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Editorial
Fran Collyer
Department of Sociology & Social Policy, University of Sydney, NSW
Article Text
Welcome to another edition of Health Sociology Review. It seems but a short time since writing my last editorial - on the eve of the 2007 federal election - with all the attendant anxieties about the future. With the Australian Labor Party now firmly in power, and the media hype slowly abating, some of the attention has turned to the kind of changes necessary for improving our health care system.
There are of course, many critics who offer a veritable barrage of negativity about the problems of the public system. Few seem to consider the possibility that equally serious problems might be occurring within our private services, private laboratories, private hospitals and private insurance agencies. But then again, the risk of litigation is higher for journalists with regard to the private sector, is it not?
More constructive commentary is currently occurring amongst the many health care workers, scholars and policy analysts who have knowledge about health systems in other countries. These are generally in agreement about the superior status of Australia's health services: its comprehensive system of accessible, high quality public and private hospitals, laboratories and clinics; crowned by a universal, national health insurance system (Medicare). What has yet to be decided however is the extent to which change is necessary in this system. Several vital questions remain to be addressed:
- Should we continue to massively subsidise private health insurance when the evidence is that it favours only the well-off and effectively robs the public sector of precious funding?
- Should the Commonwealth and the state governments continue to share the funding and provision of health services when history tells us that this merely incites cost-shifting practices and the shirking of responsibility?
- How do we address the glaring inequalities of the system, particularly the lack of universal, accessible, affordable dental health services and the poor health status of low income, rural and Indigenous Australians?
- And, perhaps most importantly, how can we re-shape the system so that a much greater emphasis is placed on preventing health problems?
While many of these questions are peculiar to the Australian context, others have pertinence elsewhere: particularly the last. Few countries pay little more than lip service to the notion of ill health and disease as the products of social practices and social organisation. As a consequence, most have highly expensive and ineffective health care systems struggling with ever-rising levels of demand. Such issues are at the forefront for many of this journal's contributors and readers however, and, whether you are a new reader or long-time supporter, we hope you will be pleased with this quarter's collection.
Contributions have come from many parts of the globe, including Sweden, Norway, South Africa, Canada, and both urban and rural Australia. This diversity of authors and nationalities is also matched by the wide range of topics for the edition. Some are empirical studies, examining the socioeconomic impact of antiretroviral therapies in Soweto for instance, or an evaluation of a school-based, mental health service in rural Australia. Others are more strictly focused on health policy, such as the paper on the shift in focus in mental health programs from 'social' to ‘biological' psychiatry. And for others, the emphasis is the conceptual realm; for example, a paper exploring Bourdieu's notion of ‘habitus' as a means to make sense of the way ‘lifestyle' is used in the health promotion literature. We trust you will appreciate the range and quality of the papers herein.
As always, I wish to thank our editorial team, publisher, reviewers, authors and the support of The Australian Sociological Association for making the journal possible.
Fran Collyer - Editor in Chief
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