Australias Health Care System | Analysis

Australias Health Care System | Analysis The key principle underlying Australian healthcare system is equity to universal access to most health care regardless of the situation or ability to pay. This is achieved since revenue for this healthcare comes from taxation. Health services are funded through Medicare and pharmaceuticals schemes which are highly subsidized by the government while public hospitals and public healthcare are partly funded by commonwealth and state funding agreements. The schemes are founded on the spirit to make public health accessible by all the citizens irrespective of their financial ability (Healy Hilless, 2001). The purpose of this paper is to expound on the concepts of equity of access of healthcare in relation to effectiveness and efficiency and the relationships that exists among these concepts. Equity of access Equity is all about ensuring that all people have the support that they need to access, participate and achieve the same level. Access and equity are two concepts that go hand in hand they imply removing barriers and opening up opportunities. In the field of health these concepts mean that people with differing needs and abilities have the same opportunities to be attended to professionally by the medical practioners whether private or public at any time irrespective of their age, disability, color, race, gender, religion, sexuality, or location. It means addressing the healthcare need of everyone (Department of education and equity standards branch, 2003). The Australian government through its insurance schemes have tried to make healthcare accessible to all, however, it has been found that compressive insurance coverage is not always sufficient to ensure equitable access to health services since other factors such as shortages or mal-distribution of health services providers or constraints presented by language or cultural differences limit access to medically necessary care for apportion of the population (Docteur, 2004). In fact there is a wide agreement that rural and remote Australian communities are underserved by appropriately trained health professionals compared to those who live in the urban areas. Further, most remote Districts of Australia communities are unable to attract medical practioners and they are dependent upon rural remote area nurses to provide their healthcare. The shortage of rural registered nurses also impacts negatively on health care delivery. Despite these short comings, Australian population enjoys good h ealth relative to other countries with an increasing life expectancy of an average of 78 years and low incidences of life threatening infectious diseases. Although the spirit of the government healthcare policy to provide equity and access to healthcare has not been fully achieved, this policy has contributed greatly to the health status of its citizens. For instance over 85% of the people consider themselves to have excellent health status. In order to achieve the equity of access to health care ità ¢Ãƒ ¢Ã¢â‚¬Å¡Ã‚ ¬Ãƒ ¢Ã¢â‚¬Å¾Ã‚ ¢s important that distribution of the health officers be checked and implements tele health services that will ensure that those Australians in remote areas have access to relevant healthcare (Jackson et al., 2009). Effectiveness There is no unanimity on how the concept of effectiveness can be defined, as a result of this there is inconsistency among scholars in their definition of the concept for instance. Some scholars view effectiveness as the degree by which organization achieves their goals, while others view it as the survival of the organization (Sudan Chand, 2004; Stephen, 2008). Other feels that effectiveness is present as long as an organization uses its resources efficiently and continues to contribute to the large system. Despite the inconsistencies, scholars have agreed on some points that may be applicable in measuring effectiveness. For instance how well has expectations of the society been met as per societal regulations and rules, the time dimension of how the system meets its goals in near future. Intermediate or in distant future and the decline or growth of the system can also be an indicator of effectiveness (Sudan Chad, 2004). Increasing the effectiveness of health care systems in Australia is growing priority for policy makers. The notion of effectiveness encompasses a broad and growing number of dimensions, reflecting increasing expectations in Australia in such away that health system must do more than just improve population health and reduce disability. The effectiveness of the access of health care by rural and remote communities in Australia has been enabled by the outreach models initiated; these are periodic supplies of the services from one location especially in towns to other location in this case remote areas. Other problems associated with heath care system especially in secondary and tertiary services such as surgery are not available to the people for instance Kimberley region has higher mortality rates than in the state level due to lack of access of specialist services like surgery which takes to long to be availed. The state rural community lacks enough medical personnel which mean that access to healthcare is also a problem. Compared to major towns like Melbourne, Kimberly the Australiaà ¢Ãƒ ¢Ã¢â‚¬Å¡Ã‚ ¬Ãƒ ¢Ã¢â‚¬Å¾Ã‚ ¢s most northern region with the highest proportion of aboriginal people always have a shortage of not lees than 20 medical