Take one with a bag full of salt

Adam Creighton recently wrote a column comparing health spending and outcomes between Australia and New Zealand without once reflecting on the fact that one of those countries is nearly 30 times geographically larger yet only has about 5 times more population.  Gee, do you think that might make the cost of providing medical services a bit more expensive, Adam?

Today he's trolling facts and figures about medical services in Australia (trying to show we are massively over-serviced) in what, I can just about guarantee, will turn out to be a shallow, ideologically driven analysis that does not bear up to scrutiny.

This one line in particular caught my attention:

Even in rural areas where the “doctor shortage” myth is entrenched, there are more doctors per person now than there were in inner-city regions in 2003.

There's not a doctor shortage in rural areas?   This will probably come down to some furphy about how "rural" is defined, is my guess.

As with the recent effort of Henry Ergas, this is all being undertaken to try to bolster an argument that the Coalition policy for co-payment is warranted, regardless of where the money from the co-payment goes.    

Anyway, I don't have the time or knowledge of where best to go to double check this article take, but I hope someone does soon.

Update:   As I suspected, Adam is engaged in spin, not in giving an accurate picture:

 Stephen Duckett: If you look at the shortage in areas like the Kimberley and the Pilbara, for example, in Western Australia, there's only about 57 doctors per 100,000 population. If you contrast that with suburban Sydney, for example, there are 122 doctors per 100,000 population. So there is only half the number of doctors in these rural and remote areas as there are in the cities. And of course health needs are somewhat greater in rural and remote than they are in the cities.

This certainly indicates that Creighton's improbable claims come from the definition of "rural"; re-read what he said and compare it to the number Duckett is citing.  

As the interview continues, it is clear that there remain large parts of the country with low numbers of doctors:

Norman Swan: And you only looked at seven rural and remote areas in this study, why was that?
Stephen Duckett: Well, we decided to tackle the worst first. We said let's concentrate our initiatives on the places with the worst access in the country and see what we can do to change that very, very quickly over a five-year period.
Norman Swan: You said north-west Western Australia being one area. Where are the other areas, just briefly?
Stephen Duckett: Northern Queensland, for example, around Mt Isa, also northern New South Wales, basically all of Western Australia is the area we're looking at, other than Perth. So we're looking at a number of places across the country, all of the Northern Territory for example is in dire straits.

Creighton is right about the large number of graduates; but it doesn't mean problems with the number of rural doctors is automatically solved:

Norman Swan: Why look for a solution when we've got this tsunami of medical graduates? We are, some would argue, over-producing medical graduates over the next few years. It's starting now. Some of them aren't actually going to have any jobs when they come out. Some people are saying there is going to be 1,200 unemployed doctors within the lifespan of this government if it goes to two terms. Why are we bothering talking about alternatives when in fact you're going to have medical graduates coming out of your ears?
Stephen Duckett: Well, the trickle-down approach, which is what you're suggesting, just pump hundreds…an extra thousand graduates into the system and hope that they will go to the places where needed, hasn't worked in the past. Sure, there has been over the last five years an improvement in access, but it has mainly occurred in what are called the inner regional areas, the major rural cities like Bendigo and so on, rather than in the more remote and rural areas.
Similarly with international medical graduates, again we push those out into the remote communities, but as soon as their time is up they try and move into the inner regional or the cities. And so these solutions don't end up with a sustained fix of the problem. So we're saying you have to try something new and something different.