I think we should close the hospitals.

I think we should close the hospitals.

Every dollar spent on preventing disease in Australia returns $14. Yet we spend 2.3% of our health budget on prevention.

Now before you laugh, I have it on excellent authority from my partner Maria, who is a Registered Nurse here on the Gold Coast, that the system is genuinely excellent if you've got a problem.

You need a new knee? Magnificent. A stent? World class. A bypass, a hip replacement, a course of chemotherapy administered with extraordinary skill and care? Australia is very, very good at all of it.

The problem is what happens before any of that.

Almost half of all Australians live with at least one chronic condition. Chronic disease accounts for 89% of deaths in this country. In 2022-23, Australia spent $82 billion treating chronic diseases. Over a third of that burden is attributable to modifiable risk factors, diet, physical inactivity, tobacco, alcohol. Things, in other words, that may not have needed to happen.

We have had these numbers for decades. They have been published in reports, presented at conferences, cited in submissions to government inquiries, and delivered in PowerPoint slides to rooms full of people who nodded seriously, went to lunch, and ate a chicken schnitzel with chips.

Our response has been to continue spending 97.7% of our health budget on the expensive end of a problem that could have been addressed at the cheap end.

It is a bit like a restaurant that has perfected the art of treating food poisoning and remains serenely unbothered by what's happening in the kitchen.

It makes sense how we got here. It is a system designed around the wrong incentive. Treatment has a billing code. Prevention does not. The hospital gets funded when someone arrives sick. Nobody gets funded for the ten years of daily decisions that kept them out of it.

The result is a health system genuinely excellent at fixing things once they break, and structurally indifferent to stopping them breaking in the first place. It's kind of like we have built the world's most sophisticated and expensive ambulance fleet and parked it at the bottom of a cliff that we are not particularly interested in fencing.

The maths is not complicated. Every dollar spent on prevention returns $14. The correct answer, taken to its logical conclusion, is to close the hospitals entirely and redirect the $82 billion upstream.

Closing the hospitals is obviously insane.

But so is investing 2.3% in prevention.

The kitchen needs attention. Maria can confirm.