Group Seminar

Drivers of Australian hospital expenditure growth 2004-2013

Adjunct Associate Professor John Goss will present a discussion on the factors responsible for the 51% real increase in admitted patient expenditure in Australia from 2004-05 to 2012-13. This presentation uses detailed data from the Australian Institute of Health and Welfare to show that factors such as ageing, increasing health prices and changing disease rates are minor contributors to the increase in admitted patient expenditure, despite the media attention these factors get. Much of the increase has been provider-driven rather than demand driven, so there is significant scope for the health system to control the rate of growth.

Because the increase in expenditure can be decomposed by age and disease group, we can develop a better understanding of which parts of the increase in provider driven expenditure were beneficial and which parts were perhaps not a cost-effective use of resources. The implications of this analysis for health funding are discussed.

Impact of welfare income management on health

Speaker: Janice Lee

Since the 1970s, economic shocks have increased youth and long-term unemployment globally. The OECD countries responded to the unemployment crisis by adopting activation measures to help the unemployed find jobs and participate in the labour market. Australia has adopted Activation measures into its welfare reform by (1) intensifying the surveillance of welfare benefits, (2) increasing conditionality and eligibility criteria for those on welfare benefits and (3) decreasing the real value of the material welfare offered by income support in the face of rising living cost.

As part of the activation measures in enforcing conditionality, Australia introduced Place-Based Income Management as a conditional cash transfer policy that quarantines a portion of certain individuals income support to pay for basic necessities. The government’s justification of PBIM is that it promotes socially responsible behaviours among recipients, especially towards their own wellbeing. However, welfare conditionality, enforced through surveillance, can be detrimental to health by widening the distribution of the social determinants of health.

Janice Lee’s project focuses on Compulsory Income Management as a regulatory instrument of the Activation regime in governing human behaviour. Using a qualitative approach, this project is to develop an empirically and theoretically informed understanding in which welfare conditionality regulates people’s lives and ultimately their health.