Wednesday, May 13, 2015

The Budget Has Some Pretty Tough Details For The Health Sector. Rises Are Less Than Health Inflation.

This appeared yesterday and highlights the bigger picture.

Federal budget 2015: Nearly $2 billion in cuts to health system

Date May 12, 2015 - 8:41PM

Amy Corderoy, Dan Harrison

The Abbott government will cut nearly $2 billion from the health system over the next five years, while pushing ahead with controversial changes to the way it funds state-run public hospitals.
After angering voters last year with proposals for a Medicare co-payment, Health Minister Sussan Ley has looked for savings from a range of little-known programs, including grants for preventative health research, chronic disease prevention and rural outreach. 
Ms Ley says the budget still represents a "sensible and moderate" increase in funding – to more than $69 billion next financial year. Health spending is projected to increase by 3.2 per cent in real terms over the next four years.
The government is proceeding cautiously on Medicare reform, allocating $34 million to support the work of taskforces which will examine elements of the system and present reform blueprints to the government by the end of the year.
But it has not retreated on its plans to cease funding hospitals based on the services they provide and shift to a new model based on population growth and inflation, which will leave states and territories $57 billion worse off over 10 years.
The Australian Medical Association has said this "will fall well short of the funding needed to position public hospitals to meet the increasing demand", locking them in to having inadequate capacity to give people the treatment they need.
Patients will welcome $1.6 billion in new drug listings, including medicines for melanoma and bowel cancer.
A number of services will be added to Medicare, including a new treatment for early-stage breast cancer, while a new cervical cancer test will mean women will only need to get a pap smear every five years instead of every two.
More here:
The really bad bit of this is the pressing on with the huge cuts to the Public Hospital Sector. You can be sure that the Premiers on either side of politics are going to become increasingly noisy regarding this issue.
Also we still don’t quite know where Pharmacy and Drug costs will land as the Agreement with the Pharmacy Guild is still unresolved - and looks like taking a few more weeks. It is good to see that some additional drugs are added to the PBS - but speaking today Mr Hockey confirmed the Government is still pushing up the PBS Co-Payment by $5.00 per prescription. That will be a big hit to some.
We will need a few more details for the full extent of what has been added and what has been removed to become totally clear.
One additional bit of good news is a new MBS item for Telehealth in ophthalmology in remote areas in 2015-16. Small but sensible I reckon.

The AMA reaction to what they saw in Health was less than keen.

See here:

What was particularly odd was this comment:

"A/Prof Owler said it was evident tonight that the health sector was not impressed with the withholding of Budget detail in the Health Budget lock-up.
“It was insulting to have the leaders of Australia’s health organisations locked in a room with no Budget detail,” A/Prof Owler said.
The AMA will make a more detailed response when full details of the health Budget are made available."

I wonder what was going on there? I also wonder of the AMA has thought through its comments on the e-Health reboot?



Karen Dearne said...

I don't believe the AMA has thought this through. Why is it advocating move to opt-out? Medical indemnity experts and insurers rejected the opt-out approach from the outset.

All the legal liability resides with participating medical providers, even when they are not in control of the operational and data quality aspects of the system.

Hmmm. What can go wrong with that?

Frankly, I've been astounded by recent AMA statements on the so-called PCEHR

Anonymous said...

Politely, it has, it is, and always will be, a cluster "schmozzle"!

Use your own imagination...

Bernard Robertson-Dunn said...


re:"All the legal liability resides with participating medical providers, even when they are not in control of the operational and data quality aspects of the system."

Can this be true in an opt-in model?

The government will creates most health records. Where would legal liability reside then? Would it change as soon as medical providers start to become involved? What will the demarcation rules be?

Anonymous said...

"The government creates most health records"...
The government may create the record holder (like a folder) for each person, but it seems there is no liability on the government for the contents (the documents) in the record – that is with the health care providers who post the documents.
Have you noticed that the original Concept of Operations for the PCEHR had proposed a consolidated view document that would collate key pieces of data from individual documents posted (event summaries, discharge summaries etc), such that the clinician viewing a person’s record could see at a glance what the current allergies, key diagnoses and medications were, without having to trawl through loads of documents which may or may not be in the chronological order or complete? There has been no consolidated view available in the PCEHR, and this is probably deliberate, as such a ‘view’ or ‘document’ would then be the responsibility and the liability of the government. They have carefully avoided being the authors of any view that contains clinical information.
And yet lack of a consolidated view is one of the key reasons that the PCEHR is not usable by clinicians. Surely this will need to be addressed in any redevelopment/reboot of the system. Otherwise, opt in or opt out, it will still not be usable.