Only for us – public health laws and regulations

It is good to have a good policeman around. Dr. Baljit Singh

Public means of the people, therefore, public health is about promoting healthcare of people through government efforts on healthcare policies and procedures at a local and national level. Public and private health institutions implement these healthcare policies and procedures to provide quality health care either free or at affordable prices.

Only for us

To promote good health of Australians, Governments of various times in Australia formed, and implemented, Health related Acts, which are highly commendable acts. For example, in 1881, the first NSW Board of Health, in response to the smallpox epidemic of 1881-1882, enacted the Infectious Diseases Supervision Act of 1881 to prevent the spread of smallpox. Likewise, the Dairies Supervision Act of 1886 stated, any dairyman or milk-vendor must maintain good sanitary conditions in his dairy-premises. The federal Quarantine Act of 1908 made it compulsory to declare all food, plant material, and animal products on arrival in Australia to ensure they are free of pests and diseases. The Ambulance Services Act of 1982 was to provide effective Ambulance service throughout the state of Tasmania.

A very good effort

The healthcare of Australians was in private hands in 19th Century Australia. Many people of that time might have died without treatment because they could not have afforded it. Many people would have borrowed money from their family members and friends or local charity. It is same today. In the absence of a public health system, poor people would have gone through undue experiences of arranging health care for themselves. A good number of people in Australia do not have private health insurance or cannot afford to pay for ambulance services in advance. It is good that the Whitlam Labor Government introduced the scheme of Medibank (the universal public health insurance) in 1975 so that people who are poor, including elderly, who cannot afford private healthcare, could have free health treatment through public health system. It covered the entire Australian population.

To Medicare: A Medicare card allows all Australian residents having a citizenship and or permanent residency to claim a Medicare benefit visiting a doctor who bulk bills, seeking treatment in a public hospital, or having a Pharmaceutical Benefits Scheme prescription filled.

Another good achievement was the introduction of concession and health care cards. Low-income health care card gives low-income earners access to cheaper prescriptions medicines, and medical services. Likewise, the Commonwealth Seniors Health Card gives older Australians access to cheaper prescriptions, Australian government funded medical services, and other government concessions – for example, free transport.

Today, things are changing; therefore, we have new acts and legislations

Society is comprised of people with different habits, culture, values, religion, and ethnicity, which affect our health and therefore, need to be addressed. Social determinants of health such as poverty, unequal access to health care, lack of education, stigma, and racism are underlying, contributing factors of health inequities. Nowadays, many wealthy, educated and professional teenage girls are getting into drinking with their male counterparts in professional settings where drinking is gaining fast acceptance. Therefore, there will be more health and social problems, because mothers would let their children drink. Drinking alcohol takes our mind away from rationale thinking. All societies are moving away from traditional health risks to modern health risks. See figure 1.

Source: Adapted from WHO 2009: Global Health Risks

The traditional health risks are, under nutrition, pollution, water and sanitation problems, and overall hygiene. The modern health risks are smoking, alcohol drinking, consumption of junk food, physical inactivity (remaining indoors watching television, on mobile phones, and computers). In addition, people using cars have multiplied the level of pollution in all countries with road accidents risk. There are occupational risks such as exposure to industrial chemicals and solvents. The ill effects of mercury when mercurial wastes are dumped in waterways gets concentrated in fish, which populations eat. Other risks occur at work from drinking liquor in offices, adultery, sexual misconduct, and AIDS, divorces, etc. Where society is progressing towards the consumption of undesirables – cigarettes and alcohol, it becomes imperative to address the consequences of these undesirables on health. In 2012, about 3.3 million deaths, or 5.9 % of all global deaths, were attributable to alcohol consumption (WHO 2015: Fact sheet). Alcohol consumption by an expectant mother may cause fetal alcohol syndrome and pre-term birth complications.

