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=**‘Keeping the Bastards Honest’**= (Lewis, 2011)
 * By Shaughna Scott**

//Presenting the artefact//
This artefact is an important element of the public health system in Australia. It is the card in which each individual possesses, displaying their family number and personal number, followed by individual names, whereby corresponding with the public health system. The card is coloured green and gold, displaying the Medicare symbol on the top right corner and the validity on the bottom right corner of the front of the card. It provides the general public with benefits in order to allow each member of the community equality in health and wellbeing.

//Naming the Public Health Issue central to analysis//
This artefact represents the public health system within Australia and the problems that are illustrated through embracing a holistic approach. Although Medicare was implemented to give the entire country a fair level of health and wellbeing, this approach is to be re-evaluated to ensure the current issues cannot be foreseen in the future of Australia’s public health. The issue that lies before us is the staffing in general or lack thereof within the public health sector, and the results of both this and limited resource, on society as a whole and for individuals alike. The re-development of the public health sector would be supported by the views of Sociologist Karl Marx, to ensure an egalitarian society.

//Literature Review//
Public health is supported financially by the government, which in turn is supported by the public and by the taxes each individual pays on food, clothes, cars and wages. We all deserve the right to good health and wellbeing; however the money that isn’t being spent on the public health system is hindering the ability for equality in health.Three years ago the Australian government proposed that $150 million will be funded to state and territory hospitals in order to reduce waiting lists (Biggs, 2008). Between 2005 and 2011 the Ipswich Hospital has had an average increase of 56% in regards to the number of doctors, nurses and practitioners that operate within the hospital (Queensland Government, 2011). There are 71% more doctors; however the populations increase since 2005 has been only 12%, making the additional doctors a real necessity (Australian Bureau of Statistics, 2011). With a population increase of one person every 1 minute and 31 seconds the rate these doctors must continue to increase is astronomical. Quite frankly, they will not be able to do it; the waiting lists have dropped by five days in seven years, but at this rate it will be another 40 years before the waiting list for elective surgery is null and void (Queensland Government, 2007).

Canadian Raisa Deber took time to evaluate the Australian health care system in 2005, providing comparisons between both the Australian and Canadian systems. Canada is comprised of private non-for-profit institutions with independent boards, were as Australia has the public sector and the private non-for-profit as well as the private for-profit hospitals each providing a separate level of care. After visiting hospitals in Victoria it was noted that they had no control over the capacity, prices or services offered to consumers and that the services provided were not equal to the entire population. Moreover, the professionals within these hospitals believed that the waiting lists were no concern, but the public view this in a very different light (Deber, 2005).

Raisa studied the opinions and relationships between each of the Australian health sectors whilst at the VHA conference, unbeknownst to her was the tension between the health care sectors. She discovered that the Australian hospitals are unwilling to communicate between one another; making her question the balance between competition and cooperation in the Australian hospital system. As each division is providing a service of health to the community, it’s hard to justify the conflict between maximising health outcomes and maximising profits. The make a positive change to the entire health care system, would mean a change to the goals of each sector. Although the public sector is providing a service to all individuals the delivery1 is not nearly adequate for the number of individuals using the service. As the delivery in each sector differs the implementation of a strategy would be difficult; however, if there is no change to the current public health system the public will begin to lose confidence in the sector, and confidence is fragile as proven by the Canadian health care system. Deber finalised this by stating that the public system needs to be revisited, otherwise there is the potential to further compromise the capacity and capability of the public sector by, increased total costs and diminished equality (Deber, 2005).

The overall need for change is evident; our public sector is supporting a large number of people within society who cannot afford private health. A new initiative by the Australian Government rendered necessary in 2010 is the Lifetime Health Cover, incorporated to encourage people to take out hospital cover earlier in life. If hospital cover isn’t taken out before an individual’s 31st birthday they pay a lifetime loading on top of their premium every year (Australian Government, 2010). Given no choice, this should alleviate public hospitals of excessive patients, however forcing society to pay for their personal health.

