Healthcare in Australia: contesting marketized provision

Research output: Chapter in Book/Report/Conference proceedingChapterpeer-review


Australia’s experience of healthcare appears full of contradictions. It is usually considered typical of OECD norms, providing universal public healthcare through the popular public insurance scheme, Medicare. Yet, public health care arrived relatively late. Efforts to nationalise health in the immediate post-War years were frustrated by constitutional barriers and partisan opposition. Only in the 1970s was public insurance legislated following a fierce political and parliamentary battle against an organised and aggressive medical profession and conservative parties. Opposition continued under a subsequent conservative government, and Australia became relatively unique when it stepped back from a functioning public health scheme. Ironically, the scheme was reintroduced and entrenched, as Medicare, from the 1980s, just as neoliberalism was eroding universalism in welfare states globally. The tumultuous history of health reform shaped a hybrid model of public provision. While Medicare is a universal public insurance scheme, it sits alongside existing systems of private hospitals, private health insurance and fee-for-service medicine. Despite bipartisan commitment to, and strong public support for, public insurance, governments have continued to provide substantial subsidies to the private sector. The private sector has undergone its own transformation. Regulation has shifted from ensuring cross-subsidies for poorer and sicker members to penalising non-members, and from non-profit ownership to corporatisation. These transformations reflect a politics of liberalisation alongside the overt and ongoing commitments to universalism.
Original languageEnglish
Title of host publicationThe Routledge handbook of the political economy of health and healthcare
EditorsDavid Primrose, Rodney Loeppky, Robin Chang
Place of PublicationLondon ; New York
PublisherRoutledge, Taylor and Francis Group
Number of pages11
ISBN (Electronic)9781003017110, 9781003846970
ISBN (Print)9780367861360, 9781032650678
Publication statusPublished - 2024

Publication series

NameRoutledge International Handbooks


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