Editorial

Abstract

The AHR Models of Care section aims to provide a diverse number of articles that canvas many areas of health care. In this issue, we look at transition care and mutidisciplinary case conferencing in aged care services, and a psychosocial model of care in breast cancer services. The first article by Giles et al is entitled “The distribution of health services for older people in Australia: where does transition care fit?”. The second article is “Perceptions of multidisciplinary case conferencing in residential aged care facilities” by Halcomb et al. A case study write up of a quality assurance project is also presented — “The Breast Service Psychosocial Model of Care Project” by Williams and Mann. As this year draws to a close, there are multiple health care reforms occurring in Australia and abroad. One of the more dominant reforms occurring is the United States health care reform considering universal coverage of its population (among other relevant reforms). The last issue of AHR included in its Models of Care section an article highlighting some of the possible ways forward for health insurance coverage of its population. Before this time and since then, there has been ample debate and discussion around draft bills of legislation and the possible frameworks and principles that any eventual reform policy would incorporate. Likewise, in Australia, there is much occurring in health reform. The Rudd government commissioned a National Health and Hospitals Reform Commission in 2008 who provided their final report A healthier future for all Australians in June 2009.1 It has outlined 123 recommendations for long-term health care reform in Australia. The report is being dissected and discussed among the government, industry and to a lesser extent the public at large. The Rudd government’s decision to wait at least 6 months to digest the report and call for particular actions is both deliberate and strategic. Other federal government reports which have received considerable attention are Australia: the healthiest country by 2020 — National Preventative Health Strategy,2 and a discussion paper around a future National Primary Health Care Strategy.3 The former was completed in June 2009 and released to the public in September 2009 and the discussion paper entitled Towards a National Primary Health Care Strategy was released in 2008. As of the time this Editorial is being written, a final draft National Primary Health Care Strategy has yet to be released to the public. I urge all readers of AHR to look at these documents to get a taste for the priority of reforms being discussed in the federal government. There are similarities and differences among the issues canvassed in both the US and Australian government health reform bills, policy discussion papers and reports. As in the topics of articles offered in AHR issues, areas of discussion include financing and governance, quality and safety, inequalities, health information, public versus private health, health service utilisation, workforce and many other areas concerning health care. As a key difference, Australia is not debating the universal coverage component. This is already valued among the majority of citizens in this country and has no intention of being changed. Yet, the financial structures and governance of health care in Australia are being hotly debated. A similarity among reforms in both countries is that they are largely battling with broader (and deeper) issues of “values” and “ideology”. It is important to distinguish this from the particulars of any report or bill of legislation and acknowledge that both countries are at important crossroads. Watch this space.