摘要: The history and current organisation of the Australian health system cannot be understood without reference to the Australian federation. Many other developed nations share the health problems associated with an ageing population, the rapid emergence of chronic disease, growth in demand (and supply) for health services, fiscal constraint and health inequality and variability in quality and access to services. But it is the Australian federation that sets the context for the unique features of the Australian health system. The Australian government and the states1 are the main policy actors in debates about health policy in Australia. The various professions, providers and consumers provide the broader set of actors. They are influential but it is the negotiations between the federal and state governments that substantially shape the Australian health system.