Budget Outcome - 2017-18
HEALTH
The government is set to fully fund the National Disability Insurance Scheme beyond 2019 in Tuesday's Budget.
The Australian reports the NDIS funding will be the centrepiece social policy, set to be revealed when the government outlines its spending plans tonight.
Medicine prices will fall and Medicare rebates for doctor's visits will rise.
Patients will be pushed onto generic versions of their medicine to save the government money.
The price of X-rays and scans could rise with the government poised to abandon an election pledge to index the Medicare rebates for these services.
And high income earners - singles earning over $90,000 and families on over $180,000- may have to brace for an increase in their Medicare Levy.
The Medicare rebate for bulk billed GP visits will rise for concession patients from July this year and from July 2018 for general patients;
Medicare Rebates for specialist procedures won't be indexed until 2019.
Every Australian will be given a digital My Health Record unless they opt out.
The price of two of the most expensive medicines on the drug subsidy scheme will be slashed by 25 per cent;
Pharmaceutical companies will suffer $1.8 billion worth of price cuts for hundreds of their medicines;
A 2014 plan to raise the price of prescription drugs by $5 is expected to be abandoned.
Chemists will get taxpayer funding to compensate them for low prescription volumes and $600 million for in pharmacy diabetes checks.
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Full details of all the Budget information is provided here:
https://www.chinchillanews.com.au/news/federal-budget-2017-bludgers-have-payments-cut/3175651/
David.
Don't mean to sound pessimistic but it seem like it is slipped in there as oh by the way it is not all 'take, take, tax, tax, look we are giving something back! I doubt they understand or care what they are giving, so long as the word 'give' is used.
ReplyDeleteIt is like so many given systems, it's there but it's use will be rare.
EFax Australia won't be happy, they now have a big competitor
ReplyDeleteGiving everyone a MyHR isn't going to achieve anything much. It's just a parking place for unreliable data. Getting healthcare professionals to use it is a whole other ball of wax. Making it mandatory is meaningless if all that means is uploading stuff - there's hardly anything in a SHS anyway. GPs will get paid for for wasting patient time, but won't need any of the data in it; there's nothing of use to specialists or emergency workers; the government will claim a large number of registrations. One day some bureaucrat not wedded to the ideology of miracle health records will suddenly realise it has no value and try something else - probably something just as useless.
ReplyDeleteAnd so the cycle will continue. Sad. Snafu.
Here's the detail:
ReplyDeletehttp://www.health.gov.au/internet/budget/publishing.nsf/Content/2017-2018_Health_PBS_sup2/$File/2017-18_Health_PBS_4.03_Digital%20Health.docx
"Following unanimous support by the Council of Australian Governments (COAG), the Government will invest $374.2 million over two years to ensure every Australian has a My Health Record, unless they prefer not to. This will support the expanded rollout of the opt-out model to all Australians, and will continue and improve operations of My Health Record, while making it easier for health providers to register for the system. Opt-out is the fastest way to realise the significant health and economic benefits of My Health Record for all Australians, including through avoided hospital admissions, fewer adverse drug events, reduced duplication in diagnostic tests, better coordination of care for people seeing multiple healthcare providers, and better informed treatment decisions."
That last sentence has never been justified.
In Budget Paper No. 2
http://www.budget.gov.au/2017-18/content/bp2/download/bp2_expense.doc
it says:
"The costs of this measure (Opt-out My Health Record) will be partially offset, by $305.5 million over four years, including by delivering health system efficiencies through greater use of the My Health Record by general practitioners, specialists and hospitals, and by utilising uncommited health program funds."
In other words, between 2012 and the end of 2021 (about ten years) they expect to have achieved about $300million in efficiency savings, having cost the Federal Government, GPs, hospitals and state governments about $2.5billion.
There appears to be no budget for MyHR beyond 2018/19.
It would seem there are no funds to change the design from opt-in to opt-out (there’s probably some small amounts to change documentation and websites) or make it reliable enough for clinical use (i.e. make it high availability, 24/7).
It looks to me as though it’s all a sunk cost exercise. They've spent $2billion so far. They'll allow one more attempt to make it work (i.e. go opt-out), if that doesn't work, it will be taken out the back paddock and put out of its misery.
