In 2008, the Council of Australian Governments (COAG) signed up to a National Healthcare Agreement to improve not only health outcomes for all Australians but also health system sustainability. How are they doing? The latest report by the COAG Reform Council—Healthcare in Australia 2012—13: Five years of performance—has good and bad news. It shows that life expectancy has increased for men (79·0 years to 79·9 years) and women (83·7 years to 84·3 years), deaths from circulatory disease have fallen (from 202·0 to 159·6 deaths per 100 000 people), as have deaths in children younger than 5 years (106·9 to 82·9 per 100 000 children) and the national smoking rate (from 19·1% to 16·3%).
However, potentially preventable hospital admissions for acute conditions (1079·6 to 1198·2 per 100 000 people) and vaccine-preventable conditions (70·8 to 82·2 per 100 000 people) have increased. The report also shows worrying increases in the overweight and obesity rate (61·1% to 62·7%), which could lead to peaks in type 2 diabetes and other chronic diseases in the future.
Monitoring is crucial to track health reforms and policies, and to identify health and health-care problems. However, this is not only the COAG Reform Council’s latest report but also its last. The Council will cease to exist on June 30, after being axed in the hugely unpopular 2014 budget delivered by Prime Minister Tony Abbott last month. One benefit of an accountability body such as the COAG Reform Council is its independence from federal, state, and territory governments. Concerns have also been expressed over who will now report on the Closing the Gap initiative of Australia’s governments to reduce disparities between Indigenous and non-Indigenous Australians.
Health agencies have also fallen foul of the new budget. Several, including the Australian Institute of Health and Welfare and the National Health Performance Authority, will be merged into a new super agency—the Health Performance and Productivity Commission. However, details are scarce on how this will happen. The future of health and health care in Australia has entered uncertain times indeed.
Getting to the heart of Abe’s vision for Japan’s military – The hottest buzzwords in politics these days are “the right of collective self-defense,” now that Prime Minister Shinzo Abe’s advisory panel on security has released its much-awaited recommendations for reinterpreting the Constitution. The Japanese people have been engaged in heated debate as Abe works eagerly to achieve a historic policy shift that would allow Japan to exercise this right, which he says would strengthen the Japan-U.S. military alliance. But what is the right of collective self-defense? Why is Abe pushing so hard for the change?
Partial Disclosure – “Glenn Greenwald is indignant, self-righteous, and self-aggrandizing—but so what? It’s a red herring, just as focusing on Edward Snowden—who is he, where is he—is a distraction. The matter at hand is not their story; as long as this is a democracy, it has to be ours.”
Iran Big Winner in the Iraqi Debacle – “The stunning success of the Islamic State of Iraq and Al Shams (ISIS), a Sunni terrorist group which began as al Qaeda in Iraq in 2003, in seizing control of almost a third of Iraq in less than a week came as a shock to Washington. Blame for underestimating ISIS is already becoming a major political issue, but America has been caught off guard by al Qaeda in Iraq for well over a decade because politics distorts intelligence. In the long run, Iran will be the big winner in the Iraqi debacle.”