I have spent perhaps five years working this out.
And when it comes to anyone who needs care in this country, from kids to patients to the disabled to the elderly or wounded, Australia is headed in the wrong direction.
My hypothesis is that, by 2037, Australia could have a largely government-funded but privately controlled human services system.
Government will still pay for care. In fact, it may spend more than ever.
But it will increasingly cease to be the organisation that decides how care is delivered, employs the people delivering it, or directly controls the infrastructure on which that care depends.
Instead, government will become the purchaser of services, the setter of financial targets, the collector of personal information and, increasingly, a financial partner of the businesses delivering those services.
A relatively small number of large organisations could control much of the infrastructure through which Australians access disability support, aged care, veterans’ services, mental health support, employment assistance, childcare and social housing.
Some will be conventional private equity businesses. Others will be investment-backed not-for-profits and social enterprises. Their ownership structures will differ, but many will operate in a system designed around government contracts, economies of scale, financial returns and measurable outcomes.
The central change will be that government increasingly purchases an outcome rather than guaranteeing the support a person needs.
The foundation for several parts of this already exists. It is being actively developed and some of the legislation passed last week, in the midst of that media flurry, will facilitate this happening. It is no single part of legislation but many parts, taken together, that give rise to this.
And the most important point is that nobody needs to secretly coordinate the entire system for it to develop this way. The financial incentives, procurement rules and investment structures can drive it in that direction on their own.
Australia is headed in the wrong direction. Our government is not listening to what people want and need.
Next week we will be holding a meeting and asking people to talk about not just these issues, but solutions. Sign up on the
enoughaustralia.com website and we’ll send you more information.
Because we are the third richest country in the OECD. And there is enough to go round.