[Music]
I’m here today to ask you all to ask
yourselves is healthcare a right or a
luxury it’s a vitally important question
but before you respond allow me to
challenge you a little I’ll start with a
story in 2015 I was offered an
opportunity to spend a year training in
one of the world’s best cancer hospitals
in the US this was a huge privilege for
me and I was really excited to go the
only strange thing was when I was
filling out my starting paperwork for
the job I was being asked questions like
did my two young kids have any
pre-existing illnesses I was also
informed that even if they were
completely medically well I still had to
pay about $25,000 a year in health
insurance or I wouldn’t be permitted to
work there $25,000 now myself being the
product of a more socialized public
system here in Australia and New Zealand
this was a foreign concept to me it was
a little scary in fact the idea that
children may not get medically treated
if they didn’t have the right health
insurance organised by their parents
what if they didn’t have parents what if
their parents were on the minimum wage
it felt wrong it felt unfair and this
was in one of the wealthiest democratic
nations on the planet but anyway I did
the needful got the insurance flew to
the US and I started work and this place
was absolutely incredible cutting-edge
medical and surgical services being
delivered by some of the most brilliant
and most dedicated doctors and nurses in
their field but there was a catch and it
was always looming in the background the
best way to describe it is that this
probably truly was the world’s best
cancer hospital if you could afford it
and I struggled with this idea
on the one hand I had seemingly
unlimited resources with which to treat
patients which was actually frickin
awesome I loved it but it was a bit like
a guilty pleasure because I knew that
for every patient I treated another
would get rejected because they didn’t
have insurance or the right level of
cover so one day I was sitting in the
tea room between operations and I
finally blurted out to a colleague of
mine I said how can you live with
yourself as a doctor knowing that a
large segment of your population can’t
access the care that you provide her
answer surprised me she said the problem
you have Tariq is you can only really
see things from a British colony
socialists perspective
she said you regard health care as a
birthright and feel that you’re
automatically entitled to it but have
you ever considered that it may not be a
birthright that in large parts of the
world including here in the u.s. it’s a
very expensive luxury she then went on
to say what makes you think that by
being born a citizen of a given nation
that you are automatically entitled to a
brand new big state-of-the-art Hospital
the latest medical technology and the
most expensive drugs money can buy
funded by your government and taxes
don’t you see if that’s what you want
then you have to accept rationing and
death panels because there’s just no way
that any government can pay for
high-quality health care for all of its
citizens it’s simply too expensive so
you have a choice crappy mediocre health
care for everyone with long waiting
lists or high-quality health care on tap
for those that can afford it I can’t lie
I was taken aback a bit by this I’ve
never heard it sort of that clearly
stated before but being as stubborn as I
am I decided I’d dig a little deeper I
started researching different health
care systems around the world surely
there must be a way to pay for
high-quality health care for everyone
and that’s when I realized she was right
at least partially you see in the
developed Western world no matter which
country you live in or what kind of
healthcare system you have we are
rapidly heading towards the day when our
health care will be completely and
utterly unaffordable we may even be
there already how did we get here well
in some ways were a product of our own
success the fundamental issue is this
people are living longer and longer the
median life expectancy in Australia is
now well over 80 years old and is
continuing to climb sounds great but the
problem is it turns out there is a
ceiling to how long a human being can
actually live biologically and that’s
around 115 years old we have an expiry
date no matter what science fiction and
health tech companies would have you
believe so as we keep increasing
people’s ages to try and reach this
upper limit the more and more difficult
and therefore the more and more
expensive it gets
partly because we’re fighting a losing
battle against biology but also because
we need to sustain and maintain the ever
aging population that continue to use
healthcare resources while they’re alive
it’s like climbing a mountain that gets
steeper the higher you climb so what
should we do well the first thing I’ll
say is this don’t freak out
there is hope but it does require
participation by each and every one of
us also like all difficult problems and
all awesome TED talks
we need a three point plan and I’ve
prepared one earlier just for today so
here we go point number one select a
system select a system there are two
basic ways to pay for healthcare a
shared public system where we fund free
healthcare for everyone through taxes
and a private system where each person
pays individually for the health care
