Australian Health Care Reform Alliance

06/10/2026

AMA Aged Care Report Card 2026

The AMA's first Aged Care Report Card puts numbers to what clinicians, families and older Australians have been saying for years: when aged care can't take people in, hospitals become the waiting room. https://www.ama.com.au/resource?resource=327 #:~:text=AMA%20Aged%20Care%20Report%20Card%202026%2Epdf

The key findings

Hospital patient days used by people approved and waiting for residential aged care rose from 286,050 in 2020–21 to 460,122 in 2023–24. That's an increase of more than 60% in three years.

The national median wait for an aged care assessment more than doubled between 2018–19 and 2024–25.

One in 10 people entering residential aged care after approval waited more than three and a half years to get there.

Why this matters for the whole health system

Every day an older person spends in a hospital bed they no longer need is a day that bed is unavailable to someone in the emergency department. It's also a day of reduced mobility, higher infection risk and lost independence for the person waiting.

Access block, ramping and elective surgery delays are often treated as hospital problems. Reports like this show they are system problems. Aged care, primary care, community care and hospitals are funded and governed in separate silos, so the gaps between them become places where patients get stuck.

AHCRA's view is that fixing this needs more than additional beds in one sector. It needs:

- Timely, adequately resourced aged care assessment
- Home care and residential capacity planned against real demand
- Joint Commonwealth–state accountability for patients caught between systems
- Investment in community-based care that helps people avoid hospital admission in the first place

Older Australians should not have to spend months in hospital because the next step in their care doesn't exist yet.

Read the AMA Aged Care Report Card 2026: https://www.ama.com.au/library

15/09/2026

Aged care report card: 4/10 – not good enough

The wicked problem: mandatory staffing requirements have raised the amount of care provided to residents – an important achievement for which the government deserves credit.

But there is a sting in the tail. Providers increasingly report that, when they staff homes to the required standard, funding does not cover their costs. They cannot break even, let alone earn a reasonable return on invested capital, which even non-profits need.

Nearly a year into Australia’s aged care reforms, access remains difficult, waiting lists persist and costs are unaffordable for many, while flawed assessment and funding systems continue to undermine care.

10/09/2026

The value of private health insurance

We're sharing a must-read analysis by John Menadue today. Private health insurance (PHI) is propped up by around $13 billion of taxpayer money annually – but what are we actually getting for it? https://johnmenadue.com/post/2026/09/private-health-insurance-costs-taxpayers-13-billion-a-year-what-for/

The article lays out what many of us at AHCRA have been saying about PHI for years:
- A subsidy for the wealthy – The rebate and Medicare Levy Surcharge exemptions flow disproportionately to higher-income earners. Around 55% of Australians – mostly lower-income people without hospital cover – miss out entirely.
- No real relief for public hospitals – University of Melbourne research found little evidence that subsidising PHI eases pressure on the public system. Both sectors draw from the same clinical workforce, and PHI rarely covers emergency care.
- The US path we don't want to follow – The article warns we're heading down America's disastrous road – a system that delivers high-quality care for a few while ranking dead last among wealthy countries for overall performance. https://tinyurl.com/3t6sb4nv
- Inefficient and top-heavy – PHI management costs run at 11%, compared to just 3–4% for Medicare. That's billions going to marketing, product design, and executive salaries – not patient care.

This article echoes many of the issues that AHCRA has highlighted before: taxpayer money being funnelled into an inequitable, inefficient system that delivers questionable value. Here are three posts:
$25 billion for public hospitals — but patients still pay the price https://www.facebook.com/AusHealthReform/posts/pfbid0mtxzrY9iiHwVkVZJzgrZ3FTuHyCBmwD6FfXTR7pzbbMAbQhSLRbLMGzeys64ZKUsl
Private health insurers are failing both patients and hospitals https://www.facebook.com/AusHealthReform/posts/pfbid02Ed6SPCrmzTzh1YYQgZwdD4feXxyDWwCHNYdXPANts2AYR85ibHiReVcMwDMjt2HQl
Evaluating private health insurance https://www.facebook.com/AusHealthReform/posts/pfbid02REbusSYaH9HtLYiUov5N5HxNFpgPwMhdUgfjnALehxt1vb86xuCyXJBvKLWb3wtGl

Imagine what $13 billion could do if redirected to mental health, public hospital specialist services, or adding dental to Medicare. What do you think? Should Australia phase out the PHI subsidy, or does private insurance deserve this continued level of public support?