Australia is trying best to overcome new health hazards

No smoking zones: Doctors and medical scientists suggest that every time a smoker smokes, he/she inhales up to 4000 poisons enough to harm their good health. The government of Australia over a period has taken quite liberal and harsh steps to overcome active and passive smoking. In 1972, the Australian government made it compulsory to put this health warning on cigarette packets ‘Smoking is injurious to health’. In the early 70s, State Cancer Councils began distributing brochures on the harms of Cigarette. The Seventh Day Adventist Church ran courses on how to give up smoking. In 1974, trains, buses, and ferries in Perth become smoke-free. In 1975, Federal laws banned cigarette advertising on television and radio. Heavy taxes on cigarettes, and bans on all in-door smoking – offices, hospitals, universities, schools, libraries, hotels, pubs, clubs and nightclubs, shopping centres, and parking areas are new welcoming legislation. Recently, outside vicinities of universities in Victoria were made smoke-free. In addition, immediate outside vicinities of shopping malls (ramping) are smoke-free; it is welcoming for non-smokers to visit shopping centres. Laws passed to make indoor and outdoor environments health safe for everyone is a good public health measure on the part of Australian government officials. It is difficult for nonsmokers to tell smokers not to smoke, but government official can.

Alcohol control: Drinking alcohol takes our mind away from rationale thinking by making our mind drowsy (sleepy), resulting in absence of rational thinking, unnecessary talk, and using abusive language, also physically and mentally hurting others, other crime, and alcohol related illnesses. Motivating people not to drink alcohol is under process through medical education. Religious institutions are also playing their role. In the 1800s, attempts were, made to develop alcohol abstinent societies. In 1852, alcohol was, prohibited in the Victorian Goldfields. All liquor establishments had to close at 6PM in the middle of the 20th century. In 1837 state legislation prohibited Aboriginals to access alcohol, because many indigenous people working for non-indigenous got involved in binge drinking. Between 1957 and 1975, Aboriginals got the right to drink alcohol in the various States and Territories; it became a symbol of equality, citizenship, and status. This freedom and equal status led to alcoholism among them with greater social, economic, and health implications such as unemployment, poverty, homelessness, domestic violence, divorces, accidents, crime, injury and other diseases, and large arrests. Before the 1970s Aboriginal had high restrictions on Alcohol consumption, therefore, it saved many families, but when restrictions were relaxed, many families entrapped in alcoholism.

Gambling control: Any kind of gambling activity whereby people lose money disheartens them. Once they get addicted to it, they can lose everything including their hard-earned money, property, and jewelry, enough for them be in sadness, leading to a short-term and long-term depression and ill health, begging, losing, and selling their possessions, and future crime. They might meet those who might eat away all of their wealth in various ways, because, people who gamble are greedy by nature, wanting to increase their wealth by all means, including by hook and crook. Although, government agencies put out the message to gamble responsibly, but it is not safe to gamble any amount of money even if you have businesses or a handsome salary or wanting to make more money quickly because you are poor, or you might think you are a responsible gambler. Neither should you be going to gambling houses, nor take children, there so that, your, hard-earned wealth remains safe generation to generation, and family, and health safe. There is no responsible gambling. If you lose, you lose. Even small amounts of money spent on lotto ticket means sadness if you do not get any money in return, and, winning even a small amount means a motivation towards addiction.

Special health services in specialized areas

In its initial stages of providing health services, public health was general in nature, but it expanded to look areas where people get affected and medical help required.

Aged care: Earlier children used to live with their parents; therefore, they used to take care of their parents, now days, children live separately, therefore, parents look after themselves, or manage to get outside care in nursing homes. This historical shift has also come into perspective, that in old age, it is difficult to provide healthcare at home and children have no time to take care of their parents, both men and women work, or live abroad (or far away). However, age related procedures like knee and hip replacement take up a fair proportion of health budgets.

Mental health: Nowadays life is busier, we all run around increasing our wealth to meet ever-increasing demand, resulting in increased mental pressure, resulting in anxiety, tiredness, sadness, and depressions. Our life is highly stressful, so that, even on Saturdays and Sundays, people work, running away from household work, which their family demands, and shifting their responsibilities on to either partner who is free to do domestic work. It has resulted in family breakdowns, isolations, depression, and ill health. That is why a formal health care of mental health has progressed in a more organized form.

Prisons: In prisons, new laws of no smoking, no drinking, and no gambling are in place to let inmates stay away from vices, which destroys, body, and mind. Moreover, punishments are not much harder the way, in olden times, hands and fingers were cut, canning, putting wax on body, etc. Nowadays, prisoners enjoy Gym to build their bodies, although, behind the back of these enjoyable activities, they miss their family members and get into depression. That is why governments frame rules and regulations to prohibit us from illegal activities, also to spread education to promote better living norms.