that they need either directly or
through insurance which is better like
most things there are pros and cons of
each the public system tends to be
compassionate and altruistic in that it
treats everyone young and old rich and
poor equally but like most large
government institutions it tends to be
quite inefficient and very slow to adapt
to change and slow to innovate the
private system on the other hand is run
like a business efficient high-volume
revenue generating but it can also be
quite brutal no money no product the
truth is a hybrid system which leverages
the advantages of both worlds is
probably the best we’re lucky here in
Australia because we have one of the
most balanced healthcare systems around
in terms of funding and it shows I
promise this is the one and only graph
as you can see compared to its peers
Australia which is the graph the red the
red line on the bottom actually spends
relatively less of its revenue on health
care despite having similar if not
better outcomes in most areas the US
which is the Green Line up to top has a
largely privatized system and the three
countries clustered in the middle have a
more socialist public system either
extreme becomes less efficient and our
role here is to continue to iterate and
innovate and build on what we’ve got so
that we can serve as an example of a
balanced well-funded healthcare model
but enough ego stroking let’s move on to
point number two of the three point plan
and this is something we are terrible at
care about costs that’s a picture of me
in the photo
I’m the vertically challenged guy on the
right in case you hadn’t guessed you
wanted the worst thing about this photo
I’m actually standing on a step stool
and it still looks like anyway in all
seriousness though during in the heat of
the moment during surgery do you think I
really care how much this stuff around
the costs if you were that patient on
the operating table in the photo would
you want me to be worried about that or
would you rather I just focus on the
task at hand but you know what maybe we
should all just grow up a little and
start to treat our healthcare dollar
like adults instead of kids in a candy
store maybe as doctors we should start
telling people how much things cost and
why and as patients maybe we should
start listening and stop equating price
with quality and actually there are
plenty of areas where we waste
healthcare resources on things that
don’t do anything at all a good example
of this is wound dressings we have high
quality evidence that wound dressings
for simple surgical incisions don’t
actually do anything they don’t prevent
wound infections they don’t improve
wound
and they don’t even contribute to
patient satisfaction it’s true for the
most part all they do is line the
pockets of the companies that make them
so if we’re going to be using wound
dressings we should use the cheapest
ones available and that’s just one of
many many examples where we could be
reducing costs with zero impact on
outcomes which brings me to the third
and final point of the three point plan
and this one’s the most difficult
quality over quantity as a society we
need to start prioritizing quality of
life over quantity of life
one thing is clear at this point no one
lives forever and the lucky few live
well for the time that they have we
shouldn’t have to keep blindly pursuing
an ever-increasing lifespan for our
population regardless of cost it’s a
losing game and it’s not always right
for patients either instead we should
focus our energy on improving the
quality of the time that we have this
would be much more cost effective as a
policy but it does require frank and
open discussions particularly around
cultural perceptions of life death and
disability this is Michael Michael is 92
years old he’s beaten odds he could be
your dad or your granddad Michael also
has bowel cancer and we recently looked
after him in hospital the team did an
amazing job and he was very happy to be
included in this talk now when Michael
is deciding about whether he wants
surgery and chemotherapy he needs to be
allowed the freedom and the space to
figure out whether extending his
lifespan even further is worth it to him
especially when you consider the
negative implications the treatment
might have on his ability to function in
society
he shouldn’t be pressured by us assuming
that he wants us to just go in all guns
blazing regardless of the cost to him as
a person simply to extend this life span
this quote was recently published in a
paper talking about cancer treatment in
it the goals of treatment are stated as
being to prolong survival yes but with
an acceptable quality of life and at a
reasonable cost so let’s go back to the
question we posed at the start is
healthcare a right or a luxury let’s
reflect on that again if something is a
right but as a society we can no longer
afford to pay for it does it then become
a luxury maybe the question shouldn’t be
how do we define or label healthcare
maybe the more important question is
this are we as a society willing to make
the right choices so that we can
continue to achieve those goals going
forward for our population or are we
simply going to stand by and watch while
our rights and our luxuries become more
and more inaccessible to us I’ll leave
that up to you to decide
thank you
[Music]
[Applause]
