During my orientation for my first ever job in the state health department, I was told by my boss that of all the service delivery systems that keep Australia functioning – law enforcement, education, social security, transport etc – health was the most complicated.
It’s taken me a long time to come to understand how true that is.
Our health system comprises a bewildering array of private/public overlap, competing interpretations of medical science, delicate balancing of prevention versus treatment, insurance versus some user-pays, dollops of for-profit services and powerful lobby groups who dictate more of how our system works than people realise.
There’s only a handful of people in each discreet part of the system who understand how that part of the system really works, let alone the whole thing.
People read media stories about the stoush between private health funds and private hospitals and have no clue what it means because consumers don’t really know how health services are funded. Meanwhile elderly Australians might be holding on to their private health cover on some false idea about what it really delivers to them.
The issue here is this is that in any open market, naïve consumers foster inefficiencies.
In health this problem is particularly relevant because while good fortune and the right decisions might mean very limited interaction with, say, the criminal justice system in your lifetime, it is almost impossible to avoid regular interaction with health services.
So where are the big, publicly-funded Australian health literacy programs? Public campaigns that explain how health insurance works, what public hospitals treat (and how they are funded), how to negotiate a better deal from your surgeon, which ailments can be treated with over-the-counter medicines without visiting your doctor and how to avoid side effects by following the instructions on the pack.
Because typically the heavy lifting around health literacy is left to the manufacturers (or not for profit foundations). When pack sizes of paracetamol changed in 2025, the task of informing healthcare professionals and consumers about the rationale for this was largely left to the over-the-counter companies most affected. While they did this admirably (Palin Communications and Haleon ANZ won the Health Literacy prize at the Self-Care Excellence Awards in 2025 for this work) it does raise the question about what efficiencies might be delivered by broader publicly funded programs focused on general health literacy.
Because informed, educated, engaged consumers make for a safer, efficient health system.
