Escalating Healthcare Costs: Why Rely on Band-aids When You Can Avoid the Wound?

The following is a summary of the presentation given by ASMR President, Dr Sarah Meachem, at Gala Dinners held around the country during ASMR Medical Research Week® 2016.

ASMR has been representing the whole of Australia’s health and medical research (HMR) sector for 55 years. The Society has never wavered from its core values – core values that have never been more important than they are today. Excellence, integrity and commitment enabling a healthier Australia, a healthier world, and a healthier you. ASMR tells it how it is, and we substantiate what we say with evidence. ASMR has a 10 vision and this blog describes briefly about where we are now, and how we can get to where we need to be.

Where we are at?
Australia faces unprecedented health and economic challenges over the next 50 years. Our sector can assist in mitigating the burden of disease and its associated costs.
Econometric data provide compelling evidence that many billions of dollars have been saved to date by the HMR sector. Australia has been the beneficiary of commercialisation of quality ideas that have emerged from curiosity driven research (e.g. the Cochlear implant, the human Papilloma Virus vaccine, the first continuous positive airway pressure machine, to name a few). Investment into HMR provides exceptional value to the community in well-being gains and economic prosperity.
At the heart of this success is the world class Australian HMR sector, our highly skilled and valuable pool of HMR scientists. These people have an appetite for knowledge and a desire to making the world a better place. It takes them decades of inspiration and perspiration to become who they are and what they do.
The largest single funder of HMR is the Australian Government. Health and prosperity are central to the goals held by all major political parties. Currently, the Commonwealth Government invests about $800M annually through Australia’s major public funder of HMR, the National Health and Medical Research Council (NHMRC) and its Medical Research Endowment Account (MREA). This is 0.6% of the total health spend. The last significant injection of money was in 2007, and prior to that 1999. In this setting, the momentum of discovery is constantly interrupted and opportunities are lost.

Right now the sector faces a variety of serious challenges; the workforce is being depleted and with it its benefits.
Over the last 5 years, the MREA has been under considerable pressure to maintain it capacity to sustain research. Funded rates are at an historic low. The situation is critical! My intention is not to disempower you. On the contrary, we need to understand the problem before we can fix it. Over the past 5 years, investment into the MREA has remained static. It has not kept pace with the rising costs of research or with the increasing health challenges that this country faces.
People ask, “How many people have lost their jobs?” A simple question, but difficult to answer, as we don’t have a registry of health and medical researchers, like the doctors registry.

What do we know?
• one grant scheme funded from the NHMRC MREA, the project grant scheme, over the last 3 years, there has been a decline of nearly 700 FTE positions,
• in terms of the Fellowship scheme there has a been 20% decrease in the number of awards being given. This represents not only a loss of highly qualified, talented and motivated individuals in the short-term, but also a devastating loss of leaders necessary to train and develop the next generation of intellectual capital.
• In a recent survey by ASMR late in 2015, more than 20% of respondents were unsure whether they had employment in 2016.
There are some of the numbers that reflect what probably you already. Where is the tipping point? If we continue to lose people, we lose a lot of opportunities to improve health. Not only that, economically speaking, replacing lost intellectual capital is costly to the country.

Where to next?
We need a short term and long term strategy, in order to create a world-leading health care system.
ASMR advocates for an immediate stabilisation of the HMR workforce by investing new money, $300M, into the MREA. This will maintain capacity and drive the momentum of research, safeguarding government’s investment. Investing in the MREA is critically important, because it supports our best and brightest. It would help to mitigate the loss of past and future investment (the latter referring to the Medical Research Future Fund [MRFF] and the National Science and Innovation Agenda [NISA]). The MREA is the bedrock of curiosity driven research. This funding feeds the pipeline of research to translation, and health products to market. The MRFF and NISA can’t replace the MREA. These new initiatives rely on the solid foundations of the MREA. Erode the foundations and the integrity of future investment will falter. That’s why the MREA is important, and why ASMR wants to safeguard it.

Some people have asked, “Is it a good time to ask for money?” But what happens if we don’t? The risk is too great!
Injection of $300M in the MREA is an important first step into a long term strategy to generate a sustainable health and medical research ecosystem to achieve expenditure of 3% of the Health budget by 2025.

What are the power and possibilities of this investment?
• Imagine a HMR sector that improves the health of all Australians, living longer and healthier lives, and mitigating health care costs.
• Imagine a HMR sector that is supported by a sustainable eco-system, underpinned by an evidence-based predictable investment strategy, a system which will allow the scientific endeavour to flourish.
• Imagine a fully integrated, equitable, agile and affordable health care system, with HMR right at the heart of it

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