our society pays for every Medicare card holder to get access to medicines they can benefit from, then we're going broke. This is a really hard area. It's where money meets human life."
It might be more accurate to say it's where human illness meets political reality. In the last couple of weeks I've heard two senior politicians say that health costs are their major worry for the long term future.
The former NSW treasurer Michael Costa said that at current growth rates, the health budget would gobble up most of the state government spending within twenty years. Or as Queensland's deputy premier Paul Lucas put it, "In the future we'll just have a premier and a health minister."
Sooner or later, the politicians are going to have to face up to the reality and make very unpopular decisions. In one form or another that's going to involve the 'R' word: rationing of health services. Whether it is done openly or by sleight of hand, through public health services or private ones, it will have to happen.
Who will be the first politician to face up to the inconvenient truth? As Irving Berlin said, "soon we'll be humming a different tune, and there may be teardrops to shed..." Time to face the music.
Comments
Why cant the government just arrange what it wants to provide in the way of health prevention through whatever health professionals it wants to employ or subsidise and inform us how our patients can access it, and let us GPs get on with our job. We will provide what we think is medically necessary (as well as accessible, practical, achievable) in relation to our individual patients, as we trained clinicians see fit. This constantly changing interference and unworkable rules on how we are to practice medicine is producing more and more chaos and totally unachievable goals. Posted by Ali Steer on Tuesday, 13 October 2009
