{"id":833094,"date":"2026-07-30T08:51:15","date_gmt":"2026-07-30T08:51:15","guid":{"rendered":"https:\/\/www.newsbeep.com\/au\/833094\/"},"modified":"2026-07-30T08:51:15","modified_gmt":"2026-07-30T08:51:15","slug":"australia-has-an-illness-system-not-a-health-system","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/au\/833094\/","title":{"rendered":"Australia has an illness system, not a health system"},"content":{"rendered":"

Australians can\u00a0expect\u00a0to live to\u00a083\u00a0years of age. That\u00a0gives us\u00a0the\u00a0tenth longest\u00a0lifespan<\/a>\u00a0in the world.\u00a0<\/p>\n

But a\u00a0new international study\u00a0of 204 countries\u00a0published in\u00a0The Lancet Public Health<\/a>\u00a0estimates that the average Australian now spends 13.9\u00a0of those\u00a0years living with illness or disability.\u00a0That\u2019s\u00a0about\u00a0one-sixth of\u00a0our lives\u00a0and\u00a0second worst in the world,\u00a0behind only the United States.\u00a0<\/p>\n

This\u00a0is\u00a0our\u00a0\u2018morbidity gap\u2019\u00a0\u2013 or\u00a0\u2018sickspan\u2019\u00a0\u2013\u00a0the\u00a0difference\u00a0between how long we live and how long we live in good health.\u00a0\u00a0<\/p>\n<\/p>\n

It\u00a0isn\u2019t\u00a0an isolated result.\u00a0A\u00a02024 study\u00a0in the\u00a0JAMA Network Open\u00a0<\/a>used a different international dataset and method, but reached much the same conclusion. It estimated that, in 2019, Australia\u2019s sickspan was 12.1 years, again second only to the United States.\u00a0<\/p>\n

The Lancet study also tracked changes\u00a0from 1990 to 2023, during which time\u00a0Australia\u2019s morbidity gap increased by 2.9 years\u00a0\u2013\u00a0the\u00a0second-largest rise recorded\u00a0globally, narrowly behind Kuwait.\u00a0<\/p>\n

Our illness system\u00a0<\/p>\n

A successful health system should postpone disease\u00a0and aim to\u00a0compress\u00a0illness\u00a0into a shorter period\u00a0later\u00a0in life. Instead,\u00a0Australia is\u00a0seeing an expansion of morbidity.\u00a0<\/p>\n

This reinforces an argument I have made previously.\u00a0That\u00a0Australia\u00a0doesn\u2019t\u00a0have a health system. We have an\u00a0illness system<\/a>.\u00a0<\/p>\n

We\u2019re\u00a0very good at rescue<\/a>. But our institutions and funding arrangements are overwhelmingly organised around responding after illness has developed. Providers are paid for episodes of treatment. Performance is measured by consultations, scans, admissions and procedures. Far less attention is paid to whether people remain healthy, illness is prevented, or whether treatment leaves patients feeling and functioning better.\u00a0<\/p>\n

Australia\u00a0spends more on health\u00a0care<\/a>\u00a0than most comparable countries.\u00a0In 2023, we\u00a0devoted\u00a010.3% of our GDP<\/a>\u00a0to\u00a0medical\u00a0care compared to\u00a06.5% in 1990<\/a>.\u00a0Our\u00a0spending on acute services\u00a0\u2013\u00a0mainly\u00a0hospitals\u00a0and specialist\u00a0care \u2013\u00a0has\u00a0grown faster<\/a>\u00a0than spending on primary care.\u00a0\u00a0<\/p>\n

But\u00a0we spend\u00a0less on prevention<\/a>\u00a0than the\u00a0average\u00a0OECD\u00a0country.\u00a0We\u2019re\u00a0among the\u00a0world\u2019s\u00a0most overweight<\/a>\u00a0nations. Preventable chronic illness fills\u00a0our\u00a0hospital beds\u00a0\u2013 avoidable hospitalisations are\u00a0above the OECD average<\/a>,\u00a0costing\u00a0about\u00a0$7.7 billion each year<\/a>.\u00a0<\/p>\n