General environment: So that people could live a much healthier life, the following measures have come into existence.

• Smoke-free environments in case of schools, universities, hospitals, shopping centres, and parks, swimming pools, and many other indoor and outdoor outlets
• Restrictions on taking dogs into park lands (children play area)
• Ban on drinking alcohol in parklands, and public functions like new-year Eve Fireworks
• Exercise equipment in parklands

Population control: High population is a problem because poor parents cannot fulfill the needs of their children due to limited income. Population control and welfare programs are in existence to enhance better living (nutrition, health care, and education). These initiatives long existed and time-to-time population policy measures included other components, for example, better mother and child health care and immunizations programs. The one child policy of China was to recover from poverty, unemployment, misery, and deprivation. The pressure of population on infrastructure is, seen through traffic congestions, housing requirements; therefore, a decentralized housing policy will help people to live in less congested areas to enjoy better health, inhaling better air.

Meeting public health challenges the characteristic of every period

Historically, providing efficient and effective healthcare to Australians have remained the most important agenda of health and medical institutions in Australia. Every time, the focus of health policy talk is on managing and overcoming pressures on health care arrangements.

• Are people on marginal income able to afford timely and preventive health care? There is substantial evidence that in Australia, historically, also in the current modern period of health care, many people struggle to afford medical and health care. The 2014-15, Patient Experience Survey, Australia found 1 in 20 people (5%) who needed to see a GP delayed or did not go because of the cost. Likewise, people do not go the dentist due to cost reasons.
• Are there health gaps in societies/communities of Australia? Yes, even in modern times of today’s health care system we observe a pattern of low socioeconomic status and low health for indigenous people. Proportionately, more people from indigenous community earn less income. They are twice as likely to work as laborers or community and personal service workers about half as likely to work as managers or professionals, their education levels are low, and unemployment high. Life expectancy is low and infant mortality high in both periods compared to non-indigenous population despite living in Australia.
• Are there shortages of health care professionals to provide good health care to public? In all periods of Australian Public health, there has been increasing demand for doctors, nurses, paramedics, and other health professionals which is due to increase in population both due to natural increase and immigration, also Australia commits to better healthcare.

