This blog is totally independent and has only three major objectives.
The first is to inform readers of news and happenings in the e-Health domain, both here in Australia and world-wide.
The second is to provide commentary on e-Health in Australia and to foster improvement where I can.
The third is to encourage discussion of the matters raised in the blog so hopefully readers can get a balanced view of what is really happening and what successes are being achieved.
Thursday, March 27, 2014
Pre - Budget Review Of The Health Sector - 27th 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.
The opinion poll released on Monday in the Fairfax media is being interpreted by some commentators as supporting the proposal for a GP bulkbilling co-payment, reportedly under consideration by the Abbott Government.
Around half of the people polled said that they supported charging a means-tested co-payment for bulkbilled GP services. The same proportion of people also supported the Government taking action to ‘curb the cost of Medicare’.
Opinion polls have their uses but caution should be exercised when interpreting the results of this poll as a vote for shifting health care costs from Governments to consumers.
In fact, polls on complex policy issues such as this should be seen as akin to horoscopes – ambiguous enough for all readers to find confirmation of their existing biases and to justify the course of action they were going to undertake anyway.
As politicians spent a hectic day trying to persuade us which messages we should take out of the Tasmanian and South Australian elections, more mundane factors that might have actually motivated voters were not getting all that much attention.
The most mundane of those factors goes to the Labor governments in Tasmania and South Australia being not so much ageing as geriatric. Voters wanted a change.
In Tasmania voters were also over the Greens and minority government. All the talk of the Greens becoming the major opposition party at Labor’s expense ended up looking very sick.
Yet the two state polls – and the latest Nielsen federal poll – do tell us some very big changes are taking place in the electorate.
Voters show appetite for tough medicine
Yet the latest poll shows the case for tougher access to Medicare, rather than protecting universal access, in the ascendency.
PROPOSALS to curb Medicare costs have earned the support of voters, with the latest Nielsen poll showing about half of those surveyed support measures such as the $6 co-payment and means-tested bulk-billing.
The Coalition leads Labor 51% to 49% in the poll published by Fairfax on Monday, down 1% from February, with Tony Abbott remaining as preferred prime minister with 48% support versus 43% for Opposition Leader Bill Shorten.
Despite the Labor campaign against the possible introduction of a $6 GP co-payment, the poll provided a boost for government indications of a tough budget in May, with 52% backing a means test for bulk-billing and 49% supporting the introduction of a $6 co-payment.
GOVERNMENT spending on primary healthcare per person increased by 50% over the last decade.
A report from the Australian Institute of Health and Welfare shows expenditure increased in real terms from $30.8 billion to $50.6 billion for primary healthcare over the decade from 2001–02 to 2011–12.
Federal government spending per person on primary healthcare rose from $669 in 2001–02 to $1005 in 2011–12 after adjusting for inflation.
But Professor Jane Hall, a health economist at the University of Technology, Sydney, said this did not back an argument to introduce a $6 co-payment to cover these rising costs.
Federal spending per person on primary healthcare services, including visits to GPs, grew by 50 per cent over the past decade, according to new figures that may bolster the case for new fees to visit the doctor.
The analysis from the Australian Institute of Health and Welfare to be released on Friday shows federal government spending per person on primary healthcare - a measure largely made up of visits to doctors - rose from $669 in 2001-02 to $1005 in 2011-12 after adjusting for inflation.
Federal spending per person on all health services - a measure that takes in spending in hospitals as well as visits to doctors - increased from $1892 to $2620.
Reports in several News Limited papers, today, are misleading the public into believing that they are overpaying pharmacists for the medicines, the Pharmacy Guild of Australia says.
A Guild spokesperson hit out at claims that PBS price cuts were a result of the Federal Government stopping “overpayments” to pharmacies.
“This is an unfair slur on hard-working pharmacists who continue to provide PBS medicines at the best possible price to patients within a system in which they have no control over the PBS price – which is determined by Government,” the spokesperson said.
“The vast majority of prescriptions dispensed under the PBS are directly subsidised and therefore the price to the consumer – the co-payment – is identical no matter which PBS approved pharmacy supplies the prescription.”
A private health scheme that guarantees members priority bulk-billed care contravenes the "spirit" of Medicare laws designed to ensure equal access to health care, an Australian Medical Association (AMA) official warns.
Medibank Private began trialling the program last November at six north Brisbane medical practices and aims to expand it to 30 more sites in Queensland, as well as other states.
