Universal Health Policy in Australia - Essay Example

? Public policy Number: Introduction A public policy refers to a principle guide to action taken by a governmenton a specific range of issues in a mode that is in line with the law and institutional customs. The government seeks to address a public issue by instituting laws, decisions, or actions significant to the problem at hand through public policy. Various issues may be addressed by public policy such as crime, health, social welfare, education, trade and housing. The process of creating new public policy basically follows three steps. The first step is the agenda setting, followed by option formulation and finally implementation. The time taken for a new policy to be put in place and be fully operational may take a short time as one week, and as long as years. Public policy draws people, institutions, markets and government into familiar patterns of decision making (Althaus, Bridgman & Davis, 2013). This essentially implies that setting and administering policy are intricate as many stakeholders and players influences decisions and choices made. Preparation of a public policy is a daunting task, which calls for intense activity and coordination with other administrative and government decisions to ensure consistency. The process may take a long time as decision makers have to incorporate expert evidence, bureaucratic and political counsel, and competing interests of people affected by the policy proposal (O'Sullivan & Gibb, 2008). This discussion seeks to explore public policy on social housing in England, as well as health policy in Australia Universal health policy in Australia Australia attains universal coverage through Medicare, which is a tax financed public insurance program that covers most medical care. The universal health care also includes physician and hospital services and prescription drugs. Majority of Australian health services are funded and regulated by the central government, but territories and states have obligations for public hospital care (The commonwealth fund, 2013). In addition to Medicare, the government subsidizes private insurance, which is used by half of the Australian citizens to cover dental care costs and private hospitals (Australia Policy Online, 2013). Issues surrounding universal health policy coordination Universal health policy in Australia has been a subject of debate in the commonwealth since 1940s. The focal point of concern is the diverging interests of major stakeholders who have conflicting interests. Healthcare givers want huge profits and earnings; the government wants to maintain a tight and strict control over the money they use, whereas consumers want to have quality healthcare facilities at affordable prices (Armstrong, 2007). In verity, these objectives cannot be accomplished at the same time, which heightens conflicts among stakeholders. In addition to the above controversy, Australia experiences ideological differences among its top organs of government. The liberal party in coalition with the national party takes on a liberal individualist approach. This favors least government intervention in the health policy, leaving private insurance and private medicine to take the largest role. On the other hand, the Australian labor party takes a social liberal stand, holding that health ought to be financed by the government in a bid to attain access and equity goals. Perspectives on policy implementation Australian government is faced by major challenges in implementing universal healthcare. Although Australian health system is globally ranked among the best; much needs to be done to address the concerns on a variety of issues. These are the health of aboriginal Australians, quality of health offered, access, equity and affordability, increase in preventable diseases, sexually transmitted diseases and HIV/AIDS and complexity of health services. In addition, the strides made in the health sector that place Australia are under pressure as a result of the ageing population, the rising burden of chronic ailments and the ever outdated organisation of the health services (Barraclough & Gerdner, 2008). Disparities existing between the rich and the poor exist, and all these affect implementation of the universal health care policy. There are diverse criteria for eligibility in the various government programs. For illustration, the aged care and health care programs have acute and artificial demarcations. In order to obtain access to certain services, one has to meet the requirements stipulated through the different gateways. Different providers of service keep different records. The health services are also coupled with misinformation that only the clandestinely insured may utilize private hospitals. Such complexity results in delayed treatment where serious complications develop before treatment commences. The Australian populace considers the country’s quality of health services as inadequate and falling below par. Armstrong et al, (2007) noted that medical errors and instability of healthcare result in poor quality. There are large numbers of medical errors that add up cost of healthcare provision. Issues in decision making Some of the issues affecting decision making are as a result of global growth. As diversification increases, there is the need to conform to the global standards in various aspects like the use of technological equipments in medication and planning for sustainable communities. Use of technological equipment such as biological therapeutics, radiological scanners, and minimally invasive surgical procedures require the government to set a substantial amount of finances. A liberal individualist view adopted by the national party, and the liberal party leaves such decisions in the hands of the private care (Centre for Policy Development, 2007). Failure to subsidize technological equipments attracts stakeholder concerns as to whether new medical developments are not available to all Australians, or they are a preserve for the affluent few. This generates a lot of political pressure from citizen interest groups (Australian Centre for Health Research, 2011). Speedy expansion of the urban Australian population is creating hardships in planning for healthy and sustainable neighborhoods. Rapid growth in urban centers in areas with little government attention have few or no pedestrian facilities, high pollution, cheap food and other health risks, which are related to high obesity rates, depression and other preventable ailments. The above urban challenges in urban planning, similar to those initiated by the public health movement in the industrial age extend beyond health to planning and architecture jurisdictions. Perils to the global environment and the international concerns on transmissions of contagious diseases and deemed with growing clarity in Australia. In addition, there is the global concern on sustainable development, and health buildings are required to meet sustainability thresholds (Victorian Health Association, 2007). Sustainability implies that any development has to be environmental, social and economic conscious. The challenge is that some of the health institutions were built in the past, and modern designs may be necessitated to reflect the global changes. Public policy on social housing in United Kingdom Social housing public policy was initiated in the United Kingdom in 1980 in order to offer homes for life to tenants as mass unemployment hit most parts of Britain in the 70s. The unemployment led many to clinging to their tenancies as a means of sheltering from the economic change. As part of promoting the welfare, the government offered social housing as part of reducing welfare dependency. Several issues have arisen since the development of social housing as critics challenge social housing because unemployment hit its 30 year lowest since 1997 (Communities and local government, 2010). Social housing focuses on the poor who specifically depend on welfare as a way of life. One is required to demonstrate the need and vulnerability while applying to qualify for social housing. Questions on social housing arise as to whether children of social tenants are helped by inheriting dependency or assets. Different approaches to policy analysis Council housing in the 20th century was aimed at enhancing physical conditions especially for the working class in leading industries. Social housing is today meant to cater for people with the need for housing, where need is evaluated in terms of homelessness. Homelessness system takes that temporary lack of somewhere decent to live necessitates long term assistance. The current UK government policy on social housing is under criticism that it is overtaken by the time as times have changed and unemployment has fallen due a strong economy. The “work pays” approach benefited most lone parents, and post-Thatcher welfare system excellently played its work in promoting housing. Prior to 1997, one was worse off in a job than on a dole, but the minimum wage has aided in boosting the appeal of work. However, this does not appear to have a key impact on social housing (The Smith Institute, 2006). A survey carried out in 2003/4 established that 62 percent of social tenancies have no-one in work. This does not include the retired, although it is still a deeply worrying figure in the context of daily life on an estate. The survey reveals a challenge to the children of social tenants as they have no experience of adults working. UK looks different currently as compared to the 1980s and early 1990s when unemployment was viewed as a price worth paying and sub regions saw their industrial base collapse with nothing put in place. In contrast, today few places are devoid of work prospects as times have changed (Policy exchange, 2010). Social housing currently appears trapped in a time warp because the country claims to have social justice and a dynamic economy whilst the majority of the poorest are still put together as a single group on stigmatized estates. Perspectives on housing policy implementation One of the most worrying trends on social housing implementation is that many lessons are not being learnt on how to succeed. Subjective evidence holds that, children of social tenants and whose parents struggled hard to win tenancy as a result of mass unemployment are essentially proficient at getting accepted as homeless today. A quit notice may be served on a 17 year old by a social tenant, and this is wholly valid as an explanation to be acknowledged as homeless. The concern as to whether children of social tenants are taking over a welfare dependency outlook arises. Subjective proof establishes that numerous local areas are identifying such trends through homeless strategies and reviews (Thornhill, nd). In the contemporary Britain social exclusion goes beyond income disparity but assets. There are growing levels of home ownership, increasingly; people have access to assets in their property that can be passed on to future generations. Equity can help cushion people against pension inadequacy and offers greater confidence to families. Nevertheless, social tenants usually have nothing and no assets to pass on to their future generations (Stone, 2003). This challenges the implementation of social housing to date. Implementing social housing is currently at odds with the modern government thinking. The government has a chancellor’s children bonds, which is a government sign to address the question of asset divide. There is also the growing emphasis to offer low cost home ownership options as a step in the housing ladder. With property proving the asset of preference to the majority of the British populace, any key rethink on housing policy is likely to look tough at how even the poorest families can be assisted to acquire assets. It is intricate to see how this will fit within a social housing system that necessitates the expression of need and susceptibility above the reward of initiative and effort. Another challenge towards the implementation of social housing is that tenants are unlikely to take care and respect the house as they do not own or pay for it.  Issues in the choice of policy instruments There is a growing concern among political divide and policy makers that social housing is a cause of welfare dependency. The former British prime minister held that housing pressures are a key barrier to opportunity, and expressed the need to reform public services. The former premier held that the country’s vision is to change essentially the contract between the state and citizens at the hub of those 20th century settlements. He further held that the nation needs to move from a welfare country that relieves poverty and offers basic services, to one that offers high quality services and the chance for all to fulfill their potential to the maximum. Applying the above thinking to social housing implies that a major renovation of the housing policy to match the 21st requirements. Social housing has been a subject of debate as most policy makers see it as a system that entrenches poverty and dependency, usually stigmatizing people as unlikely to succeed. Such system cannot be the aim of a government that is dedicated to enlarging opportunity and spreading the wealth. However, such renovation will not be simple (Beider, 2008). The explanation is that labor usually perceives social housing as part of its legacy. Issues in decision making in the social housing policy United Kingdom is currently experiencing high costs of home ownership as more people want to one home against limited resources like land. The market forces are driving up the cost of home ownership. This shatters the dream of the numerous people wishing