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Purchasing prevention: making every cent count

National Health Policy Round Table

8 August 2006, Melbourne
Attended by Libby Kalucy

The Australian Institute of Health Policy Studies convened a stimulating National Health Policy Roundtable on 8 August 2006, facilitated by Dr Norman Swan.

What happens in Treasury?

Treasury relies on being presented with a coherent strategy for investment: providing compelling evidence that a problem exists, something can be done about it, the solution is cost effective and will achieve results in terms of population, participation and productivity.

Prevention is on the national agenda - the time is ripe for action

Prevention has been on the Council of Australian Governments (COAG) agenda for the last two meetings with substantial results. The door is open for a broader preventive health strategy after comprehensive evaluation of the human capital reform diabetes initiative.

Evidence exists

The Australian burden of disease studies provide a powerful set of tools about cost effectiveness for allocation of resources, as a result of intensive analysis and increasingly robust data. The big health gains will continue to be from tobacco control, prevention of coronary heart disease, and injury control.

So why not prevention?

Despite the evidence, preventive success is invisible - we don't personalise prevention as we personalise rescue and illness services. Misperceptions abound that prevention doesn't work, that people don't change their behaviour.

Prevention is undervalued, under resourced, and dominated by curative medicine and the rule of rescue. It is seen to be optional not indispensable.

Australia has neither a single authoritative source of guidance on prevention equivalent to the US Preventive Services Taskforce, nor a modality for funding preventive interventions.

The proven cost effectiveness of prevention is not equivalent to cost savings. Prevention is disadvantaged by high upfront cost, with benefits way down the track.

Public health practitioners need political, cultural and economic skills. They must speak the language of the public and politicians, work with industry if possible, and challenge it when necessary to maximise health and minimise harm.

For presentations, discussion paper and summary:
Web: http://www.aihps.org.au