Stoelwinder Johannes U
Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
Med J Aust. 2009 Oct 5;191(7):387-8. doi: 10.5694/j.1326-5377.2009.tb02846.x.
The National Health and Hospitals Reform Commission (NHHRC) has recommended that Australia develop a "single health system", governed by the federal government. Steps to achieving this include: a "Healthy Australia Accord" to agree on the reform framework; the progressive takeover of funding of public hospitals by the federal government; and the possible implementation of a consumer-choice health funding model, called "Medicare Select". These proposals face significant implementation issues, and the final solution needs to deal with both financial and political sustainability. If the federal and state governments cannot agree on a reform plan, the Prime Minister may need to go to the electorate for a mandate, which may be shaped by other economic issues such as tax reform and intergenerational challenges.
国家卫生与医院改革委员会(NHHRC)建议澳大利亚建立一个由联邦政府管理的“单一卫生系统”。实现这一目标的步骤包括:达成一项“澳大利亚健康协议”以商定改革框架;联邦政府逐步接管公立医院的资金;以及可能实施一种名为“医保精选”的消费者选择健康资金模式。这些提议面临重大的实施问题,最终解决方案需要兼顾财政和政治可持续性。如果联邦政府和州政府无法就改革计划达成一致,总理可能需要寻求选民的授权,而这可能会受到其他经济问题的影响,如税收改革和代际挑战。