doctors (OECD, 2002). Efficiency Measuring efficiency in healthcare is concerned with comparison of inputs with outputs or outcomes of the health care system to access the degree to which goals are achieved while minimizing resource usage. From economic perspective, efficiency put two elements into consideration that is allocative efficiency and dynamic efficiency.Allocative efficiency is aimed at allocation of resources so that the input invested in heath care system yield the best output. To achieve this technical efficiency, effectiveness and priority setting must be addressed. Effectiveness is aimed at maximizing outputs to a limited amount of inputs. Priority setting involves deciding amount of resources to be allocated in each and every disease while technical efficiency is achieved by ensuring that the staff serves to their full potential. Efficiency can also be measured in three levels i.e. the disease, subsector and system level. The disease level focuses on each disease on the gains in heath status brought by healthcare system, while the subsector level focuses on gains brought specifically by hospitals, outpatient care and pharmaceuticals and the system level relies on the holistic view of the system (OECD, 2010). Large hospitals and multi general practioners practice and specialist medical centers are most common in urban Australia and rare in rural Australia and services that look similar are actually structured differently. These healthcares deliver different services and cater for different populations. Rural residents are not equal participants in the primary health system since there are few general practioners in rural areas, they also make few visits in healthcare centers and they spend much to seek health care than their urban counterparts this means that the Medicare scheme of the government is not efficient in providing equity of access of health care to all citizens. The cost of time, transport and greater competition for services in regional centers contributes to lower utilization rates of those in smaller isolated communities (Luck, 2011). In addition the experienced pre-exist nurses in rural area can be up-skilled to serve a broader range of primary health care hence reducing t he burden of the general practitioners rather than trying to fill every vacancy of general practitioner. The nurses serve by complementing the work of medical practitioner. Interrelationships A properly functioning health system can be evaluated in terms of equity of access, efficiency and effectiveness of all the components of the system. Although there are a number of challenges in these dimensions, Australian health care system has strengths which manifests that the government has made efforts to maintain the proper functioning of the system in recognition that all these aspects are necessary and inseparable in a good health system. Efficiency, effectiveness and equity of access concepts are thus interrelated and their matrix is important when formulating policies of a system. Healthcare has remained a focal point for discussion throughout the history. However with entitlement spending dramatically increasing, poised for further increases, healthcare has been placed at the fore front of public policy. Globally very few countries have achieved an efficient and equitable healthcare industry. Australia serves as an excellent example in their health care policy because its system balances for equity of access and efficiency through the adoption of the free market policies in health provision as well as the base safety net for individuals who cannot afford free market rates hence making sure that the biggest population can be able to access the health services. According to Duckett (2008) efficiency compare outputs to inputs in this case, the number of health care staff to the number of people seeking health care services putting in to consideration the satisfaction the patients. Ità ¢Ãƒ ¢Ã¢â‚¬Å¡Ã‚ ¬Ãƒ ¢Ã¢â‚¬Å¾Ã‚ ¢s possible to estimate the number of health staff required to attend patients satisfactorily in every region if efficiency ratios are known. In the efforts to achieve efficiency and effectiveness of the medical staff the policies of the government ensures that the citizens can access adequate and qualified medical personnel equitably. For instance in rural Australia there is an average of one medical doctor in a population of one thousand people. This is in contrast with the urban settings where the number of medical doctors is higher in the same population. While doctors in rural area may be efficient due to high number of patients they attend to access to them by citizens is limited hence contributing to the in effectiveness of the system due to citizensà ¢Ãƒ ¢Ã¢â‚¬Å¡Ã‚ ¬Ãƒ ¢Ã¢â‚¬Å¾Ã‚ ¢ dissatisfaction. Australia government and private sector has invested heavily in construction of health facilities in all regions so that citizens can access them easily and equitably. For instance it had 1051 acute care hospitals of which 734 were public hospitals providing 70% of the bed stock and 317 were private hospitals. Public hospitals are funded by the government or by charitable organizations while private hospitals are privately funded (Healy, 2001). Due to large number of public hospital with many facilities and resources they at times underutilized hence operating inefficiently. To ensure that efficiency is achieved public hospitals liaise with private hospitals to provide private services that are not available in