This blog is totally independent, unpaid 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.
Friday, February 14, 2014
This Is Looking Very Ominous For Health Expenditure Over The Next Few Years. A Bit Of A Worry.
FORMER drug squad cop Peter Dutton spent most of the election campaign in witness protection.
What passed for Coalition policy on health was a flim-flam affair packed with previously announced policies.
Tony Abbott promised to "maintain existing levels of health funding, but try to ensure some of that money is redirected from bureaucracies to frontline services." That is code for cuts by another name - "savings".
Now Health Minister, Dutton's modus operandi was to starve the health debate of oxygen, allowing Tony Abbott to focus on boats, the carbon tax and Labor's soap opera.
As a political strategy it proved effective. But what many in the health sector are wondering now is: What does Dutton actually plan to do?
The answer, as the Commission of Audit finalises a report proposing tough savings in the health portfolio, is about to come more sharply into view.
It should prove interesting because Dutton, an economic conservative, is far more interested in marking out his credentials as an economic manager in the portfolio than playing Santa Claus.
The Queensland Right-winger is already a permanent member of the budget razor gang - cabinet's expenditure review committee - which gives another hint about his future ambitions.
Over summer, Dutton let speculation that a $5 fee could be levied on bulk-billed GP visits run and run.
While co-payments are clearly in the Commission of Audit's sights, it's not clear the government will proceed with a plan that leaves it open to serious politician pain and a "GP tax" campaign. Particularly when it would raise only a modest $750 million over the forward estimates.
Put that in the context of a $64 billion-a-year federal health budget. Include other spending, including by the states and private sources, and spending on health doubles.
Medicare is 30 years old this month and an obvious target for the Abbott government and its Commission of Audit as they search for savings to return the budget to a sustainable surplus.
But the savings should be a consequence of legitimate reform.
An out-of-pocket charge for currently bulk-billed general practitioner consultations should not be out of the question; it was seriously considered by the Hawke government and it could be easily accompanied by measures to assist cash-constrained families.
But if the government is serious about getting the budget back to surplus in the years ahead and strengthening Medicare for the challenges of population ageing, it should do much more than put a small charge on GP visits.
The most important change under way in healthcare is Kevin Rudd’s reform of public hospital funding.
This centres on the introduction of US-style case-mix funding, which was used to great effect by the Kennett government in Victoria.
AUSTRALIA'S health expenditure grew at an average 4.9 per cent a year between 2002-03 and 2011-12, according to a Productivity Commission report released last week. Health Minister Peter Dutton said the figures showed why the federal government needed to cut waste for a sustainable health system. JODIE STEPHENS speaks to Tasmanian health figures about why health costs are rising, and what needs to be done.
And the health funding analyst says Tasmanians are particularly vulnerable.
Mr Goddard said the Tasmanian population was older, sicker and poorer than others, making it more dependant on the public health system.
"That's why this is serious," he said.
"If we don't get a lot better as a nation, a lot of people are going to die unavoidably and a disproportionate number of those people will be Tasmanians."
The cost of health is back in the public spotlight after the federal government approved a 6.2 per cent rise in health insurance premiums, and the Commission of Audit received a submission suggesting a $6 patient co- payment on GP visits.
In a report released in November, the Productivity Commission also recommended raising taxes and lifting the pension age to cover increasing health and aged care costs, caused by an ageing population.
But Mr Goddard said an ageing population had little to do with increasing health costs.
"The real drivers have been the cost of drugs, the cost of technology and the constant advent of new and expensive techniques," Mr Goddard said.
Tasmanian Health Organisation North chief executive John Kirwan said rising demand was the key issue at Launceston General Hospital.
Emergency presentations at the LGH increased by 21.6 per cent in the five years to 2013, while raw separations (episodes of admitted patient care) rose 14.7 per cent from 2010 to 2013.
"What we're seeing is just more numbers, higher acuity, and interesting challenges that come from bariatric patients and others," Mr Kirwan said.
The divisions within the Coalition's federal cabinet are well worth watching in the coming months and years.
Who wins the battle over the ideological direction of the government when it comes to subsidising businesses will be a key determinant of whether or not this government is regarded as a good one when the history books are eventually written.
The popularity chasing path of subsidising industries to allegedly "save jobs" has support from quarters such as industry minister Ian Macfarlane and agriculture minister Barnaby Joyce.
Let's put them in the red corner.
In the blue corner we have treasurer Joe Hockey, receiving strong support from health minister Peter Dutton. They are trying to hold the line on traditional liberal economic values.
Most of the cabinet are on Hockey and Dutton's side, but support is fragile for a number of reasons.
First, because in Liberal Party cabinets the power ultimately resides with the Prime Minister more than anyone else, and it is far from clear that Tony Abbott supports Hockey and Dutton's corner.
"Who wins the battle over the ideological direction of the government when it comes to subsidising businesses will be a key determinant of whether or not this government is regarded as a good one when the history books are eventually written."
Secondly, unpopularity is a real risk when Liberals choose to support economic rationalist decision making. That's why the government capitulated by offering Cadbury millions of dollars in assistance, and Hockey buckled and blocked the GrainCorp takeover by the American company ADM.
More here - including more comments on Ministers Dutton and Hockey from a different source.