It seems as though the government is slowly making changes to the public health sector. After many years of waiting lists, limited beds and underpaid staff, the government has made some select changes to assist the public hospitals and avoid diminishing standards. Although Deber makes the claim that the population’s confidence in the public sector will subside, for the mean time the limited changes that have been made will holt the opinions of society. Sociologists would agree that the public health system is an appropriate way to provide equal standards of health care to society (Breslow & Cengage, 2002). There is no need to eliminate the public health sector; there is only a need to adjust its minor issues.

**Private health insurance 1995 to 2004-05 (a) (b) **
 Between 1995 and 2005 the private health insurance rates have slowly increase approximately 10%. Continuing with that rate of increase a further 6% of the population have taken up private health insurance at the year to date. The majority of the people in 2005 to hold private health insurance were couples and couples with children. This trend to move towards private health insurance may be due to a need for security or could be a direct result of the public health care system and its limited ability to support the growing population (Australian Bureau of Statistics, 2006).
 * (Australian Bureau of Statistics, 2006) **

**Insurance status by household structure, 2004-05 (a) **
 The groups affected by this trend include those who under take health insurance, but also include the doctors, residence and nurses who work in the public sector, who may lose their position due to the lack of patients. The enormous costs involved with full comprehensive health insurance, can sometimes exceed the need to have it. Family with children can cost an average of $4000.00 a year to ensure the optical, dental, hospital and other remedial benefits are included. On the other hand, families who cannot afford this cost on top of everyday living costs can reap the benefits of bulk billing clinics and Medicare rebates. It is important to understand that many families takeout private health insurance as a security screen, so that if an injury does occur there are no financial setbacks. However if bulk billing and Medicare rebates are provided to ensure that families do not suffer through injuries, why has this trend developed (Australian Bureau of Statistics, 2006)?
 * (Australian Bureau of Statistics, 2006) **

It is important to make the federal and state governments of Australia aware that there is a growing trend towards private health insurance, due to the limited number of beds and staff in the public sector. The governments should be aware that they are providing a diminishing service, whereby free health and wellbeing is placed aside, while families opt to pay for their health. Parliament needs to address this issue as a life or death problem, as if potentially could be if the issues within the sector are not resolved. If the public are receiving equal opportunity and rebates with Medicare, yet there are waiting lists that exceed some individual’s life expectancy, the community are not suffering as a whole. Socials groups and community groups that cannot afford the treatment are suffering from the lack of equality within the system.

The focus should be taken from; persons undertaking health insurance to ensure they are always able to receive the necessary treatment, to, why are these people who may not be able to afford health insurance opting for just that? The focus should be to better the public sector, rather than to force individuals above 30 to buy hospital cover. The focus should be, what can we do to ensure that our patients are able to receive the correct treatment? Maybe a slight increase in the Medicare levy will allow the government to further improve the public health sector, and not lose the confidence of the population.

//Analysis of Artefact and learning reflections//
A Medicare card; a piece of plastic that sits on your wallet; a piece of the public health system that gives each individual the right the health and wellbeing; an object that reflects the continual lack of change within the public health sector that could, in its own rights, cause a life or death situation. This card displays what is only evident within the health system in Australia, and that although there may be issues within the sector, it still gives everybody the right to good health within their life. We may have a limited number of beds, a limited number of staff and a waiting list the exceeds one month for elective surgery, however we have a diplomatic society, whereby we all agree on what is right and what is needed in the community.

It is easy to say that we all should move to support private health, however too many people in either category, could cause a limited number of supplies that are required. When looking at the Canadian health care system, the society lost all their confidence within the public system, causing a ‘private health’ run society. For equality and fairness for all in public health, we must support the need for public hospitals; if a minimal increase on the Medicare levy were to occur, it can only benefit us wholly as a society. The government need to be aware of the changes that are required in the system; however, they also need to be aware the system works.