IMHO, we won't have to (or be able to) do anything to accelerate its demise. They will keep going in spite of all the evidence and contrary opinions until the hole they have dug themselves into is so big nobody can get out.
If it's a roaring success, then everyone will keep their jobs and be seen as heroes and some of us will be proven wrong. I know where my money is. It's been there since I commented on the ConOp 5 years ago. Nothing's changed.
And finally, Health (not ADHA) has a telehealth project:
Prioritising Mental Health — improving telehealth for psychological services in regional, rural and remote Australia:
"The Government will provide $9.1 million over four years from 2017/18 to improve access to psychological services through telehealth in regional, rural and remote Australia. The Government will amend Medicare Benefits Schedule items to allow psychologists to provide video consultations to clients living in eligible regions, improving access and outcomes for people who currently have to travel to access these services. This will mean people living in regional, rural and remote Australia will get the same access to psychologists as those living in major cities.
Further information can be found in the joint press release of 19 April 2017 issued by the Minister for Health and the Minister for Regional Development."
Just how the wheels of Government work.
ReplyDeleteThe Strategy and forward costs will need to be delivered to COAG and AHMAC, that will take at least a year (no tiger teams for this lot). If successful it will then be submitted in the 2019 Budget considerations, it will then be funded for four years as is the norm.
So the next year or so will be a lot of marketing, stories and questionable claims. They will be hoping and praying the volume or replication of data does not bring the aging Oracle system down and that a major breach occurs resulting in massive identity theft. However is these occur, they are well practiced in covering it up.
As for DOHA getting real eHealth, well the ADHA is like NEHTA just the bunch bag that Canberra can chuck scraps and hot potatoes at.
I would like the $ 500k plus back, that investment has failed
In The Art of War, Sun Tzu said, "To secure ourselves against defeat lies in our own hands, but the opportunity of defeating the enemy is provided by the enemy himself."
ReplyDeleteThere are many things wrong with PCEHR/MyHR that have been pointed out to government starting with the Royle review followed by many submissions from people who really know the consequences of the health record system, as well as academic analyses of it.
Very few, if any of these concerns have been addressed.
Now they want to turn an opt-in system into an opt-out one without changing any of the fundamentals. Although one fundamental has been changed and that is the need to get patient consent to gather and upload data.
What could possibly go wrong?
Many of us know but it would seem that the powers that be don't know, don't understand or even worse, don't care.
I, for one, would love to know what the government requirements are of the Health IT infrastructure needed to support psych with engagement in rural and remote areas. Methinks this is political marketecture. It is one thing to have a dream; quite another to make it reality. This said, I really do think that mental health support for the population is a nation building strategic direction we need to commit to for the long term, not just 4 years as it appears to be funded for.
ReplyDeleteIsn't it called the Internet? Oh, silly me, not everyone has the internet in rural and remote areas. Maybe they'll use HF radio like the school of the air and the flying doctor.
ReplyDeleteAnd they did have the internet, with Mandatory Data Retention, would ISPs know who is getting mental health assistance? And if they use Skype, would Microsoft be able to eavesdrop?
As someone has already asked, What could possibly go wrong?
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ReplyDeleteJust idly thinking about opt-out and unintended consequences.
ReplyDeleteMaking MyHR opt-out could make people think one of two things:
1. I'll be giving the Federal Government great access to a lot of my health information, which they might use against me.
2. If I opt-out they might think I've got something incriminating to hide.
I wonder how ADHA will spin that little conundrum.
If the government tries the "trust us we have legislation in place to protect you", the nation won't be able to stop laughing. They'll remember all the policemen who have illegally accessed databases, or the Centrelink revenge attack on Andie Fox, or the ABS going after that guy who had a rant, or the linking of ATO data with welfare data and then robodebt.
Trust? IMHO, they've got a long way to go before that argument sticks.
Back to quietly musing.
The suggested efficiencies and savings are based on absolutely zero publicly available evidence
ReplyDeleteTherefore, the figures simply cannot be relied upon. Offsets? That's a laugh
"Truthiness" - a quality characterizing a "truth" that a person making an argument or assertion claims to know intuitively "from the gut" or because it "feels right" without regard to evidence, logic, intellectual examination, or facts.
ReplyDelete