Toward a Lifetime Health System: Can Australia Do Better?
Introduction
Australia prides itself on having one of the world’s fairest and most accessible health systems. Yet many people who rely on Medicare feel that the system no longer reflects the realities of modern health, long-term wellbeing, or even basic equity. “Universal healthcare” in Australia remains a patchwork of historical choices, exclusions, waiting lists, and imbalances between public and private services.
This blog explores some of the foundational issues — and invites a public conversation about where we go from here.
Dentistry: The Most Obvious Gap in “Universal” Healthcare
Medicare does not cover routine dentistry, despite dental health being inseparable from overall health. Untreated dental conditions can lead to chronic pain, infections, poor nutrition, and hospitalisations. Affordability remains a major barrier: millions of Australians delay or avoid dental care entirely.
If universal healthcare excludes dentistry, can it really call itself universal?
Many OECD countries incorporate dental coverage into their public systems. Australia’s omission is increasingly difficult to justify on either medical or equity grounds.
Other Exclusions: Acupuncture, Chiropractic, Complementary Care
Australians commonly use various non-biomedical therapies, from acupuncture to chiropractic to meditation-based practices. These reflect diverse cultural, religious, and philosophical understandings of health.
The central question is:
Should a public health system recognise the full diversity of healing practices that people actually use?
Or should it restrict funding to narrowly defined biomedical treatments?
This question will become increasingly relevant as complementary therapies grow in popularity.
Public Waiting Lists — And the Silence Around Them
Access to surgery diverges sharply between public and private pathways:
- Private patients are generally scheduled quickly.
- Public patients often face months or even years of waiting, with little communication or transparency.
This leaves people in pain and uncertainty, undermining the principle of equitable access based on clinical need.
A diagnosis can be quick — but treatment can feel endlessly out of reach.
A System That Treats Symptoms Rather Than Lives
Australian general practice is excellent, but structurally constrained. The system is oriented around short consultations and reactive care.
A genuine lifetime health system would support GPs to:
- build long-term health plans
- monitor early warning patterns
- integrate movement, stress reduction, balance training, tai chi or meditation
- act as navigators for complex referrals
- coordinate whole-of-life preventative care
Other countries do this. Australia could too.
What Should Government Provide?
Given the diverse beliefs Australians hold about health, what role should government take?
Possible models include:
- a universal baseline “health policy” for every citizen, similar to a standardised insurance contract
- regulated options for complementary, holistic or culturally specific treatments
- salary and staffing safeguards to prevent private hospitals from hollowing out public ones
- clearer rules about what services Australians can expect — and why
These questions go to the heart of fairness, autonomy, and what a community owes its members.
The Revenue Question
Universal dental care, shorter waiting lists, expanded primary care, and better staffing cannot emerge from thin air.
Australia currently tries to deliver high-quality services on relatively low tax levels compared with other advanced nations. Public expectations and public funding are misaligned.
We cannot expect Scandinavian outcomes with American tax settings.
If Australians want a truly universal, lifetime-oriented health system, we must be willing to have an honest conversation about revenue.
Why Reform Feels Impossible — And Why It Shouldn’t Be Impossible
The system is large and complex, and people often feel powerless to influence it. Yet health is the one institution every person interacts with across their entire life.
A coherent lifetime health system would:
- cover essential needs including dental
- bring transparency to waiting lists
- integrate preventative and complementary care
- guarantee a universal baseline policy for all
- maintain a strong, well-staffed public sector
- be sustainably funded
We should not assume the status quo is the best we can do.
An Invitation to Comment
We would genuinely like to hear your views. Please don’t just think this is the best we can get. Unless you say what concerns you, bureaucrats may well do a good job, working hard to steadily improve things but priorities may be different from the public’s.
Also, how well do you think Australia’s health system works for people across their lifetime?
What have your experiences been with dental care, hospital waiting lists, or preventative health?
What should be included in a genuinely universal guarantee, and what role should government, private providers and citizens play?
Your comments will help shape future discussions in the Universal Fellowship.
References & Further Reading
Australian Institute of Health and Welfare (AIHW)
- Australia’s Health 2024. Canberra: AIHW.
- Oral Health and Access to Dental Care. AIHW reports.
Productivity Commission
- Public and Private Hospitals: Performance Indicators. PC Report Series.
- Report on Government Services (ROGS) 2024.
OECD (Organisation for Economic Cooperation and Development)
- Health at a Glance 2023: OECD Indicators.
- Comparative data on dental coverage and public health spending.
Grattan Institute
- Duckett, S. & Nemet, J. Waiting List Realities in Australia’s Public Hospitals. Grattan Report.
Australian Bureau of Statistics (ABS)
- Health Service Utilisation and Health Insurance Statistics.
- Patient Experiences Survey.