04/09/2026

In uncertain times for public health and prevention, what lessons can be drawn from the history of the now-defunct Australian National Preventive Health Agency?

04/09/2026

Victorian promise for free public dental clinics

The urgent need to improve equitable access to oral healthcare across Australia has been highlighted by a Victorian Labor election campaign announcement.

02/09/2026

Cutting the cigarette tax risks undoing a health win

The Coalition has proposed cutting the to***co excise by 80 per cent — from about $30 to $6 on a standard pack — arguing with little evidence, that closing the price gap with illicit to***co will starve organised crime of its profits. https://www.abc.net.au/news/2026-09-03/coalition-unveils-plan-to-slash-to***co-excise/107109642

Illicit to***co is a real problem: illicit product is etimated to now makes up more than half of ci******es sold, and around 80 per cent of to***co, vapes and pouches combined. (3 Sep)

But the numbers don't add up. Even after an 80 per cent cut, a legal pack would still cost roughly $18–21. That's barely below, and maybe still above, the $15–20 illicit price, with nothing stopping illicit sellers from undercutting the price further.

Not surprisingly, fifteen public health bodies, including Cancer Council, Heart Foundation and the Public Health Association of Australia, warn that the cut would make ci******es more affordable, lift smoking rates, and hand billions in profit to multinational to***co companies while barely touching the black market it's supposed to kill. https://www.cancer.org.au/about-us/news-and-media/media-releases/health-bodies-unite-to-expose-big-to***cos-push-for-tax-cuts

Here's the part that should make everyone pause: the evidence is that the excise is working.

AIHW's 2025 National Drug Strategy Household Survey found daily smoking has fallen to a record-low of 5.6 per cent. That’s down from 8.3 per cent just two years earlier, and down from 19.5 per cent in 2001. So the raw smoking rate has diminished significantly with the increased excise and other initiatives to reduce smoking. That’s a real health bonus that also has economic benefits.

The decline in smaking rates has held steady right through the years that illicit trade has exploded. What did spike is illicit purchasing among smokers. That's up from 16.7 per cent to 34 per cent in the same survey. That's a customs, retail-licensing and organised-crime enforcement failure. It is not evidence the health policy and excise tax have failed.

The ABS's separate experimental ni****ne-consumption series (not the AIHW survey) found total ni****ne consumption up about 30 per cent since late 2021 (the figure Mr Taylor has quoted) but the ABS itself cautioned the estimate is experimental, and the data does not establish that the excise caused overall consumption to rise. The Coalition's "consumption is up 30 per cent, therefore the excise has failed" claim conflates two different, non-equivalent datasets.

The overall picture: on the health outcome the excise was designed to modify i.e. smoking prevalence, has worked quite effectively. The problem that has emerged is a supply-chain/enforcement/retail-regulation failure, not a health-policy failure, and the AIHW and ABS data don't support treating them as the same problem.

Treating a border-security and retail-regulation problem as if the fix is a single number on a tax schedule is exactly the kind of siloed policymaking that AHCRA warns against and populist political advocates use.

What's actually needed is a “Health in All Policies” approach. That means customs, retail licensing, criminal enforcement, health promotion and taxation working as a coordinated strategy, each part doing the job it's good at, instead of suggesting the excise will solve a problem it didn't create and dismantling a ground-breaking public health success in the process.

The $200 million enforcement surge and $60 million awareness campaign in the Coalition's package are policy moves worth having on their own merits. Bolting an 80 per cent tax cut onto them isn't positive as a health policy, it's a bet that the fastest way to beat the black market is to make legal ci******es cheap enough that the market stops worrying. And it’s a bet against better health and wellbeing that twenty-five years of falling smoking rates say would be a bad move.

AHCRA calls for to***co control policy to be developed jointly across health, customs, law enforcement and retail regulation portfolios, not through a focus on excise settings alone.

A future Coalition government would slash the to***co excise by 80 per cent, legalise and tax vapes and ni****ne pouches, and bolster law enforcement to shut down the illicit trade.

