- Total health care expenditure in Australia is rising faster than inflation and population growth. Growth in spending has been fuelled by factors including the growing prevalence of chronic disease and an aging population, and is exacerbated by workforce challenges and an increasingly complex service sector.
- Nearly three-quarters of total health expenditure is consumed by public and private hospitals (39%) and primary health care (35%) AIHW 2018. (reference: Reference: AIHW. Australia’s Health 2018. Chapter 2.2: How much does Australia spend on health care?
- Figure 1, as informative as it is, fails to depict the contribution of other funding streams to population health. Siloed approaches to health funding have created administrative ease but have limited joint responsibility and action for population health outcomes. By way of example, the National Disability Insurance Scheme (NDIS) is a social insurance initiative jointly funded by the Federal and State and Territory governments which provides essential services to eligible people with disabilities. The annual cost for the NDIS is approximately $14 billion though forecasts indicate significant year-on-year increases. (Reference: Dickenson, H. (2018). Explainer: How much does the NDIS cost and where does this money come from? The Conversation.
- Research shows that healthcare is only a modest factor in preventing premature death – e.g., only 10% of the contribution to premature death in the United States (reference: 4 New England Journal of Medicine (2007). We can do better: Improving the Health of the American People. 357: 1221- 1228.
- Healthcare reform agendas have emphasised a whole-of-government approach to achieve improved population health. Applying resources from other sectors would have a substantial multiplying factor on Australia’s health investment. (reference; 7 Bartlett C, Butler S and Haines L (2016). Reimagining health reform in Australia: Taking a systems approach to health and wellness. Pricewaterhouse Cooper.
- Below is an alternate picture of cross sectoral investment in population health. Here, it is clear that many sectors make significant contributions to health needs across the continuum of care. As a mock up, the figure indicates the probability of service duplication and service gaps when investment is considered collectively. Accordingly, this paper promotes shared investment as a way to leverage cross sectoral action on shared health determinants and outcomes.
Figure 2 depicts a highly condensed picture of healthcare funding. Even with this simplification, the complexity of the system is apparent.
Figure 3. Cross sectoral investment in the health continuum.