The relationship between healthcare expenditure and sickspan \u2013 shown in the chart below \u2013 isn\u2019t straightforward. But it illustrates that high medical expenditure is no guarantee of healthy longevity. Despite our higher-than-average health spend, Australia has a substantially larger sickspan than countries such as Japan, Austria and Chile, which spend a similar or greater share of their GDP on healthcare.\u00a0<\/p>\n<\/p>\n

Medical care\u00a0remains\u00a0essential and can extend life. It can\u00a0sometimes turn what would have been an early death into years lived with a chronic condition. But population health is shaped by much more than medical treatment.\u00a0Things like income, housing, education, working conditions,\u00a0and access to healthy food\u00a0all affect when illness begins and how disabling it becomes.\u00a0<\/p>\n

Medical interventions do little to promote health compared to healthier living, which is driven by social, economic and cultural factors. These are far less costly than medical care.\u00a0<\/p>\n

In high-income countries, musculoskeletal, cardiovascular and mental health conditions account for much of the morbidity gap. The Lancet study identifies high blood glucose, high body mass and tobacco use among the leading preventable risks.\u00a0<\/p>\n

These problems can\u2019t be solved by building more hospitals. They require sustained investment in primary care, social care and early support for people to manage chronic conditions. They require action on the environments that promote unhealthy food, physical inactivity, smoking and harmful alcohol consumption. And they require governments to start treating prevention as a fundamental part of our health system.\u00a0<\/p>\n

Measuring what matters\u00a0<\/p>\n

As the Lancet study shows, we\u00a0would do well to\u00a0start measuring what matters.\u00a0\u00a0<\/p>\n

Life expectancy is\u00a0an\u00a0important\u00a0measure. But\u00a0in modern times\u00a0it\u2019s\u00a0no longer\u00a0a\u00a0sufficient\u00a0way of measuring a healthy Australia.<\/p>\n

Governments could report healthy life expectancy, the morbidity gap, and illness avoided as headline indicators of national performance. Given our high obesity rates, consumption of processed, sugar-laden food and beverages could also be an indicator.\u00a0<\/p>\n

All of\u00a0this is\u00a0eminently achievable\u00a0in\u00a0the data-rich\u00a0society\u00a0we\u00a0now inhabit.\u00a0<\/p>\n

In addition, healthcare funding\u00a0could\u00a0move away from\u00a0simply\u00a0paying for\u00a0the volume of services delivered\u00a0towards\u00a0also\u00a0rewarding prevention, care coordination, and\u00a0things that matter to people:\u00a0improvements in symptoms,\u00a0function\u00a0and quality of life.\u00a0<\/p>\n

None of this diminishes the importance of treating people who are already ill. Good hospitals,\u00a0specialists\u00a0and medicines\u00a0remain\u00a0essential. But a system that concentrates its resources downstream will always be\u00a0less effective\u00a0and less efficient\u00a0than it could be.\u00a0<\/p>\n

Luke Slawomirski is the Senior Postdoctoral Research Fellow at The Australia Institute.<\/p>\n","protected":false},"excerpt":{"rendered":"Australians can\u00a0expect\u00a0to live to\u00a083\u00a0years of age. That\u00a0gives us\u00a0the\u00a0tenth longest\u00a0lifespan\u00a0in the world.\u00a0 But a\u00a0new international study\u00a0of 204 countries\u00a0published in\u00a0The…\n","protected":false},"author":2,"featured_media":833095,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[34],"tags":[64,63,137,500],"class_list":["post-833094","post","type-post","status-publish","format-standard","has-post-thumbnail","category-healthcare","tag-au","tag-australia","tag-health","tag-healthcare"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/posts\/833094","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/comments?post=833094"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/posts\/833094\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/media\/833095"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/media?parent=833094"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/categories?post=833094"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/tags?post=833094"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}