On the 23rd of September our Federal Health Minister spoke at the Annual MTAA Conference.
This speech is reported here:
Nicola Roxon takes whip to 'cowboy' marketing
Siobhain Ryan | September 24, 2009
Article from: The Australian
CANBERRA will target its $14.8 billion Medicare system for major savings and crack down on "cowboy" marketing practices for flashy new medical technologies.
Federal Health Minister Nicola Roxon has issued a strongly worded challenge to doctors, drug and medical device makers to stop resisting reform and to help trim costs by backing more cost-effective technologies.
"It is frustrating that wherever I go I find almost universal agreement that we need reform and to use taxpayer funds more wisely, but it is always with a 'not in my backyard' caveat," Ms Roxon told the annual conference of the Medical Technology Association of Australia in Sydney yesterday.
"When we spend $14.8bn a year on the MBS, there are clearly some major savings to be made," she added.
Doctors, pathologists and drug companies all suffered cuts to their taxpayer-funded fees in this year's budget, with the government signalling more pain could follow next year to help finance its ambitious health reform agenda.
Last month, Kevin Rudd outlined plans to regularly review the effectiveness of subsidised medical treatments and cut funding from those found to be ineffective.
Ms Roxon said the current review of the way Canberra assesses health technologies, to report at the end of this year, would drive the Prime Minister's push for accountability. She said one area of savings would be to wean doctors and patients off the "flashiest technologies" in favour of better-value ones.
More here:
http://www.theaustralian.news.com.au/story/0,25197,26117209-23289,00.html
For those of us interested in e-Health we find the following in related to e-Health.
“What savings can pay for
All of this is just by way of explaining that we need to look at a smarter use of our health budget because the reform directions proposed by the Commission, whilst exciting and far reaching, do not come cheap.
The Commission estimates its recommendations could cost more than $5 billion per annum, plus $4 billion a year for a national dental scheme, and system wide capital costs of up to $7 billion. Others have already indicated these costs may be rather low estimates.
Think of the potential offered by the introduction of person-controlled electronic health records. The Commission recommends we do this by 1 July 2012, and estimates the cost at somewhere between $1.1 and $1.8 billion.
An electronic health record really does have the potential to revolutionise how we deliver health care services.
It is estimated that 30 to 50 per cent of patients with chronic disease are hospitalised because of inadequate care management.
An Electronic Health Record would mean patients will be able to present for health service treatment anywhere in the country, and with patient approval, the treating health professional will be able to access a summary of the patient’s treatment and medication history at the touch of a button.
For health professionals, this will mean that less valuable time is lost, expensive tests are not being re-ordered or duplicated at a cost to the taxpayer, and knowledge is shared.
In fact, it has been estimated that up to 18 per cent of medical errors are attributed to inadequate availability of patient information, and between 9 and 17 per cent of pathology and diagnostic tests are unnecessary duplicates. When we spend $14.8 billion a year on the MBS, there are clearly some major savings to be made.
The Commission’s report is quite clearly excited by the potential shift towards more personal, patient-centred health care that e-health and medical technology can help create.
I said earlier it will require leadership from the profession and the industry to help us realize this potential.”
The full speech is found here:
I am really getting a little tired of this approach of linking the fate of e-Health in Australia to savings being made elsewhere in the budget.
This is genuinely 19th Century thinking in my view. The government has cost benefit studies from NEHTA, The Allen Consulting Group and KPMG, among others, all of which show e-Health done properly will actually save money in considerable quantities.
The evidence for this (in Australia) is quite well summarised here:
as well as in the NHHRC final report (in a slightly confused way) and here:
http://www.accesseconomics.com.au/publicationsreports/getreport.php?report=201&id=257
Ms Roxon needs to just stop running this silly line and get the Health Sector’s share of the Stimulus Funds spent in this area! (given health has missed out totally to date!)
David.
She may find this easier if she could convince her colleagues that the sector will not waste the funds on flashy technologies.
ReplyDeleteThe Minister acknowledges that “leadership from the profession and the industry to help us realize this potential.” is required to make the shift towards more personal, patient-centred health care referred to in the NHHRC's Report.
ReplyDeleteOk, so we all now that eHealth is fundamental to making that shift and the “leadership from the profession” to which the Minister refers must come from the professional bodies. But which of them are showing leadership in ehealth?
There is plenty of rhetoric but that doesn’t readily translate into leadership, action and progress; with one exception - the Pharmacy Guild. The Guild does seem to standout through its capacity to demonstrate commitment with investment leading to action. But that comes as no surprise as they are the only peak body with access to an impressive funding source!! Isn't it time to level the playing field?
Did you see this David - it's straight from the Minister's mouth. She said: "An electronic health record really does have the potential to revolutionise how we deliver health care services."
ReplyDeleteSurely this means she has heard the message and she understands. She also said " Think of the potential offered by the introduction of person-controlled electronic health records. The Commission recommends we do this by 1 July 2012, and estimates the cost at somewhere between $1.1 and $1.8 billion."
Does this mean we should all be very pleased, that she actually gets it?
If she got it she would be talking about how she was going to fund implementation of the National E-Health Strategy from new funds - not savings - as it will pay for itself. She is talking about a PHR which has unproven benefits instead.
ReplyDeleteDavid.
Hooray, the Minister does get it at last. I'm sure you aren't the only one who will be pleased David. But hey, getting it is one thing, being able to do something about it is another.
ReplyDeleteNicola Roxon admits she doesn't have the money and she knows what the savings could be if she did have the money. So what is the problem? What is the barrier to progress?