private hospitals. This way efficiency is achieved and at the same time the satisfaction of the citizens by the kind of collaboration that exist between private and public hospitals indicates that the hospitals are effective in accordance with social rules and regulations. Eff iciency of hospitals has also been achieved through the policy of regional hospitals constructed in regional centers especially to cater for rural population. The regional hospitals also help the citizens to access specialist health care with ease. All this efforts contributes to the success of the health system in the spirit on universal access to health care (Duckett, 2008). For the societal satisfaction with the health care system the founding principles of the Australian health care system must work hand in hand. Effectiveness, efficiency and equity of access principles should be demonstrable in a perfect system. Although perfection cannot be achieved the governments through its insurance policies have tried to make accessibility a reality. In addition to accessibility the efficiency of the health workers has been tried to be achieved through encouraging the general practitioners to work in the remote areas where there is shortage of practitioners this is done through incentives, perks and allowances offered to those who practice in rural areas in addition to this tele health care services are adopted such that health care services are moved closer to the people from the urban areas where it concentrated these practices are done periodically. Conclusion The underlying principle in Australian healthcare system is equity to universal access to most health care regardless of the situation or ability to pay. This is achieved since most health care system get revenue from taxation thus promoting equity of access of the health system. The concept of equity of access in relation to effectiveness and efficiency is also explored in Australian heath care system (Healy, 2001). In this case efficiency is measured by degree to which goals are achieved in health care system while minimizing resource usage while effectiveness is measured by degree to which health care system achieve their goals. Large hospitals and multi general practitioners practice and specialist medical centers are most common in urban Australia and rare in rural Australia. This indicates that the Medicare scheme of the government is not efficient and effective in providing equity of access of health care to all citizens. Representations Of Women In The Media: Unrealistic Representations Of Women In The Media: Unrealistic In this essay I will discuss the images of women in mass media and mass culture and how realistic or discursive they are. I will approach this through observing and analysing media advertising and stereotyping of females as a whole. I will examine the role of the woman in modern society and consider her position in public culture. I will begin with an explanation of Cantors theory that representations of women in the media are unreasonable and too different from reality in present society (Cantor, M. 1978). This hypothesis suggests that these images reflect only a few â€Å"real† women and disregards those of different colour, age, status or sexual orientation. The fact is that female icons in the media reshape the perceptions of women and exacerbate the flaws of ordinary ones. Goffman (1979) argues that while images of men are closer to reality, female are represented as â€Å"models pretending to be real persons†. This comes from the fact that women in mass media have lost their personality and have become an object of sight, a thing to be gazed at (Berger, J. 1972). I conclude that women in popular culture do not represent the complete reality but we can witness some improvement throughout recent years, which I will mention later in the essay. First, I will start with the way that women are displayed in the media and what their role they adopt in terms of populism. Females, either celebrities or models, are often put on exhibit in different types of media in order to promote products, shows, movies, events. There are different stereotypes- from the femme fatale to the supermom but there is a connection between all of them. They are always white, slim, and perfectly-shaped which implies a certain ideal of the modern woman. Problems come when ordinary women are forced to conform to this ideal. And when I say â€Å"forced†, I mean trying to live up to the imposed visions of female beauty. There are set standards of beauty and women try to meet these standards in order to be liked and admired. Womens main concern is their body shape. They try to achieve this mesomorphic figure. This means an ideal shape of the body which for women is an â€Å"hourglass† figure (Handout â€Å"Is Media Sexist†). I argue tha t these beauty standards are established for a purpose. Everybody gains from womens insecurities except them. When women are not self-confident, they turn to cosmetic and diet products to achieve the desired standard. This results immediately in the profit and the development of the companies and the industries. For evidence I turn to data from (BBC News World Edition, Feb 5. 