31/08/2026

New national AI roadmap released.

The Australian Alliance for Artificial Intelligence in Healthcare (AAAiH) has launched its Third National Policy Roadmap for Healthcare AI, "Don't Walk. Run."

The Roadmap sets out 28 recommendations across eight priority areas, drawn from submissions by more than 90 member organisations and tested against 20 focus groups and interviews with state and federal officials over nearly a year of development. (22 Jul)https://aihealthalliance.org/wp-content/uploads/2026/07/AAAiH_3rdNationalPolicyRoadmap_FINAL.pdf

Paramedics absent from the text.
The Roadmap discusses AI professional guidance for general practitioners, radiologists, physiotherapists and nurses by name. It does not mention paramedics or ambulance services despite their role in healthcare.

That's an oversight given the extent of AI support being developed for dispatch triage algorithms, secondary triage, automated ECG interpretation and deterioration-prediction decision support that are already in use across Australian ambulance services.

Automation bias risk flagged.
A related piece in MJA InSight+ this month warned that over-reliance on AI risks "automation bias" — clinicians accepting unsafe AI outputs — and a deskilling effect on core diagnostic reasoning, "particularly for students and trainees who have not yet fully developed these core competencies."

AHCRA notes that risk is highest for any clinical workforce making high-stakes calls without on-site senior backup, which fits paramedics working solo at the roadside as much as any other frontline clinician. (Aug 2026) https://insightplus.mja.com.au/2026/31/when-your-patient-arrives-with-an-ai-self-diagnosis

System "unprepared," Croakey warns.
Croakey Health Media's assessment of the Roadmap was blunt: Australia's healthcare system is unprepared for AI disruption. AHCRA's position is that national AI governance needs to name every clinical workforce it intends to cover, including paramedicine, rather than leaving gaps for individual sectors to fill in after the fact. (22 Jul) https://www.croakey.org/australian-healthcare-system-is-unprepared-for-ai-disruption-new-report/

AHCRA will be watching how the Roadmap's recommendations are implemented as the role of AI is further developed across health.

The Australian healthcare system is unprepared to maximise the opportunities and manage the risks of artificial intelligence (AI), according to a new report putting forward dozens of recommendations for change.

13/08/2026

A public health crisis with global ripples

The executive order signed by US President Donald Trump on August 10, 2026, marks a significant and deeply concerning shift in American childhood vaccination policy. By slashing the number of routinely recommended vaccines from 18 to 11, calling for the separation of the combined MMR vaccine, and encouraging states to relax school-entry requirements, the order undermines decades of established scientific evidence and public health practice. https://theconversation.com/why-trumps-mmr-vaccine-order-is-the-latest-public-health-disaster-with-effects-set-to-last-years-289479?utm_source=twitter&utm_medium=bylinetwitterbutton

While the order does not ban vaccines, it lends credibility to scientifically unfounded notions of vaccine risk, including the debunked link to autism. Public health experts, including the World Health Organisation, have voiced alarm, warning that such changes could lead to delays in vaccination, reduce overall coverage, and trigger outbreaks of preventable diseases like measles, which is already on the rise in the US and globally.

The potential for damage extends far beyond America's borders, threatening global health security through the disruption of international aid and the weakening of key health institutions.

Ramifications for Australia
For Australia, the consequences of this order are both direct and indirect:

One impact is potential increased exposure to infectious diseases. As a nation heavily reliant on international travel, Australia is directly exposed to global disease outbreaks. The resurgence of measles in the US and other regions creates a higher risk of imported cases, a threat Australia is already grappling with as 2026 cases have surpassed those of the same period in 2025. A less vaccinated global population increases the probability of travellers introducing the virus, putting pressure on Australia's own vaccination coverage, which is already slipping below the 95% herd immunity threshold.

Another impact is weakening of health and medicine supply chains. Australia has long relied on US health institutions like the FDA and NIH for drug approvals and biomedical research. The hollowing out of these agencies threatens the pipeline for new medicines and could disrupt access to vital therapies. Furthermore, the Trump administration's "most favoured nation" pricing policies and 100% tariffs on pharmaceuticals directly target Australia's Pharmaceutical Benefits Scheme (PBS), placing pressure on affordability and availability of medicines. This creates significant uncertainty for the Australian health system's ability to provide equitable access to essential drugs.

