Acute health sector reform: an analysis of the Australian Senate’s proposals

On reforming health systems The sun rose yesterday and with it came a reformed health system. Someone was hired as a policymaker and introduced a fresh idea. A heavily lobbied health Minister changed his mind and gave a new instruction to his permanent head. A government committee altered its stance, and as a consequence, a different policy initiative emerged. New research showed that one type of managerial system was better than another, and several hospital managers took note. Some managers redirected funds from one program to another. Numerous people tweaked the service they offered to patients. A few groups of clinicians, and even more individual clinicians, changed their practice to become more evidence-based. A number of patients, newly signed with a health fund, received private care in advance of the publicly insured. Obviously, these kinds of occurrences happen every day. The system is always undergoing change, the nature of which is usually small-scale and iterative, and sometimes cyclical. We can contrast this micro-level, emergent reform with the big bang alternative. Some attempts have led to major changes on the ground: the introduction of the USA’s Medicare and Medicaid programs by the Johnson administration in 1965 (which gave millions of poor people reasonable access to health care for the first time); the change to a socialist market economy in China in 1982 (which contributed to the destruction of primar