Most of us use Australia’s care system in some way, or know someone who does. After all, from birth to death we all need support at one time or another.

But as royal commissions into aged and disability care, and national scandals in child care have shown, this care isn’t always good quality. Sometimes it’s not available at all. At worst, it’s harmful.

One of the major drivers of these failures is the very business model of care itself.

In Australia, as in many rich countries, private businesses are delivering an increasing share of care.

But it wasn’t always this way. So how did we get here, and how do we reform the system to better serve all of us?

From charities to profits

As the welfare state developed in rich countries after the Second World War, governments took on some of the care for children, older people and people with disabilities that families, mutual aid associations and charities had provided.

The degree of government involvement varied across the world, and looked different in different countries.

In the high-taxing Nordic countries, for example, local councils built up extensive public care systems, offering child care, nursing homes and home care.

In Australia, lower taxation rates and long periods of conservative government laid different foundations.

Our constitution also shapes how care services are funded and regulated by prescribing different roles for federal and state governments.

After the war, Australian governments provided some care services themselves. But they also funded private organisations, mostly non-profits run by churches and charities, to deliver them.

In the 1970s, the Whitlam government funded community organisations to provide care services alongside established bodies.

Further change has happened since the 1980s. Demand for care services began to grow, driven by population ageing, increasing workforce participation by women and changing community expectations.

Influenced by the ideas........

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