A third issues is erosion of the global health framework. The US withdrawal from the World Health Organisation and the disruption of its foreign aid programs will cripple global efforts to control diseases like HIV, tuberculosis, and malaria. The breakdown of the international health surveillance and response network, which has been a cornerstone for protecting Australia from emerging global health threats, leaves Australia more vulnerable and potentially forces a more costly, independent response in the future.

Trump’s latest executive order is set to lead to delayed vaccinations, falling coverage and a resurgence of diseases once brought under control.

12/08/2026

The Fauci case: Science, Politics and Accountability

Writing in Pearls and Irritations, Professor John Dwyer offers a personal and professional defence of Dr. Anthony Fauci, reflecting on their decades-long acquaintance and Fauci's contributions to HIV/AIDS and COVID-19 research.
https://pearlsandirritations.com/post/2026/08/vindictiveness-is-fuelling-the-fauci-fiasco/

Dwyer addresses recent political attacks on Fauci regarding mask guidance, gain-of-function research funding, and rejected treatments, framing them as politically motivated rather than genuine accountability.

While Dwyer argues strongly for Fauci's integrity and scientific track record, the piece also raises broader questions about the balance between supporting scientific researchers and ensuring transparent oversight.

The letter responses to the article highlight differing views—some readers endorse Dwyer's assessment, while others argue that Fauci still has questions to answer, particularly around pandemic origins and decision-making processes.

The article and its responses underscore ongoing tensions between the need to back scientific expertise and the imperative for evidence-based, accountable public health governance, free from ideological or personal agendas.

The attacks on Tony Fauci over COVID-19 advice, masks, gain-of-function research and rejected treatments are vindictive politics dressed up as accountability.

10/08/2026

Healthy Starts - the first 2000 days explored

A new report from the Centre for Policy Development (CPD), Healthy Starts, maps what actually happens to families from pregnancy confirmation through to a child's fifth birthday — and finds a child and family health system that is nominally universal but functionally a postcode lottery. https://cpd.org.au/work/healthy-starts/

AHCRA's stated position is that the health system needs to be built on a social determinants of health perspective, and that inequalities in those determinants, not just direct access to care, drive inequalities in health outcomes. Healthy Starts maps onto that almost point for point.

Ten systemic barriers are identified: patchy access and workforce shortages, out-of-pocket costs that delay first contact, inconsistent cultural safety, rigid "eligible or not" service design, fragmented digital records, and — perhaps most tellingly — no national oversight body holding any of it to a consistent standard.

Compare that to maternity care, which has strong national clinical guidelines tied to funding and hospital accreditation. Child and Family Health services have eleven different guideline documents and none of that authority.

What makes this report worth reading is how squarely it lands on the case AHCRA has been making for years: that health outcomes are shaped far more by the social determinants — housing, income, transport, cultural safety, parental mental health — than by clinical care alone, and that no single sector can fix that on its own.

Healthy Starts finds those determinants are "rarely considered in service design, eligibility criteria or care pathways," and that there's no whole-of-government mechanism bringing health, education, disability and family services together around shared outcomes for this age group. That's a textbook Health in All Policies (HiAP) gap — the kind of siloed, sector-by-sector blindness a commitment to HiAP exists to correct.

It's also a sustainability question, not just an equity one. Early underfunded prevention shows up later as avoidable acute healthcare, justice system contact and income support costs. CPD's own Avoidable Costs work and the Front Project's Cost of Late Intervention report both make this case. A system built on progressive universalism — universal in reach, flexible in intensity by need — isn't just fairer, it's the more fiscally sustainable design over the life course.

The stakes are real: children in the most disadvantaged communities are developmentally on track at less than half the rate of those in the least disadvantaged (41.2% vs 61.1%), and around half of children identified as developmentally vulnerable never catch up.

Worth the read for anyone working across health and early years or social policy. CPD's recommendations report is still to come, but the mapping here is a solid, evidence-based foundation.

Healthy Starts is a report from the Centre for Policy Development that maps the experiences of families accessing health services across the first 2000 days, from pregnancy to age 5.