These changes are of prime importance to achieve better public health in general

• In current times of modern medication and good education, war (organized killings) and riots (organized killings) are causes of mortality and morbidity. Doctors and nurses try their best to save even one life, but war and riots kills in heaps.
• You must have heard on Australian television that $80,000 per annum is a good income to live a better life in Australia. But the per capita income of Australia is only $37,000 per annum? How can we practically live on $37,000 per annum in Australia? From where do we get them this extra $43,000? Elsewhere, in countries like India, poor people and middle-class people cannot afford dialysis and other health treatments, including day-to-day medication. Millions are being paid only Rs 10,000 per month (Aus $196 per month). How can they afford dialysis when per visit costs more than Rs 10,000? How are they going to rear up their children? Real measures are required to improve their health care. The income of the low paid workers must be raised and free health treatments must be provided to them.
• Health professionals and academicians are aware that, millions of people live near the open drainage system, which is spreading diseases. This requires fixing.
• Overcrowded hospitals need a better system to spread out patients according to their health needs.
• A highly sympathetic attitude on part of all personnel health and administration is important to be, seen – patients need a courteous attitude, rather than rough.
• Children of some wealthy parents are pale, and anaemic. This includes children studying medicine. In this case, their family GPs must suggest to them to improve their diet and maintain their vitality, energy, stamina, fitness and general health. A daily run of two to three kilometres would keep them healthy.
• Everyday exercise and controlled diet at a proper time will not create a situation whereby it is difficult to manage healthy weight.
• The Public should be, protected from improper sanitation and communicable diseases. Why do authorities in countries like Australia keep public sanitation neat and clean?
• To avoid common cough and cold, doctors may recommend gargling every morning and evening with Luke warm water with salt added in it. It would save lots of money spent on painkillers. Doctors say, there is no cure for common cold.
• Providing medication at most affordable prices is important, although we do not rule out the fact that, people should avoid taking medications unless and until doctors, say. Most medical/health clinics are trying to establish in a corner a small pharmacy, which charges a much higher price from their loyal patients. Quite often in Economics, economists build model (s) for the best functioning of the economy. If we feel that all people prefer to buy medication online or from the Chemist Warehouse like in Australia, then it is a best model to get prices right for the community of Australia and other countries. There is not dispute in this argument. Getting all over the influx of Chemist Warehouse like in Australia which provides medication to all citizens at a much cheaper rate will not only save resources spent on providing medication, but also citizens will have limitless praises when tourists could buy medication at a much affordable prices. The establishment of Chemist warehouses will make Australia and other countries highly competitive and efficient in providing medication to people to cure diseases and can use the money saved not paid to the overpriced chemists on their daily nutrition. The price of medication provided by the Chemist Warehouse must be reduced when they realise monopoly element in their business. Could we imagine, in the absence of ALDI store, how, the poor would end up by buying little from Coles or Woolworth. Yes, we can imagine. Nevertheless, it is good that the wealthy shop where they pay more to bring a balance, just the way, wealthy parents send their children to private schools. We do not rule out the fact that, public schools provide equal level of good education, because, teachers impart good education, and students receive it.
• It is important to provide effective health services in rural and urban areas. If we spread out and prefer to live in jungles and remote areas, even Australia would feel she has insufficient resources to have a railway line or water pipe line or electricity, broadband connections, school, colleges and universities, hospitals, etc. Why do more people prefer to live in the urban area? People need to cooperate with their government and other socio-economic-health agencies so that precious resources could be, used appropriately towards immediate and ultimate health care and social-wellbeing.
• It is very important to provide good education on health to citizens, also to the health care workers. Why do parents say, school X is better? The gold medallist Olympic Swimmer Ms Stephanie Rice inherited exceptional strength from her parents it does not matter which school she has gone to, but a good school environment is imperative. There is a mental and physical pressure on children and adults where children are, bullied by students and by staff at work place.
• Making international medical and health authorities WHO, UNICEF and UNDP better functioning institutions just the way we expect other institutions to be efficient, reliable, and responsible. These authorities can get public health system in developing and developed countries more disciplined – impose better norms and standards. For example, improvements in work ethics will straight away be ready to provide better health services without further increases in costs. When poor patients buy medication from the Chemist Warehouse like in Australia, people will have more money at their disposal to be, spent on better nutrition, rather than chemists ripping them off in their own countries. In a similar way, when the production of alcohol and cigarettes gets stopped, future generation (s) will not know about cigarettes and alcohol and millions of lives get, to be saved from illnesses related to smoking and drinking. Note: Real measures are important to be, taken to realize improvements in public health.

In a nutshell

To improve health of any society, it is important to work on those realities, which are affecting people’s health. Resources must be, diverted to the immediate care of people, rather than on third parties. The improvements in health require basics to get correct which would lead to reductions in mortality and morbidly. The life-style of today’s youngsters must change to enjoy better health today and tomorrow. This way, a fewer resources (or money) shall be required to treat illnesses. Half of the diseases get, cured if people could adopt better societal norms, giving up smoking, alcohol, and gambling. Those trapped in illnesses related to these undesirable activities, faces consequences, also their folks and friends bear consequences of their ill health. Millions of dollars can go to better nutrition and health care, rather than on curing illnesses due to smoking, alcohol, and gambling. Half of the social problems (domestic violence and crime) get, rectified through better societal norms, to begin with giving up smoking, alcohol, and gambling. The effects of these vices are direct and indirect and can be on any person – educated, professional, or otherwise at various times.

Better health life norms improve health rather than deteriorating it. Australian governments along with medical, religious, and social governing bodies played a very important role in mitigating and providing better health care through, legislation and norms under which better health is expected preventing illnesses and diseases, which may be due to preventable causes such as smoking, drinking, and gambling. The right way of allocating a nation’s resources (land, labour, and capital) including money, requires a greater attention towards rearing up new generation away from consuming cigarettes, alcohol, and gambling. This requires legislation, for example, petrol stations and supermarkets in Australia will not be allowed to sell cigarettes and alcohol, this way, millions lived shall be saved. Also, in developing countries, we really need to address real problems, which people are facing, rather conducting more academic research, because, the problems of health care are still basic in nature. This way we could have a better acceptable international image in the eyes of those health care professionals who are working abroad in countries like Australia and England towards better health of those in need who cannot afford it. Australia too through her consistent effort is trying to gain improvements in health and health care of all.