Cradle to Grave Care in Australia's Universal Health System - Longer Life Sicker Patients

When we look at Australia’s Medicare we can see that the government has, since the 1940s, successfully provided universal health to it citizens/residents. It provides prevention and intervention for children to a certain extent through immunizations, health checks and dental care. However, as the child grows into an adult the preventative measures disappear. The adult is left to find his/her way completely unaware that he is supposed to take care of his health. Medicare is there to provide medical cover for anybody who might fall sick over the years. Good medical attention and a good lifestyle have helped to extend life expectancy and as a result the number of elderly people is growing every year. On the downside, most of the elderly suffer from at least one chronic disease and/or disability. The terrible box trifecta – age, chronic disease and disability - have become commonplace and increasingly a challenge for the health care system. This is increasingly expensive as infrastructure is aging while demand for services keeps increasing. The government needs to redesign the health care system so that every adult is made aware of health and can prevent diseases.

We have to applaud the government for taking care of the disabled members of society through the National Disability Insurance Scheme. The NDIS is still being rolled out and it may need to be improved in some areas but it is a great idea. For those who are born with disabilities or who develop disabilities early in life, the NDIS is available from cradle to grave. It relieves families of the financial burden of caring for the disabled loved ones. It also gives the disabled people an opportunity to be useful members of society by providing training and linking them to job opportunities.

For middle aged people who are developing chronic diseases, there is Health Care Homes that was introduced in 2017. The aim is to provide properly coordinated care for chronic disease sufferers and to keep them out of the hospital. The program develops customized care plan together with the patient and the patient’s family, then it coordinates, manages and supports patient care with the GP leading the care team. It is a great idea that is still being tested and still has to prove itself.

Australian Aged Care program takes care of the needs of people who are over 65 years old up to the time of death. Whether the elderly person can stay at home independently or needs disability assistance or frail care, Aged Care is a solid program up to the time of death. The increasing numbers of elderly people is a huge challenge for the nation which cannot continue to build more homes for the aged. That is why the government is encouraging the aged people to remain at home longer. However it is not just for financial reasons: the truth is that it has been found that keeping the aged at home with assistance is more beneficial than keeping them in a nursing home.

For everyone else there is Medicare which covers people for primary care, hospitalization and medication through public hospitals and GP's. Considering Medicare, NDIS, Health Care Homes, Aged Care and the many programs for the disadvantaged, one can truly say Australia has a universal health care system that takes care of its people from cradle to grave.

There is just one limitation: the system is great for treatment of diseases. So far, every effort is being made to respond to illness while nothing is being done to prevent diseases. Without prevention the system will continue to be overloaded with sick people. As a larger and larger proportion of the population grows old, the national burden (to take care of old, sick and disabled people) grows while the proportion of tax payers shrinks. It is possible that one day there will be a huge imbalance when demand for financial resources to look after the elderly people will outweighing supply.

Growing old cannot be prevented but chronic diseases can be prevented if people develop health consciousness. Right now, most people have no health awareness and without health awareness, they will continue to develop chronic illnesses. Without health awareness they continue to eat anything that they find in stores without question. They use any personal care product on the market without thinking about the ingredients that might cause harm. Unless people react immediately to a food or a product, they consume them blindly. The damage to the body happens gradually and when people develop chronic illnesses they have no idea how that happened. When they visit the doctor, few people ask the question, “why did I develop this disease and what can I do to get rid of it?” They simply expect the medication to remove the disease, only to find out later that they have to take the medicines for the rest of their lives. Without learning anything new they do not change their lifestyle to prevent further damage to health.

Without changes to the health care system, most people will not change their lifestyle and they will continue to develop illnesses and continue to be a burden to the system. Change must be initiated by government. The current efforts by the government to develop programs for the chronic diseases sufferers, like Health Care Home, are honorable. However, the programs accept chronic diseases as normal, yet chronic diseases are not normal and they should not be accepted. There is a combination of causes which include diet, pollution, chemical additives in food, harmful agricultural chemicals, harmful chemicals in personal care products and cleaning products, and many other causes. As people continue to consume harmful foods, products, air and water, they will continue to be affected. A lot of chemicals are bio-accumulative, i.e. they accumulate in the body, and they interfere with bodily functions and cause diseases. As long as this is ignored, cases of chronic disease cases will continue to rise.