2003) where the diet industry alone is worth 40 to 100 billion (U.S.) a year. What is worse, being surrounded by all these perfect images, women start to feel depressed, lose their self-confidence and develop eating disorders. The American research group Anorexia, Nevrosa Related Eating Disorders, Inc. says that one out of every four female students regulates her weight through fasting, skipping meals or vomiting. â€Å"Beauty demands sacrifices† this is the excuse for women suffering and struggling to achieve the ideal. However, this ideal lies in the realm of the unrealistic beauty. It is impossible to achieve perfection and what is more, flaws make us unique and charming. Nevertheless, not everybody feels that way, especially when every single advertisement, show or magazine has imposed the thinness as the main factor for attractiveness. Canadian researcher Gregory Frouts reports that over three-quarters of the actresses in television shows are underweight and those who happen to be heavier are criticised and get negative comments. Magazine industry has made some efforts to oppose the trend of displaying only slim models by putting a heavy-set model on its cover but the advertisers remain sceptic towards their ability to sell beauty products. Another group being affected by the beauty standards are teenagers. 50% to 70% of all preadolescent girls, for instance, are reported to have been on at least one diet and are dissatisfied with their bodies. This stems from the fact that more young girls are involved in media and popular culture. By observing their idols that dress provoc atively and act controversially, teenage girls look up to them and imitate them, believing this is the right behaviour. In her book the Beauty Myth, Naomi Wolf (2002, page 3) says: â€Å"The notorious Calvin Klein ad campaigns eroticised sixteen-year-olds when I was a teenager, then eroticised fourteen-year-old models in the early nineties, then twelve-year-olds in the late nineties.† With reducing the age of the girls on exposure in the media, it becomes harder for youngsters to ignore the sexualized ideal and not to obey the markets and the industrys conventions. The truth is that this sexualized ideal and pornography have started to influence popular culture and this leads to the objectification of women (Briggs, A. and Cobley, P. 1998). Knowing that sex sells in todays society and men are attracted to women on the base of sexuality and seductiveness, the only thing which comes to mind when seeing another commercial with a beautiful and provocative girl, is sex. The need for mens attention and the wish to be desired are the main reasons for a woman to change herself. In spite of the change, women will hardly achieve this ideal because of the high and unattainable requirements it sets. The term which applies to this situation is hyperreal. It is a post-modern theory which suggests that we cannot tell the difference between image and reality (Baudrillard, J.) It seems that media has reshaped usual representations and it is hard to perceive an image of a celebrity going out in the public without makeup to walk her dog, for example. The incapability of making a distinction between media image and reality and setting an expected model for womens appearance make it harder for women to meet the demands of the popular media. That is to stand for something that does not exist. This is the time when the simulacra replaces reality. The Simulacra (a copy) starts as a reflection of reality, then it masks and misrepresents it till there is no longer a basic reality and the simulacra becomes a substitution for the real world (Baudrillard, J. 1988). Good example s are processes which help us transform our image such as digital photography and editing, virtual reality, controlling weight. These methods of changing oneself could have a great impact on the simulacra and it will start to disguise and fight reality. For instance, nowadays is easier to fool the audience. With the developing technology and the growth of cosmetic surgery industry it has become a common practice for faces of the media to cover certain imperfections and to hide flaws. I will argue that female movie stars are highly misrepresented regarding their appearance. The paradox comes when even in movies for ancient times, female characters are still perfect, with perfect skin and white teeth never mind the situation, the place (stranded on a desert island for example, the TV series Lost) or the period of time. Also, body doubles are used to veil some weaknesses of the actresses. (such as Julia Roberts in Pretty Woman). Studies show that 85% of these body doubles have breast implants. (Kilbourne, J., Cant Buy My Love, 2001). However, there is scientific evidence which suggests a lot of women with breast implants suffer different side effects: pain, deformations of the skin, insensitive breasts or potentional tumour. (Centre for Policy Research for Women and Families, Washington, D.C.) Studies indicate that even plastic surgeries among teens have increased by 50% from 1996-1998 mostly for girls. This results from media superstars parading with their plastic surgeries and advertising them everywhere which eventually leads to a model for imitation. This non realistic model, however, cannot be accepted by everyone. Very few women could achieve this ideal. Even so advertised among girls Barbie cannot be a measure for perfection. Research comparing a computer model of a woman with Barbie-doll proportions shows that if put into practice, this exemplary woman would have a too weak back and a too narrow body to include all human organs. Eventually, such a woman would die from malnutrition. (Time, Nov 11. 