The fact that she is so ineffective as a Minister she can't get Mr Rudd, Mr Tanner and Mr Swan to give her some funds to spend on something which, if done properly, would save money and create jobs!
ReplyDeleteHeavens they can find $43 Billion to create the NBN on no evidence - having yet to even do the business case!
David.
You ask “What is the barrier to progress?”. That should be obvious. Quite simply it is how to fund and implement a solution.
ReplyDeleteThe operative words are:
- HOW TO FUND?
- HOW TO IMPLEMENT?
- WHICH SOLUTION?
We have a National E-Health Strategy that explains all that!
ReplyDeleteDavid.
So, how about putting aside, let’s say for starters $20 million. That’s a digestible bite size chunk.
ReplyDeleteNow let’s understand one thing - it must not be for a ‘pilot’ - because when the gas gets turned off the pilot goes ‘futt’.
Now, let’s split the $20 million up in some way. Aaahh - stand aside - this is where the screaming starts everyone wants some of that moulah. Let’s make some containment decisions. First, direct the money into ehealth in the Primary Care environment (as opposed to the hospital sector). Second, choose the highest priority solution pathway recommended in the National E-Health Strategy. We could keep going but let's stop there for the moment and digest those thoughts. Not bad for starters?
$20 million! I like that. If it was prudently deployed we could see some progress. How much progress would we see if 50% was allocated to supporting further development and implementation of the Pharmacy Guild’s and the RACGP’s e.prescribing and medication management exchanges?
ReplyDeleteAll,
ReplyDeleteStop it. It needs between 1.0 and 2.0 Billion over 4-5 years to get things rolling - at a minimum. Even Ms Roxon realises that - which is why she is not planning to fund it as she should. Benefits are estimated to be 5-7 Billion per year once implemented.
Funny that in the quote above she talks of the costs but not the benefits.
David.
That's a minimum of $200 million over 5 years for the whole shebang. So 10% would be $20 million. Your commentator 1:34 PM above suggested $20 M to support the further development of the two e.prescribing exchange. That seems pretty sensible in that it drives that sector forward, energises the market, involves doctors, pharmacists and consumers, and doesn't cost a bomb in the process as much of the infrastucture is already in place. So, I think you're wrong to say "stop it". When the other $180 million you refer to becomes available it can be allocated to projects other than e.scripts and medication management. That seems an incredibly sensible suggestion If You Don't Mind Me Saying So.
ReplyDeleteSorry guys, but unfortunately, spending $20 million is just not a credible response to what needs to be done, especially given that the investment will yield much larger savings down the track.
ReplyDeleteHaving funded NEHTA for $218 million just to get the standards and business case going, we are then going to somehow make it happen for a fraction of the cost?
Sorry. This assumes that we have the luxury of not doing anything until the money magically appears, while the health system becomes ever more unsustainable in its current form - have you seen the latest intergenerational report projections on rising health costs?
This is what other nations have already done -
UK -> 12 billion pounds.
US -> US$18 billion.
Canada -> C$1.5 billion on Infoway (so far)
Australia -> $$20 million? Do you see how out of proportion that response is?
Get real. I'd much rather we just said it was all to hard, accept we are heading for an unsustainable health system, tell NHHRC thank you for your reform blueprint but we dont want to go there, and all the bright health IT folks can go to the US to get paid the salary they deserve, and do the work they were trained to do. Which, come to think of it, is not such a bad idea. How long before our best and brightest get strip mined away to the US? 18 months max. And we have just so many experts in the area hanging around anyway.
This is way past silliness.
I disagree and so do many of those experts you refer to who are ‘hanging around’.
ReplyDeleteThe $20 million should be directed at ‘one’ focused project or goal. It is a catalytic amount. It assumes we do not have the luxury of “doing nothing”. It assumes the private sector can deliver more outcomes, perhaps by a factor of 3 to 5 times, with less funding than any bloated bureaucracy could ever do.
It assumes that with “so many experts in the area hanging around” (hopefully not from a rafter on a rope) that the two private sector exchanges could pick and choose and put some of them to good use.
It assumes you understand the $20 million is not for doing the “the whole shebang”. It assumes you understand that Deloitte estimated the cost of developing the National Prescription Service to be $60 million over 5 years. It assumes you can numerate and understand that $20 million is one third of $60 million.
It assumes you understand that waiting for standards to be developed and mandated is like ‘Waiting for Godot’ - standards evolve and NEHTA is working on that with Standards Australia, but for heavens sake don’t just stand there picking your nose waiting for them on high to say “here, use these”. Use what’s there and absorb others as they come along. The standards’ goal posts will keep moving as new horizons open up and as technology changes.
So get on with doing something with what you’ve already got. And don’t be so narrow minded, short sighted and pathetic to suggest that prudently used $20 million would not go very far, in the right hands it would go a long way. Your limited, narrow, visionless thinking is what the bureaucrats thrive on and I hope you are not one of them.
Sept 26 12:02:00 PM makes some good points. It would be interesting to know what outcomes "the two private sector exchanges" would deliver if they each had access to say $8 million.
ReplyDelete"Your limited, narrow, visionless thinking is what the bureaucrats thrive on and I hope you are not one of them."
ReplyDeleteOh great - now lets get personal, rather than listening to the arguments being put forward. Ad hominem attacks usually indicate only one thing, and I wont go there myself.
The time for small projects in the absence of a resourced (public, private) national strategy is well past its due date. Nothing has been put forward above to counter that proposition.
Its like saying we can invest $20 million in low power light bulbs to fix climate change. Sure the bulbs help, but they are not going to take you where you need to be.
Now I guess we will get some climate change push back too. Sigh.