to own homes and instead lengthening the list of people seeking social housing. Families that rent private low incomes have to grapple with poor living conditions and insecurity (Shelter, 2013). The number of family units is growing at a higher rate than the number of house builds. Shelter England advises the government to take several measures to resolve the current situation. One of the resolutions to the government is to build more social homes. Shelter England is championing the government build more social homes and ensure that the new homes are decent and suitable for inhabiting. A key issue challenge arises as to whether the government will build more social homes, yet it views as a way of creating more dependency on welfare services. In addition, the country is a capitalist economy where market forces determine the cost of goods and services (Shelter, 2013). Building new social homes may impact on the housing market, which is a significant sector in the Britain’s economy. Shelter England also recommends the government to improve the existing housing stock. With a countrywide shortage of social housing and affordability challenges in the asset market, low income households are more and more relying on a largely uncontrolled private rented sector to meet their housing requirements. There is poor or no security of tenure in rented private sector. Shelter organization calls on the government to improve the existing house sectors, to make sure that, British populace have both decent and secure homes. However, the government is faced on the challenge on whether to repair or replace, putting in mind that the social housing was constructed in the 20th century. On its part, the government seeks to have housing policy reform that reflect a global perspective, as well as buildings that incorporate new technologies while at the same time observing on environmental sustainability. Following the social housing policy in Britain and the universal health policy in Australia, it is clear that the two have several differences. One of the observable differences is that Australia’s health policy is geared towards health provision for all while social housing caters for the lowest income households in Britain. Social housing is perceived as a source of marginalizing poor households in one location, and it is viewed by many as a way of perpetuating dependency. On the other hand, universal Medicare seeks to promote equity among all Australian populace (Koutoukidis, Stainton, & Hughson, 2012). The high cost of access to Medicare prompts the Australian government to finance its health services to ensure affordability, equity and access. This is in a bid to achieve the society goals, reduce the health gap and level the social gradient (Willis, Reynolds, & Keleher, 2009). While universal healthcare is for all Australian citizens, social housing is for special groups of people, who must first show their need and vulnerability. This is the requisite conditions for one to have access to the council provided houses. The social housing policy is an issue of the government and the needy people in the United Kingdom. This implies that major stakeholders in the social housing are the government through the local authorities and councils. The healthcare system in Australia is a mixture of public private partnerships. The government finances both the public and private hospitals and insurances to offer health services nationally. This usually creates pressure among the various stakeholders such as the government, consumers and the health care providers. The constant wrangles involving the multiple stakeholders make access to health services less equitable. The quality of care is compromising, and healthcare cost keeps on increasing, thus creating a barrier to healthcare access (Fletcher, 2000). The makeup of healthcare as a combination of government and private financing and service delivery is presented as an issue of preference. The private health insurance supplement may be perceived as inequitable by citizens living in rural areas as access to private health amenities is limited in rural areas. One notable similarity affecting the social housing policy and the universal healthcare is the aspect on globalization and global requirements. The social housing units were constructed in the 1970s and have not been changed since then. The government grapples with the question on whether the rebuild afresh or to renovate the existing facilities. The decision on whether to reconstruct the houses afresh stems from the fact that the housing requirements have changed and there are pressures from the government to construct houses that meet the 21st century requirements. Similarly, some of the health units need to be constructed to meet the technological and global requirements, especially ensure environmental sustainability. There is an increasing global concern on the need to observe sustainability on the environment. A health facility is likely to result in environmental damage through the various chemicals, and thus the planning and architecture jurisdictions are needed to design new hospital buildings that incorporate that fact. Conclusion The above public policies are made to protect the general public and the needy groups in Australia and the United Kingdom communities respectively. However, several issues affect policy implementation and coordination. One of the major issues is that a public policy involves several stakeholders, who usually have conflicting interests. The diverse interests and views affect implementation, coordination and decision making, which may affect the success of the public policy. Another notable challenge is the financing issues and difficulties. The government is usually the key financier of most public policies. As such, the government often tightens its budget since resources are few. Low finances may imply compromised quality, low or poor security and disparities since the rich few will opt for privately offered but expensive services. The majority poor have to grapple with the poor quality resources provided by the government. This is viewed as a source of dependency. Bibliography Althaus, C., Bridgman, P. & Davis, G., 2013. The Australian Policy Handbook. Sydney: Allen & Unwin. Armstrong, B.K. et al., 2007, challenges in health and health care for Australia, medical journal of Australia, 187(9), 485-489. Australia Policy Online, 2013. Health policy in Australia. Accessed on 4 June 2013 from< http://apo.org.au/commentary/health-policy-australia>. Australian Centre for Health Research, 2011. Health care in Australia: prescriptions for improvement. Accessed on 4 June 2013 from< http://www.achr.com.au/pdfs/ACHR%20Book%20- %20Health%20Care%20in%20Australia%20- %20Prescriptions%20for%20Improvement.pdf>. Barraclough, S., & Gerdner, H. 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