Health Politics Policy and Planning - Question 1

Identify and describe:

The public health issue in this case is the inclusion of a potential treatment for fighting against cancer in the list of medicines to be rendered by the Pharmaceutical Benefits Scheme of Australia. The cancer mortality in this country is high and there are 50,000 deaths related to cancer every year in this country. Additionally, it has been found that the cancer mortality is largely skewed by the socio-economic status, age and location. Therefore, people in the lowest socioeconomic groups, remote areas and aged above 65 years are more likely to die from cancer than their counterparts (AIHW, 2019).

The policy actors involved in this public health issue are the Anpha pharmaceutical company, the Federal Minster of Health, Cancer Council, Wholesalers, pharmacists, Australian Healthcare and Hospital Association (AHHA), Australian Medical Association (AMA), Public Health Association of Australia (PHAA), Doctors Reform Society (DRS), the Close the Gap Campaign and a number of interest groups created by the families of cancer patients.

Social justice ethics in this public health issue underpins the position of the key policy actors. These actors advocated for the inclusion of Braxane in the PBS medicine list so that the cancer treatment can be provided to the people suffering from cancer and are in the group where the mortality from this condition is high. Social justice ethics maintain that it is the right of all the people to have good health (Marmot, 2017). In this issue given the high cost of the treatment and a considerable number of deaths and higher susceptibility of deaths in the given group directs the responsible parties to take action. Therefore, the groups are advocating for including the medicines in the PBS list.

Health Politics Policy and Planning - Question 2

Drawing on the sociological, political, and economic contextual factors shaping this public health issue explain:

It is likely that this issue will be placed on the public health agenda. This is because there have been reportedly 50,000 deaths per year due to cancer. The lowest socio-economic, older age and living in remote regions are the factors which continue to skew the mortality rate for the cancer. The recent recovery of the celebrities with Braxane is also likely push the issue to be included in the public health agenda.

The information that is likely to be considered as a part of the public policy formulation in this issue is that there is high death rate due to cancer and a section of population is at particular risk of increased mortality. The cost of providing subsidized Braxane to the people is not feasible economically as the country is under recession. However, it has to be noted that the subsidized medicine is not to be used for the general population and it is only for a section of population. Therefore, the advice given for this public health issue is that this country must not lag behind in establishing justice for eradicating the health inequities related to cancer.

The most likely solution which could be adopted by the government is that the Braxane would be included in the PBS. However, this will be targeted only to the needy people who are found to be incapable in getting this medicine due to its high cost.

Health Politics Policy and Planning - Question 3

Anpha is likely to benefit from the listing of Braxane on the Pharmaceutical Benefits Scheme (PBS). Using concepts and theories discussed in the unit how do you think the pharmaceutical industry (Anpha competitors) are likely to react?

The competitors would be against the listing of Braxane on the PBS as demanded by the Cancer Council Consortium. This is because with this amendment, Ahpha would have higher profits and this will strengthen its position. Further, this company will get a unique advantage in the industry if the Braxane is included in the PBS.

The pharmaceutical competitors therefore, will react in opposition to this amendment. The Advocacy Coalition Framework suggests that there are coalitions amongst the groups which seek to interpret their own beliefs into the policies, they use tactics and strategies to influence the government decision makers (De Leeuw, Clavier, & Breton, 2014). Therefore, the competitors would point at the loss which the government will make in providing the subsidized medicine to the population. Further, these may also use tactics of developing coalitions with the groups who want the resources to be used on economic development of the country rather than to be used on the health policy.

The pharmaceutical industry is impacted by the factors that weaken and strengthen its capacity in shaping the policy. The first factor is that of recession, the country may not have enough resources to fund for this health issue. Therefore, this will weaken the capacity of the industry in advocating for this new drug. This is because the government will first consider the welfare of the whole population rather than a section of population. The next factor is that of the coalition of the groups who are advocating the inclusion of this drug in the PBS. This will strengthen the industry capacity to shape the policy. This is also informed by the Social Movement Theory wherein the disappointed people join the social movement for mobilizing the resources and the political opportunity for changing the public policy for their advantage (De Leeuw, Clavier, & Breton, 2014). This will also strengthen the industry capacity as these people who have suffered from loss due to cancer will give support for this policy change.

Health Politics Policy and Planning - Question 4

The PBS has existed since 1948. Identify and explain:

The PBS was implemented by the Curtin Wartime government as a legislation (Goddard, 2014). It was enacted as a response to the need of providing access to many critical antibiotics like the streptomycin, penicillin and sulfonamides to the whole population and not only for a section of the population. Considering this public health issue if Braxane is made available through the PBS, then this will change the main agenda of this legislation. However, it is to be noted that the PBS implemented has helped in improving the health status of the population. But there are health inequities which needs to be addressed with amendments.

The theory of policy implementation maintains that the public policy moves through six stages and these are the identification of the problem, a causal diagnosis is made, plans are made, political decision-making is done on the reform initiatives (adoption of policy), reforms are implemented and lastly, its impacts are evaluated (Campos, & Reich, 2019). In the case of PBS, these steps were not followed as there was opposition from the other political parties who declare it as the wastages of resources. The problem of addressing the health issue of the population was identified after the second world war. The legislation was made, was introduced in the parliament but the stakeholders like the opposition parties, pharmaceutical companies, pharmacists, healthcare organizations and the doctors resisted. This was because with the subsidized medicines the healthcare cost would be lowered which was thought to lower the profitability of the industry. Even after its implementation no desired results were seen and hence it was opposed by the parties and groups. Later, this legislation became a reality as the parties realized the need for fairness and acting according to the scientific progress for improving the health status of the population.

Reference List for Health Policy Implementation Analysis

Australian Institute of Health and Welfare. (2019). Cancer in Australia: In brief 2019. Cancer series no. 122. Cat no. CAN 126. Canberra: AIHW.

Campos, P. A., & Reich, M. R. (2019). Political analysis for health policy implementation. Health Systems & Reform, 5(3), 224-235.

De Leeuw, E., Clavier, C., & Breton, E. (2014). Health policy–why research it and how: health political science. Health research policy and systems, 12(1), 55.

Goddard, M. S. (2014). How the Pharmaceutical Benefits Scheme began. Medical Journal of Australia, 201(S1), S23-S25.

Marmot, M. (2017). Social justice, epidemiology and health inequalities. European journal of epidemiology, 32(7), 537-546.

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