Wednesday, March 12, 2014

Pre - Budget Review Of The Health Sector - 12th March 2014.

As we head towards the Budget in Early to Mid May 2014 I thought It would be useful to keep a closer eye than usual on what was being said regarding what we might see coming out of the Budget.
According to the Australian Parliament web site Budget Night will be on Tuesday 13th May, 2014.
Here are some of the more interesting articles I have spotted this week.

Doctor visit co-payments are a healthy price signal, not a tax

March 3, 2014
Kelly O’Dwyer
Consistent inane attempts to brand the proposal by the Australian Centre for Health Research for a $6 co-payment for GP visits a “GP tax” distort the debate about the very real need to rein in growth in health spending.
On the plus side, the ALP has clearly worked out that Australians think tax is a dirty word. On the downside, they misunderstand the difference between a service fee and a tax, and signal a wrecking ball approach to attempts to set the Australian budget on a sustainable footing.
If a co-payment for GP visits is a “GP tax”, then what are the existing payments to a pharmacist for prescriptions? Are they a “medication tax”? What about payments for stamps? Or connection and usage fees for the national broadband network – are they “communications taxes”?
Posted: Mar 4, 2014

AMA calls on food industry to stop "undermining" star rating system

The vice-president of the Australian Medical Association (AMA) has called on the food industry to stop “undermining” the new star rating system.
Dr Steve Hambleton says the Australian Food and Grocery Council (AFGC) was lobbying against the system on the same day that the website was shut down by the Assistant Minister for Health’s office.
“Even though they worked closely with the public health sector on the development of the new system, the AFGC has lobbied against the consumer-friendly food labels since they were agreed by the federal and state governments last year,” Dr Hambleton said.

Government abolishes pharmaceutical pricing body

Joanna Heath and Jessica Gardner
The government will abolish the independent body responsible for recommending prices for new medicines on the Pharmaceutical Benefits Scheme, in a bid to speed up the listing process for subsidised drugs.
The Department of Health made a surprise announcement late on Friday that the Pharmaceutical Benefits Pricing Authority would stop operating. The announcement was made without consultation with major stakeholders, according to sources.
“This measure will further streamline the PBS listing process and reduce the time taken to list medicines,” a spokesman for Health Minister Peter Dutton said.
“The PBPA has served government well in formalising processes for PBS pricing, but those processes are now well entrenched and will be subsumed into the PBAC and the Department of Health where most of the work is already undertaken.”

Final report of the Pharmaceutical Patents Review will not be released or actioned

This week in the Australian parliament, the Pharmaceutical Patent Review quietly disappeared off the radar. The Minister for Industry, Ian Macfarlane, stated in response to a question from the Opposition that ‘the government has no plans to release the final report at this stage’, and further: ‘the government is not considering the recommendations made by the panel’.
On the 15 October 2012, the then Parliament Secretary for Innovation, Mark Dreyfus, announced a review of pharmaceutical patents in Australia. The report was initiated to evaluate Australia’s current system for pharmaceutical patents and its ability to ‘effectively balance the objectives of securing timely access to competitively priced pharmaceuticals, fostering innovation, and supporting employment in research and industry’. Central to the review was an investigation of the patent extension of term provisions available under section 70 of the Patents Act 1990, specifically the impact of these extensions upon the market entry of new generic pharmaceuticals.

NIB CEO says private health penalises young customers

Jessica Gardner
The chief executive of NIB, Mark Fitzgibbon, has written to Health Minister Peter Dutton claiming a policy that forces health funds to subsidise the costs of other insurers’ most expensive members drives up prices and discourages young people from signing up.
Mr Fitzgibbon wants a “sensible ­discussion” on risk equalisation, which partially compensates health funds for the hospital costs of high risk patients. It supports “community rating”, which means funds can’t price their policies based on risks such as age and pre-existing conditions. Equalisation shares a proportion of costs for members aged 55 years and older on a sliding scale with the industry. Funds pay a share based on the size of their membership.
NIB would be significantly more profitable without risk equalisation. In the first half of 2013-14 it paid ­$101 million to the shared pool. It had net profit of $40 million in the half. The reason NIB has a high liability, and doesn’t receive money back, is a result of its younger membership. NIB customers are aged an average 37 years, compared to 40.5 years across the industry, Mr Fitzgibbon said.

