Listening to the PM and Opposition leader the other day, “debating” the future of health care in this country, I felt a bit woozy.

One of the biggest items in the budget, and certainly the item of huge interest to most Australians, and what do we get, nothing but more of the same crap!

The PM’s scheme to take some greater control over expenditure is doomed to failure, even if he could get the states to agree, how can a pack of weenies in Canberra deliver hugely complicated system like health; would you like a pink bat with that?

 The opposition is determined to be a policy free zone, OK, this tactic has won elections in the past, but health is too important to be a political pissing contest.

The real challenge is to go back to basics, strip away the layers of vested interest, from all in the game, and redesign it from the ground up, with the only objective to build an infrastructure to deliver patient outcomes into the long term.

Over time, the vested interests, bureaucracies & bureaucrats, doctors, nurses, private investors, equipment and consumables suppliers, employees and their unions, the list goes on, have all taken positions that have narrowed the options of sensible management of the system for patient outcomes, a bit like the plaque build-up in the arteries leading to the heart, and the heart of the system is in real trouble. Each action taken to protect a small bit of turf anywhere in the system reduces the opportunity of the whole system to grow and innovate, it is a sacrifice of the potential for greater good on the alter of self interest.

One bit at a time, the system has become narrow, brittle, inefficient, and ineffective, just like that artery with a bad case of sclerosis. We need a radical by-pass, it will be painful, dangerous, and require more practical skills, will, and vision than I suspect are currently available, but there is little alternative if we are to have a system that is effective, affordable, and equitable.