Unless the state and federal governments can agree to make big structural changes to the way they collect revenue and spend it on health, then millions more people will die sooner than they need to, live in more pain than is medically necessary and waste years of their lives navigating a broken system rather than doing something far more productive — like working, caring for their kids or simply gardening.
The problem is that we have left the problem to the state health ministers to negotiate solutions with the federal health minister and they are stuck in a zero-sum game.
In the current negotiations, every dollar gained by one state either comes at another’s expense or adds to the Commonwealth deficit.
The obvious solution is to find more revenue, but that’s usually a conversation for treasurers, not health ministers.
Trying to fix our public health system without talking about how to collect more revenue is like trying to cure heart disease while ignoring the need for better diet and exercise.
Systemic problems respond best to systemic solutions. And luckily there is a simple solution to the health ministers’ woes.
But before prescribing the cure, let’s first accurately diagnose the problem.
The states’ major source of revenue from the Commonwealth comes from the GST.
When John Howard and Peter Costello proposed the GST, they roped in state premiers to help sell the idea by promising that all of proceeds from the GST would flow to states to fund services such as health and education.