1996). This is another example of the unrealistic image and role which women accept. There is another alternative that women have started to apply their desire for beauty and change- the reality TVs Extreme Makeover, The Swan or I Want a Famous Face. These people, mostly women, participating in the project are subjected to a strict diet and exercise regimes, psychological counselling and many surgical procedures. The aim is to transform the person physically and then the inner peace and tranquillity will be achieved resulting in ones satisfaction with life. These programmes claim that all social and personal problems could be solved through cosmetic surgery. The only thing that the shows miss, however, is showing the potential risk of such interventions. Neither of them reveals the possibility of complications of plastic surgery. In this way particularly women are made to believe that ideal bodies are attainable and transforming ones figu re is a normal thing now. (Turner, L. 2004). In other words, all kinds of media television, film, radio, magazines and music video industries have a great influence on defining and identifying the conceptions of ideal physiques and figure. Music televisions such as MTV often display girls and women in the traditional role of a sex object, inviting and evoking sexual fantasies, whereas serious female musicians are rarely featured. Also, men are shown as sex objects less frequently. (MTV Programming; and Media Use in America, 2000, Mediascope). So, women are again in the submissive role but this is the way audience will perceive them. Most often, there is a connection between images and audiences. Fiske (1987) suggests that audiences recognise two different strategies when interpreting womens images. One is the realistic interpretation which implies the presence of real persons and the belief that the representations are genuine. The other is the discursive interpretation which reveals a non realistic image and depends on the so cial and cultural values of the audiences themselves. This suggests that images of women in the media correspond to the needs and the values of contemporary society. Eventually, interaction occurs between media representations and their addressees. It is in their hands to decide whether to believe or not, whether to be like these images or not but the most important thing is that the women should have the right to choose and not to follow an unrealistic ideal just because of the trend. I conclude that the conception that women always have to perfect their bodies has made a huge progress. Nevertheless, there have been some indications for a change in recent years. Naomi Wolf (2002) argues that from the first publishing of the book, which criticise the demand and the judgement upon women concerning the beauty, there has been some room for improvement now. According to her, there is no more just one representation of the woman in popular culture. Women of colour have now more publicity in all fields of media (e.g. Rhianna, Beyonce), as the second one is one of the most successful and profitable singers and is more of a plus-size woman at the same time. Speaking of plus-size women, I suggest looking at celebrities like Queen Latifah launching a plus-size clothing line. Before, it was unthinkable to display old women and whenever this happens, they were transformed in such a way that they will have no wrinkles and will look no older than thirty. Now, media is overwhelmed by statements like â€Å"Demi Moore is not afraid of getting old†. Different age, colour, even sexual orientation (Ellen DeGeneres- openly gay TV host) have started to get accepted by general public and gain more popularity in terms of the real representation of women. I would like to conclude that there are still stereotypes and a common misrepresentation of women in the media but it is all starting to create a greater variety of beauty standards which result in a more realistic, though still demanding, conception of beauty and femininity. References 1. Baudrillard, J. (ed.) (1988) Selected Writings, Stanford: Stanford University Press. 2. BBC News World Edition, Feb 5. 2003, The Diet business: Banking on failure. http://news.bbc.co.uk/2/hi/business/2725943.stm 3. Beauty and Body Image in the Media http://www.media-awareness.ca/english/issues/stereotyping/women_and_girls/women_beauty.cfm 4. Berger, J. (1972) Ways of Seeing, Harmondsworth: Penguin. 5. Briggs, A. and Cobley, P. (1998) The Media: An Introduction, Essex: Pearson Education Limited 6. Cantor, M. (1978) â€Å"Where are the women in public broadcasting?† in G.Tuchman (ed.) Hearth and Home: Images of Women in the Media, New York: Oxford University Press. 7. Centre for Policy Research for Women and Families, Washington, D.C. 8. http://www.mediaandwomen.org/problem.html 9. http://www.monstersandcritics.com/people/news/article_1393908.php/Demi_Moore_s_age_ease 10. Friske, J. (1987) Television Culture, London: Methuen. 11. Goffman, E. (1979) Gender Advertisements, New York: Harper Row. 12. Handout â€Å"Is Media Sexist† 13. Kilbourne, J. (2001) Cant Buy My Love, New York: Touchstone. 14. Moore, S. (1998) â€Å"Heres looking at you, kid!† in L.Gamman and M.Marshment (eds) The Female Gaze, London: Womens Press. 15. MTV Programming; and Media Use in America, 2000, Mediascope 16. The Canadian Womens Health Network (Body Image and the Media). http://www.cwhn.ca/node/40776 17. Time, Nov 11. 1996, Barbie boots up. http://www.time.com 18. Turner, L. (2004), Cosmetic Surgery: the new face of reality TV 19. Wolf N. (ed.) ( 2002) The Beauty Myth, London: Chatto Windus