A presentation in two acts

By Justin Bowra, Sydney Adventist & Royal North Shore Hospitals,

Australia SMACC 2015

The Elephant in the Living Room

DISCLOSURE

PROLOGUE

PART I

The Elephant in the Living

Room

But…

AUSTRALIA

Health spending

1995: 7.5% of GDP

2012: 9.1%

Australian Institute of Health and Welfare

USA

1995: 13.3%

2012: 17.9%

AT THIS RATE…

2050

Australia 13%

USA 25%

What’s going on?

Ageing population?

Better treatments?

‘On average, a 50-year-old now is seeing

doctors more often, having more tests and

operations…’

‘Health systems themselves are

becoming a threat to society’s

wellbeing.’Atul Gawande, Reith lectures

Doctors

Government Special

interests

Hospitals

Insurers Lawyers

Consumers

Doctors

Plumbers

PART II

Fixing the system

Doctors

Government Special

interests

Hospitals

Insurers Lawyers

Consumers

Doctors

HOW CAN THE

ELEPHANT HELP?

1. Look at the big picture

2. End-of- l i fe discussion

about the healthcare budget

3. Sur render some

autonomy

1. Look at the big picture

2. Shared decision making across society

3. Surrender our autonomy

A challenge

FINAL THOUGHT

‘Business as usual’ is not an option

THANKS

Rob Day, Mark Gillett, Cath Herlihy, Sally

McCarthy, Stella McGinn, Larry Melniker & Nick

Stow

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