The Economic Crisis, the Pharmaceutical Benefits Scheme, and the Dilemmas of Medicines Policy

AS THIS SPECIAL ISSUE of Australian Health Review was finalised, the media reported daily on the global financial debacle and its deepening into a crisis in the real economy. The causes of the crisis are hazy ? but its impact, across the globe, on people?s lives is real and distressing. Many people are affected by worsening poverty and deteriorating access to health services and medicinal drugs. In the United States, unemployment often means the loss of health insurance, reinforcing risks of financial and social disaster for many families who would have previously considered themselves comfortable middle class. For those lucky enough to retain jobs, the cost of health insurance may rapidly become unaffordable; ?Healthcare a Budget-Buster for Families; Even County?s Middle Class Can?t Afford It?, ran a typical recent headline in a non-metropolitan newspaper.1 Even before the present crisis, tens of millions of Americans were excluded from health insurance. Those not excluded pay premiums to insurance companies that spend vast resources trying to insure the healthy, avoid the sick, and deny payment for claims wherever possible. Gaining power partly on a wave of resentment against the excesses of neo-liberalism, President Barak Obama has promised public health insurance for those not otherwise covered. Should this reform be successfully implemented, it will belatedly bring to US citizens a level of security approximating what Australians, and many Europeans, have had for decades.