Consumers Health Forum slams GP fee proposal

Date March 4, 2014

Dan Harrison

Health and Indigenous Affairs Correspondent

The introduction of a fee to see the doctor would hit the poor and chronically ill hardest and would be unlikely to generate savings, according to a report to be released on Tuesday by consumer advocates.
The Consumers Health Forum prepared the report in response to a proposal by a former adviser to Tony Abbott, Terry Barnes, for a $6 fee for GP visits, and a call by Health Minister Peter Dutton for a national conversation about the sustainability of the health system.
"CHF wants to ensure any changes are evidence-based and are not at the expense of those most in need of care," said chief executive Adam Stankevicius.
In a submission to the government's Commission of Audit on behalf of the Australian Centre for Health Research, Mr Barnes predicted his plan would save $750 million over four years by reducing avoidable demand for GP services.

Keynote Address to the General Practice Registrars Australia Conference 2014

Minister for Health Peter Dutton presented the Keynote Address to the General Practice Registrars Australia Conference 2014 on 6 March 2014.

Page last updated: 06 March 2014
6 March 2014
Check Against Delivery
Good morning ladies and gentlemen and thank you for welcoming me here this morning to open the Future of General Practice 2014 (#fgp14) conference.
For the past four years I have spoken at the GPRA’s annual conference while in Opposition, so I’m pleased to have the opportunity to address this event as the Minister for Health.

GPs may be given lump sum payments to treat patients

Joanna Heath

Key points

  • Lump sum payments
    to doctors may replace the fee-for-service model.
  • Major overhaul of Medicare expected in the May budget based on the first report from the Commission of Audit.
Doctors may be given a lump sum payment to treat individual patients rather than be paid by the number of consultations they provide, under plans being considered by the government.
Health Minister Peter Dutton said the government was “open to a conversation” about scrapping the fee-for-service model which has been in existence since Medicare was established. He said the government would look at a greater role for lump sum payments as an incentive for doctors to improve a patient’s health quickly and prevent repeat visits.
Mr Dutton is softening the ground for a major overhaul of Medicare in the May budget based on the first report from the Commission of Audit, according to sources. In a speech delivered a fortnight ago, he described Medicare as “unsustainable” and canvassed the introduction of mandatory GP co-payments and the means-testing of bulk billing in other areas.

Medicare costs must be reined in: Dutton

  • 10 hours ago March 05, 2014 1:16AM
  • AAP
HEALTH Minister Peter Dutton says the Medicare system needs to modernised to be affordable, but he won't say if GP co-payments will be part of the mix.
The Consumers Health Forum on Tuesday reignited debate on GP co-payments, when it released research showing that not only would they hit the needy, but they would fail to provide any overall budget savings.
Co-payments of up to $6 have been flagged as one way to tackle health spending as the government grapples with the budget deficit.
Prime Minister Tony Abbott has downplayed the likelihood of a co-payment being introduced, saying he wants the government to be "the best friend that Medicare has ever had".

Tackling avoidable cost has to be at the heart of how the hospital system works

PUBLIC hospitals are wasting up to $1 billion a year and should be held to account for inefficient and substandard medical care, the Grattan Institute has warned.
In a report released last night, the think tank headed by long-time reform advocate Stephen Duckett has called for activity-based funding to be accompanied by measures that would reduce costs and rein in health inflation.
Health Minister Peter Dutton is awaiting the findings of the budget Commission of Audit, along with reviews of Medicare Locals and electronic health records, to decide the future of the health system.