I’m here today to ask you all to ask
yourselves is healthcare a right or a
luxury it’s a vitally important question
but before you respond allow me to
challenge you a little I’ll start with a
story in 2015 I was offered an
opportunity to spend a year training in
one of the world’s best cancer hospitals
in the US this was a huge privilege for
me and I was really excited to go the
only strange thing was when I was
filling out my starting paperwork for
the job I was being asked questions like
did my two young kids have any
pre-existing illnesses I was also
informed that even if they were
completely medically well I still had to
pay about $25,000 a year in health
insurance or I wouldn’t be permitted to
work there $25,000 now myself being the
product of a more socialized public
system here in Australia and New Zealand
this was a foreign concept to me it was
a little scary in fact the idea that
children may not get medically treated
if they didn’t have the right health
insurance organised by their parents
what if they didn’t have parents what if
their parents were on the minimum wage
it felt wrong it felt unfair and this
was in one of the wealthiest democratic
nations on the planet but anyway I did
the needful got the insurance flew to
the US and I started work and this place
was absolutely incredible cutting-edge
medical and surgical services being
delivered by some of the most brilliant
and most dedicated doctors and nurses in
their field but there was a catch and it
was always looming in the background the
best way to describe it is that this
probably truly was the world’s best
cancer hospital if you could afford it
and I struggled with this idea
on the one hand I had seemingly
unlimited resources with which to treat
patients which was actually frickin
awesome I loved it but it was a bit like
a guilty pleasure because I knew that
for every patient I treated another
would get rejected because they didn’t
have insurance or the right level of
cover so one day I was sitting in the
tea room between operations and I
finally blurted out to a colleague of
mine I said how can you live with
yourself as a doctor knowing that a
large segment of your population can’t
access the care that you provide her
answer surprised me she said the problem
you have Tariq is you can only really
see things from a British colony
socialists perspective
she said you regard health care as a
birthright and feel that you’re
automatically entitled to it but have
you ever considered that it may not be a
birthright that in large parts of the
world including here in the u.s. it’s a
very expensive luxury she then went on
to say what makes you think that by
being born a citizen of a given nation
that you are automatically entitled to a
brand new big state-of-the-art Hospital
the latest medical technology and the
most expensive drugs money can buy
funded by your government and taxes
don’t you see if that’s what you want
then you have to accept rationing and
death panels because there’s just no way
that any government can pay for
high-quality health care for all of its
citizens it’s simply too expensive so
you have a choice crappy mediocre health
care for everyone with long waiting
lists or high-quality health care on tap
for those that can afford it I can’t lie
I was taken aback a bit by this I’ve
never heard it sort of that clearly
stated before but being as stubborn as I
am I decided I’d dig a little deeper I
started researching different health
care systems around the world surely
there must be a way to pay for
high-quality health care for everyone
and that’s when I realized she was right
at least partially you see in the
developed Western world no matter which
country you live in or what kind of
healthcare system you have we are
rapidly heading towards the day when our
health care will be completely and
utterly unaffordable we may even be
there already how did we get here well
in some ways were a product of our own
success the fundamental issue is this
people are living longer and longer the
median life expectancy in Australia is
now well over 80 years old and is
continuing to climb sounds great but the
problem is it turns out there is a
ceiling to how long a human being can
actually live biologically and that’s
around 115 years old we have an expiry
date no matter what science fiction and
health tech companies would have you
believe so as we keep increasing
people’s ages to try and reach this
upper limit the more and more difficult
and therefore the more and more
expensive it gets
partly because we’re fighting a losing
battle against biology but also because
we need to sustain and maintain the ever
aging population that continue to use
healthcare resources while they’re alive
it’s like climbing a mountain that gets
steeper the higher you climb so what
should we do well the first thing I’ll
say is this don’t freak out
there is hope but it does require
participation by each and every one of
us also like all difficult problems and
all awesome TED talks
we need a three point plan and I’ve
prepared one earlier just for today so
here we go point number one select a
system select a system there are two
basic ways to pay for healthcare a
shared public system where we fund free
healthcare for everyone through taxes
and a private system where each person
pays individually for the health care
that they need either directly or
