Let’s learn from the pandemic: economists

Skimping on the public health basics leaves the vulnerable exposed to poor health outcomes.

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Funding holes in Australia’s public health system have left the nation’s most vulnerable people exposed to poor health, economists say.

Softening the blow of a recession with targeted spending to drive jobs growth is at the core of the federal government’s budget, and professional bodies representing health practitioners aren’t expecting more for the sector than the telehealth changes announced last month.

But across the eastern seaboard, economists say now is the time to take action on lessons learnt from the coronavirus pandemic.

Hospital and elective surgery wait times were among the political bugbears before the global health crisis that killed more than 800 Australians and left the economy in tatters.

It has since revealed just how badly skimping on the public health basics can exacerbate illness and death during and beyond a pandemic.

“The big issue we’ve seen relating to health is a lot of the less glamorous stuff hasn’t been funded properly,” University of Queensland economics Professor John Quiggin told The Medical Republic.

Reforms to produce better outcomes in the largely privatised aged care sector had failed, Professor Quiggin said, and the underpaying of its workforce had contributed to the spread of disease among a frail population.

Last week, Australia’s former chief medical officer and now secretary of the federal Health Department, Brendan Murphy, told a Senate inquiry the deaths of so many aged care residents and additional outbreaks might not have occurred if the Morrison government had acted sooner.

But Professor Quiggin said cuts to Victoria’s health system and the outsourcing of contact tracing and quarantine hotel security had further the propelled crisis in that state.

“That’s one thing we’ve learned through all aspects of the pandemic, is if the governments want something done properly they do it themselves, they don’t contract it out to private providers, and they don’t rely on competition and choice,” he explained.

“What we need is more public provision and more funding of those kinds of services that haven’t attracted attention and mental health is another that is chronically unsupplied because it doesn’t have a very effective constituency.”

However, he said it was unclear whether the federal government would act.

“One day they’re doing positive stuff you would never have believed of them, and the next day they’re talking as if it was 2019 again and none of this ever happened,” he said.

“We can afford financially to have a much better system, and we can survive with a system which fails in crucial respects and lets hundreds of people die in aged care.

“But we can make choices, and I think we’ve seen the consequences of cost-cutting choices played out in various respects recently.”

Income support investment in response to the pandemic has been vital in supporting families make healthier choices and should stay, Australian National University Health Equity Professor and Menzies Centre for Health Governance director Sharon Friel told TMR.

“Those things really matter for keeping people healthy and well, they’re very good for people’s mental health, but of course they also provide sufficient money for people to choose to live healthy lives,” she said.

“Investment in those areas I would certainly be arguing for, not just from an economic and social policy perspective, but also from a health perspective.”

Cutting that investment will force households back into poverty and lead to more preventable, chronic disease, mental ill-health and a significant burden on the healthcare system, Professor Friel added.

She pointed to free childcare as a critical driver of increasing household incomes and women’s economic participation, as well as the impact it can have on family health outcomes and a child’s development.

“It gives them the resources to choose a healthy life, but it also gives them the social capital to be able to seek and understand health,” Professor Friel said.

Meanwhile, the reliance of governments on everchanging data to inform its response to the pandemic had revealed the need for more spending on real-time and accurate data collection, Griffith University Professor Fabrizio Carmignani said.

“It was very important, for instance, as we saw, to have reliable data on the distribution of cases by neighbourhood,” he added.

“In the case of COVID in Melbourne, it has demonstrated how having this type of information can be critical.”