Activity-based hospital funding healthy way to go

SIX Australian public hospitals do more than 200 hip replacements a year. In one, the cost of a hip replacement is $9700 a patient. In another it is $23,400, nearly 2 1/2 times higher.
Similarly, the cost of a common treatment for gallstones - laparoscopic cholecystectomy - ranges from $4100 to $7900 a patient, depending on the hospital.
Grattan Institute’s new report, Controlling Costly Care: A Billion-Dollar Hospital Opportunity, reveals substantial differences in costs among Australia’s public hospitals. Much of this cost can be avoided. If it is, nearly $1 billion will be freed up to address other needs every year.
When state finances are tight, such large differences cry out for attention. There is also a moral imperative: it is unethical to ration services or shift costs to consumers when there is inefficiency in the system that, with better management, could be reduced and the savings used to address unmet needs or future cost pressures.

Health system could save a billion a year

Date March 5, 2014 - 5:54AM

Dan Harrison

Health and Indigenous Affairs Correspondent

Governments could save a billion dollars a year by cutting waste in public hospitals, according to a former top health bureaucrat.
A report by the Grattan Institute think tank found a high level of unexplained variation in the average cost of comparable procedures between hospitals. For example, among the five hospitals nationally that perform the most gall bladder removals, median costs range from $4200 to $8000. In NSW hospitals, the average cost of the procedure varies from $3500 to $8000.
Grattan Institute researchers led by Stephen Duckett, a former head of the federal health department, analysed public hospital cost data to identify differences that could not be explained by patient or hospital characteristics. It finds in some cases the cost of providing the same kind of care to the same kind of patient was two or three times more than in other hospitals in the same state. The researchers calculate these unexplained costs amount to at least $928 million a year across the nation.

Better hospital management needed to improve patient care

Date March 5, 2014

Peter Breadon

In one NSW public hospital, removing a gall bladder - a common treatment for gallstones - costs $3500. In another, it costs $7300.
The story is similar for hip replacements, which cost $15,000 in one hospital and more than $20,000 in another. Such big differences are not inevitable. States could easily reduce them, saving taxpayers nearly $1 billion a year.
A new Grattan Institute report, Controlling Costly Care, shows such gaps don't come from treating patients with more severe problems. They can't be explained by the cost of running different types of hospitals, or hospitals in different kinds of places - both the hospitals mentioned above are in Sydney.

Senate censures Fiona Nash over conflict of interest concerns

Date March 5, 2014 - 9:58PM

Amy Corderoy, Dan Harrison

Parliament has censured Assistant Health Minister Fiona Nash for misleading the Senate and refusing to produce documentation about her employment of a junk food industry lobbyist in her office.
Labor says Senator Nash’s position is no longer tenable and has called on her to resign after the censure motion passed 37 to 31 votes.
Only three such censure motions have passed in the past 10 years.
Senator Nash had until early Wednesday afternoon to produce a document that she claimed outlined the measures she put in place to address the fact her chief of staff, Alastair Furnival, co-owned a lobbying firm that did extensive work for soft drink and confectionery companies.
6 Mar 2014 - 7:05pm

Labor on WA hustings, slams Medicare idea

Opposition health spokeswoman Catherine King says a co-payment to see a GP is only going to add to cost of living woes in WA.
As West Australians prepare to return to the polls, Labor has appealed to their hip pockets, saying the Abbott government's planned changes to the Medicare system will only increase their high cost of living.
The government has flagged the possibility of co-payments of up to $6 for GP visits as one way to tackle health spending.
Opposition health spokeswoman Catherine King said on Thursday WA already had some of the nation's highest out-of-pocket expenses for attending a GP, with some Karratha doctors charging a gap payment of $85.
"Imagine what will happen to that if you add a co-payment, a tax from the Abbott government, on top of that," Ms King told reporters in Perth.
It seems even clearer there is a significant change coming on the basis of this week’s news.
Was very interesting to see the variability in the costs of delivery of common hospital treatment from the Grattan Institute and the speeches and comments from Mr Dutton.
Also very interesting was exploration of the possibilities of moving from fee- for service GP visits.
As usual - no real news on the PCEHR Review.
More next week.

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