Policies that work

Policies that work

Dr Bilgrami’s findings were reported on the front page of the Sydney Morning Herald, and by many other publications nationally. The research was also covered in Human Resources Director magazine, reaching key people in this sector, and Dr Bilgrami also discussed the potential effects of proposed changes to the parental leave scheme proposed by both major parties during the federal election in 2022 in The Conversation.

“There is often a limited quantitative and causal evidence base for many Australian policies. My parental leave findings push the debate for further optimising policy settings to support mothers in the workforce,” Dr Bilgrami said.

“Health outcomes for mothers and babies, along with greater labour force participation rates, are goals for effective policy. By teasing out causation, we can see which policies work and whether policies have had intended and unintended effects to further refine policy settings.”

This research not only offers direct inputs to policy debate and policy design, but has wider application for the efficient and equitable design of other policies, given that mothers’ health outcomes are strongly linked to labour force participation and return to work.

Research on private health insurance reforms is another area where Dr Bilgrami’s analysis is making an impact, directly contributing to policy debate and future policy design. Her research looked at whether means testing premium rebates and the Medicare Levy Surcharge, a reform introduced in 2011-12, impacted hospital coverage amongst higher income earners.

“This particular reform hadn’t been analysed at all, and this was an important research area, because the premium rebate costs the government $7bn annually. It is important to ascertain whether current policy settings are cost-effective and achieve their purpose,” she said.

Importantly, her analysis showed that the Medicare levy surcharge may be a more effective lever than subsidies in supporting membership among higher income earners.

Her previous work in industry has given additional perspective on how an enhanced allocation of valuable and scarce resources in the health care system can best be achieved using robust research methods.

“Evidence-based research reduces wastage in the health care system, with the ultimate goal being to allocate resources to their best fit and maximise population health and wellbeing. This involves estimating both the impacts and costs of different policies and interventions,” Dr Bilgrami said.

Dr Bilgrami approaches policy evaluation using robust econometric methods applied to large datasets, to estimate causal impacts.

Her recent research applies these methods to policies within the Australian aged care system, including looking at demand for different types of aged care and how older Australians and their informal carers make important financial decisions when entering aged care, through research funded by a Macquarie University Covid Recovery Fellowship and grants from The Ecstra Foundation.

“We’re looking at how families substitute between different kinds of aged care, including informal care, residential care or in-home care. Aged care financial decisions are also an important area for further research. The decisions people have to make are complex, with competing interests, and often follow a health shock,” Dr Bilgrami said.

Dr Anam Bilgrami is a Research Fellow at the Macquarie University’s Centre for the Health Economy. Others involved in her past research included her doctoral supervisors, Associate Professor Kompal Sinha and Professor Henry Cutler.