Reducing cancer costs is a laudable policy, but we must also try to prevent it

Removing the financial worries of Australians diagnosed with cancer is a popular gesture.

Australia's $ 2.3 billion cancer plan announced in Bill Shorten's budget response speech Thursday night aims to ensure cancer treatment costs for scanners, specialists and drugs are met billed as a block or subsidized under the PBS program. It would be a hard heart indeed that did not welcome such an approach.

Perhaps even better than avoiding the costs of treatment, it is to prevent future cases of cancer. About one-third of all cancers can be prevented by avoiding smoking, maintaining a healthy weight, eating healthily, being physically active, minimizing alcohol consumption and avoiding excessive exposure. under the sun.

However, apart from a small commitment to tobacco control in the 2019 budget, neither the government nor the opposition has made even the most vague commitment to preventing HIV / AIDS. cancer, nor have they invested in it.

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So far, neither party has talked to us about efforts to fight obesity, promote healthy eating, encourage more physical activity, reduce alcohol consumption , promote sun protection or intensify efforts to increase participation in cancer screening and immunization programs.

The government currently spends about $ 2 billion a year on "public health," which includes surveillance, regulation, prevention, and immunization. This represents less than 2% of the country's total health expenditure of A $ 170 billion. That's about half of what we spend on patient transportation.

An increase of 5% – or closer to 8.5 billion Australian dollars – could significantly improve prevention programs, thanks to high quality research.

Bad balance sheet

With respect to investments in disease prevention, the story is not convincing for the Coalition.

The Rudd Labor Government created the Australian National Agency for Preventive Health (ANPHA) in 2009, with funding of about 60 million Australian dollars a year. The agency has run national programs focused on tobacco, alcohol, healthy eating and reducing alcohol consumption.

But the new Abbott government abolished the agency in 2014, after drafting legislation to wipe it off the account.

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From 2008 to 2014, the National Preventive Health Partnership Agreement (NPAPH) funded programs in Australia to address malnutrition, physical inactivity, excessive smoking and tobacco use through $ 872 million in funding.

Programs such as Liver Lighter and Foodcents, for example, have provided practical and evidence-based help for people to lead healthy lives. Other programs have helped to improve the availability of nutritious foods and to ensure that walking and cycling are safe and viable elements of transportation planning.

In 2012, the Labor government of the time was committed to maintaining the NPAPH until 2018, but the Abbott government eliminated it in the 2014 federal budget.

This has taken hundreds of millions of dollars otherwise engaged in efforts to prevent the calculation of the federal budget.

All these abandoned efforts had probably had a major effect on the fact that future generations of Australians did not hear these terrible words: you have cancer.

Like any human endeavor that targets big changes in systems and behaviors, stopping and starting the programs that lead to these changes diminishes the chances of success.

So why is it difficult to get governments to invest in prevention?

Strong and influential industries constantly put pressure on governments to protect their business interests. This is what happens in a market economy democracy. The alcohol, processed food and even tobacco industries continue to play a decisive role in the halls of power.

Unsurprisingly, the industry is strongly opposed to higher taxes on these products ("sin taxes") and programs that discourage their use.

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It is common to hear politicians tell stories of individuals, "real people" who are benefiting from new treatment or have access to new medical care or new drugs. We all communicate with these comforting stories that illustrate the importance of investing public funds.

Such stories are harder to tell in prevention. How can we find the 64-year-old enjoying the first day of school for his granddaughter, largely because he did not die of a smoking-related illness in his 50s, do not to start smoking?

To talk about our success, we return to dry and dusty but impressive statistics, with an estimated 500,000 premature deaths averted over the last 20 years.

Effective prevention policies, such as the imposition of a minimum floor price on alcohol, help to reduce the harm badociated with alcohol. But making it harder to reduce the price of alcohol is politically unpopular.

Reforms such as the extension of non-smoking areas are taken for granted, but were opposed when they were introduced.

Finally, the benefits of prevention often take several years or even decades to materialize. Political calendars are often linked to three or four year electoral cycles.

A long-term vision is essential. For example, every dollar invested in skin cancer prevention brings about $ 2.20 in cost savings to avoid the costs of treating the disease. But there are decades between reducing children's sun exposure and avoiding treatments when these children reach the age of 50 or 60 years.

As the election campaign unfolds, hopefully the two budding Australian governments will continue to show real interest in the health of Australians and commit to preventing disease. Is 5% of the health budget too much to ask?