Medibank national medical director Dr Ian Boyd says many of the 4,500 patients who have tried the scheme have done so more than once, and the feedback is positive.
"The service allows them to have access to a GP within 24 hours for a standard daytime visit, and also allows them to have access to a GP in the metro areas in the after-hours period for home visits," he said.
A plan to means test bulk-billed GP visits and charge an extra $5 for medicine was estimated to save the government nearly $2 billion but would upset doctors, who have threatened a mass walk-out if it is implemented.
The proposal from the Department of Health to reduce medical subsidies was rejected by the Labor government before last year’s budget. But it is likely to be reconsidered by Health Minister Peter Dutton, who believes Australians who can afford to, should pay more for their healthcare.
Under the plan, which was leaked to The Australian Financial Review, there would be a major change in how GPs are repaid by Medicare for treating patients. Bulk billing would be limited to concession card holders and children, saving $860 million over five years.
A spokesman for Mr Dutton would not rule out the changes, saying only the government would not comment on deliberations for the budget, which comes out May 13.
MORE than a thousand senior doctors working in public hospitals across Queensland have voted to reject the state government's offer on individual contracts.
The unanimous vote of no confidence in the government's last-minute compromise came after Queensland Health Director-General Ian Maynard acknowledged their concerns at a crowded gathering in Brisbane on Wednesday night.
"The concerns that I've been told you had were consistent wherever you worked in the state," he told the crowd of about 1200 doctors, including one holding a placard, "Trust Gone, Goodwill Lost".
Senior medical officers (SMOs) had met with Mr Maynard and Health Minister Lawrence Springborg last week to express reservations about working conditions.
Health Minister Peter Dutton has backed a proposal from Medibank Private managing director George Savvides that would change the way doctors are paid to treat the chronically ill to a per year basis, instead of a payment per visit.
Writing in Monday’s The Australian Financial Review, Mr Savvides says the system now failed “high needs” patients because there was no structure that pays doctors to provide extra care.
In what would be a major reform of Medicare, Mr Savvides said Medibank wants to fund a “capitation” model of funding for GPs alongside the government. “We’re not asking government to be the only source of that funding,” he told the Financial Review.
TThe polls this week suggest half of Australians think the Abbott government should reduce the cost of Medicare. My solution? Claw back some of the A$9 billion the government pays to private hospitals…
Senior Lecturer, School of Economics at La Trobe University
The polls this week suggest half of Australians think the Abbott government should reduce the cost of Medicare. My solution? Claw back some of the A$9 billion the government pays to private hospitals.
Consider my experience … A few years ago I twisted my knee playing football. My GP, maybe after estimating my salary, suggested a private sports physician to diagnose my injury. The sports physician pulled and prodded at my knee before telling me:
It doesn’t seem like any ligaments are torn, but I can’t tell for sure. Why don’t we get you a scan – you’ll only pay $60. And Medicare will pay the rest.
THE federal government fears it could be powerless to enforce the performance of Labor’s $420 million GP Super Clinics program, a third of which have yet to be built or are not operating.
This is despite the super clinics being cornerstone Labor election promises in 2007 and 2010.
The latest update of the progress of the program obtained by The Australian, shows 10 of the 64 super clinics planned are yet to be started with another 14 still under construction.
Despite its $420m price tag, Health Minister Peter Dutton has confirmed that under the program the federal government owns none of the assets at the super clinics. Instead, the government holds 20-year contracts for service provision from the recipients of the grants.
But Mr Dutton is concerned the front-end loading of funding in the contracts could compromise the federal government’s ability to guarantee performance.
Countries that rely heavily on private insurance to fund healthcare have more expensive health systems, the federal government's Commission of Audit has been told.
In an analysis of the health expenditure by Organisation for Economic Co-operation and Development countries submitted to the commission, researchers from the Centre for Policy Development say competing private health insurers were unable to keep costs down.
The government has hinted at cuts to health spending, warning that private funding needs to play a bigger role in containing rising healthcare costs.
It has appointed the commission to examine all federal spending and recommend budget cuts.
It seems even clearer there is a significant change coming on the basis of this week’s news as well.
What has been interesting this week has been the emergence of Medicare means testing and criticism of private health insurance. Additionally we have polls suggesting co-payments are fine and discussion on how these polls can mislead. All good fun and grist for the mill!
Importantly there is also a great deal of useful discussion here from The Conversation.