The system must stop reacting to diseases. First, the government must spearhead research into causes of chronic diseases so that they can prevent them. They must research the effect on health of various foods, chemical ingredients that are used in foods, hormones and medicines given to farm animals, ingredients used in personal care products, ingredients used in cleaning and laundry products, insecticides, herbicides, and chemicals such as chlorine and fluoride that are put in water. This will need a budget to be set aside and it will take a number of years to come up with results.

Armed with results of their research, the government should then introduce prevention of diseases as a major subject at the university to be studied by all health professionals. Health practitioners must understand that health is an asset that everyone must safeguard. Health practitioners should alleviate symptoms while making an effort to regain heath for the patient. Treatment should cease being about symptom management and be about healing the patient. Well -trained health care workers will be able to teach their patients about prevention and reversal of illness through lifestyle changes.

Next, the government must implement integrated healthcare into the nation so that the physical, emotional, mental and social aspects of health are taken care of. Government can lead by example by integrating the Department of Health, the Department of Social Services and the Department of Human Services which all serve the same clients but operate separately. By merging these departments the government will streamline the processes and make them easier for people to understand. Also, the government will save money by employing less people.

Integration should not be a government initiative alone. Businesses can help by providing health insurance for their employees while GP's, allied health practitioners, private clinics and non-government organizations also set up integrated health care systems. That is because Integrated Health Requires More Than Just Health Service Integration. In an integrated system, every health care person and organization must be committed to teamwork within the organization and also with other facilities. The teamwork in integrated care can be vertical, e.g. in terms of general practitioners working closely with specialists. The teamwork can be horizontal in terms of co-ordination between primary care, social care, specialists, voluntary groups and user groups. All relevant agencies or professionals in every case have to speak and listen to each other and also communicate well with the patient and the patient’s family. Each person and each organization must all Be An Enabler Not a Barrier to Integrated Care.

Integrated care is therefore based on willingness to work with others, and willingness to share information with others and the patient. The federal government of Australia is committed to digital health which is why they implemented My Health Record, Healthcare Identifier Service and the Health Professional Online Services (HPOS). Not to be outdone, the private sector uses Health Pathways. All of them are making efforts to provide patient information and patient care information to all health care providers. The digital revolution is definitely upon us, but, unfortunately, all these systems operate in silos and medical service providers have to jump from one system to another trying to get enough information in order to serve patients. Isn’t it time to implement a universal system that provides everything that healthcare providers need to provide the right care at the right time?

At least the health care system has realized that they cannot do everything for patients while patients remain passive recipients of health. The Australian state and territory governments now encourage patients to become actively involved in their health and health care. Big unprecedented change is happening to create active participants. After all, carers are not available to a patient every day, so patients are being encouraged to take charge of their health between visits to the doctors.

For example, the government of Australia has introduced Health Direct Symptom Checker. This is an online government funded service that helps people to understand their symptoms. The Symptom Checker explains the possible cause of symptoms and recommends action, whether to see a doctor or go the emergency rooms or see a pharmacist. It even searches for the nearest health facility in the area. Also, the government is introducing self-management programs for people who suffer from chronic diseases, with specific programme for each disease, so that they can manage their conditions with adequate knowledge and support within the community. Each program provides books, leaflets, and DVDs for patients and carers. This is a very good move that may need improvement but is definitely in the right direction. Health care in Australia is a shifting paradigm indeed.

Whether the health care system is integrated or not, the interdisciplinary nature of health care is very complex and it is very difficult for lay people to understand. The government must understand the importance of utilizing service navigators in Integrated Care. Service navigators play a key role in making sure that patients are guided and informed as to what is involved in their treatment. They provide timely, seamless, and culturally appropriate guidance and support to help patients develop health literacy. This empowers patients so they can better navigate through the services that they need and they can participate in decision making.

Lastly, but not least, the government should introduce policies that promote the prevention of diseases. These policies will restrict the use of harmful chemicals in agriculture, in processing food and in personal care products. The policies will restrict the amount of harmful chemicals in imported products. They will also strictly monitor manufacturers and randomly test products to make sure that they all comply with government restrictions. When they have those policies in place, they will cut the causes of diseases at the roots.

Australia is doing very well in providing cradle to grave care in their universal health system. All the new programs that they are coming up with are filling all the gaps to make sure that every population group is cared for. All the programs simply need to be brought together in an integrated system that is centrally controlled by government. For this to work the private sector and the non-governmental organizations must be included in the integrated system. The other missing piece is prevention which must be taught to all healthcare practitioners who can then teach it to their patients. Efforts to prevent diseases should then be supported by policy that requires all citizens of the nation to comply.