through insurance which is better like
most things there are pros and cons of
each the public system tends to be
compassionate and altruistic in that it
treats everyone young and old rich and
poor equally but like most large
government institutions it tends to be
quite inefficient and very slow to adapt
to change and slow to innovate the
private system on the other hand is run
like a business efficient high-volume
revenue generating but it can also be
quite brutal no money no product the
truth is a hybrid system which leverages
the advantages of both worlds is
probably the best we’re lucky here in
Australia because we have one of the
most balanced healthcare systems around
in terms of funding and it shows I
promise this is the one and only graph
as you can see compared to its peers
Australia which is the graph the red the
red line on the bottom actually spends
relatively less of its revenue on health
care despite having similar if not
better outcomes in most areas the US
which is the Green Line up to top has a
largely privatized system and the three
countries clustered in the middle have a
more socialist public system either
extreme becomes less efficient and our
role here is to continue to iterate and
innovate and build on what we’ve got so
that we can serve as an example of a
balanced well-funded healthcare model
but enough ego stroking let’s move on to
point number two of the three point plan
and this is something we are terrible at
care about costs that’s a picture of me
in the photo
I’m the vertically challenged guy on the
right in case you hadn’t guessed you
wanted the worst thing about this photo
I’m actually standing on a step stool
and it still looks like anyway in all
seriousness though during in the heat of
the moment during surgery do you think I
really care how much this stuff around
the costs if you were that patient on
the operating table in the photo would
you want me to be worried about that or
would you rather I just focus on the
task at hand but you know what maybe we
should all just grow up a little and
start to treat our healthcare dollar
like adults instead of kids in a candy
store maybe as doctors we should start
telling people how much things cost and
why and as patients maybe we should
start listening and stop equating price
with quality and actually there are
plenty of areas where we waste
healthcare resources on things that
don’t do anything at all a good example
of this is wound dressings we have high
quality evidence that wound dressings
for simple surgical incisions don’t
actually do anything they don’t prevent
wound infections they don’t improve
wound
and they don’t even contribute to
patient satisfaction it’s true for the
most part all they do is line the
pockets of the companies that make them
so if we’re going to be using wound
dressings we should use the cheapest
ones available and that’s just one of
many many examples where we could be
reducing costs with zero impact on
outcomes which brings me to the third
and final point of the three point plan
and this one’s the most difficult
quality over quantity as a society we
need to start prioritizing quality of
life over quantity of life
one thing is clear at this point no one
lives forever and the lucky few live
well for the time that they have we
shouldn’t have to keep blindly pursuing
an ever-increasing lifespan for our
population regardless of cost it’s a
losing game and it’s not always right
for patients either instead we should
focus our energy on improving the
quality of the time that we have this
would be much more cost effective as a
policy but it does require frank and
open discussions particularly around
cultural perceptions of life death and
disability this is Michael Michael is 92
years old he’s beaten odds he could be
your dad or your granddad Michael also
has bowel cancer and we recently looked
after him in hospital the team did an
amazing job and he was very happy to be
included in this talk now when Michael
is deciding about whether he wants
surgery and chemotherapy he needs to be
allowed the freedom and the space to
figure out whether extending his
lifespan even further is worth it to him
especially when you consider the
negative implications the treatment
might have on his ability to function in
society
he shouldn’t be pressured by us assuming
that he wants us to just go in all guns
blazing regardless of the cost to him as
a person simply to extend this life span
this quote was recently published in a
paper talking about cancer treatment in
it the goals of treatment are stated as
being to prolong survival yes but with
an acceptable quality of life and at a
reasonable cost so let’s go back to the
question we posed at the start is
healthcare a right or a luxury let’s
reflect on that again if something is a
right but as a society we can no longer
afford to pay for it does it then become
a luxury maybe the question shouldn’t be
how do we define or label healthcare
maybe the more important question is
this are we as a society willing to make
the right choices so that we can
continue to achieve those goals going
forward for our population or are we
simply going to stand by and watch while
our rights and our luxuries become more
and more inaccessible to us I’ll leave
that up to you to decide
thank you
[Music]
[Applause]
Please follow and like us: