Policies That Shape How Australian Patients Navigate the Healthcare Maze: A Critical Discourse Analysis

Governments around the world are endeavouring to work out how to meet patients' expectations regarding universal health coverage. Even wealthy nations such as Australia that formally enjoy universal health coverage experience gaps and inequities in access to health care. Not all patients enjoy an equal capacity to choose. Inequities in access to care, long waiting times for surgery and increasing out-of-pocket expenses are creating a divide in healthcare between those who can afford to pay either out-of-pocket or via private health insurance, and those who cannot. The aim of this project is to advance policy-relevant sociological knowledge about the factors that shape and constrain patient choice as a basis for transformative healthcare professional education and evidence-informed policies.

The study is informed by a critical discourse analysis of selected Labor and Coalition Federal policy texts to examine how patient choice is spoken about, shaped and enacted at the federal level in Australia. The content of speeches and statements by key politicians was accessed through the database services of the Commonwealth Parliamentary Library. The sample comprises speeches and statements pertaining to health policies made by Prime Ministers, Ministers of Health, and Opposition Leaders and Health Spokespersons.

Critical discourse analysis reveals the core policy messages that emerged during the Howard Coalition (1996-2007) and Rudd/Gillard/Rudd Labor (2007-2013) governments. Our study compares and contrasts Labor and Coalition policies in relation to access to health care in order to explicate the underlying assumptions regarding patient participation and choice within the context of universal health coverage.