Private health insurers are losing their most profitable members, younger people whose contributions subsidise older members. Rather than forcing young people back into private insurance, the government should break private hospitals’ dependence on private insurance and let private insurance go the way of other high-cost industries.
The media and the PHI lobby consistently understate the taxpayer subsidy to PHI. It is not $6b per annum. It is $11b pa (more…)
Will legalised suicide, even when presented as ‘assisted dying’, adversely impact on efforts to reduce do-it-yourself suicide?
If it looks like a duck and it quacks, then . . . (more…)
Christian Porter, the Minister for Social Services, has been trying to make his mark as an upcoming minister in the Turnbull Government. Porter thinks he might have found the perfect silver bullet: mandatory drug tests for unemployed welfare recipients. (more…)
In 1970, conservative republican US President Richard Nixon introduced a health bill into the American Congress. It passed but was defeated in the Senate. He didn’t realise it was a health bill, nor did many of his fellow politicians. It was called the Family Assistance Plan, a guaranteed income for families with children, not adequate to bring the income up to the poverty line, but substantially more than was previously on offer. (more…)
Jeremy Hunt, Health Secretary in the UK, accused Stephen Hawking of a ‘pernicious lie’: “(he) is a brilliant physicist but wrong on lack of evidence.” Stephen Hawking had said his survival for 75 years with motor neurone disease was due to the care he received from the British National Health Service (NHS) and he now feared it was being turned into a “US-style insurance system.” (Guardian Weekly, 25 August). (more…)
What if the media covered alcohol like it does other drugs? This was a question that came up in my coverage of flake hka, a synthetic drug that made headlines after law enforcement blamed it for people running in the streets naked in delusional paranoia. What follows is a satirical attempt at capturing that same type of alarmist reporting, but for a substance that really causes widespread and severe problems. (more…)
Infections acquired in hospitals are a major contributor not only to avoidable deaths but also to the cost of health care. Among preventative measures the simple but often neglected practice of hand-washing stands out. (more…)
Across Africa there are examples of governments trying to introduce policies that improve health and protect the environment only to find their efforts undermined by unhealthy corporations and their industry associations. A case in point is South Africa’s efforts to introduce a tax on sugary drinks to reduce the growing burden of obesity. In the process they are facing a barrage of resistance. This is one small example of unhealthy industries undermining the public’s health and the global environment. This is about how rent seekers go about protecting their selfish interests. (more…)
The transformation of big health funds into for-profit business enterprises sheltered by significant government subsidy and regulations has failed to prompt a complementary response from federal governments, Coalition or Labor, to even the playing field for consumers. (more…)
Australians pay too much when they go to medical specialists. The government can and should do more to drive prices down. A current Senate Inquiry on out-of-pocket costs will hopefully lead to some policy action. (more…)
Our quality of life is about much more than our standard of living. (more…)
Coal is the new tobacco in terms of the harms it has on our health. No hospital would think of lending its logo to support the marketing of cigarettes or allowing any of its key decision makers to have strong links to cigarette companies. Yet, such an extraordinary situation has arisen around the Mater Hospital in Brisbane. (more…)
“The problem is ………. that we have been pursuing economic policy that benefits the one per cent. Trickle-down economics is defunct and does not work”.
“Politics quickly departs from evidence into the realm of ideology ….. But evidence must be a key part of the conversation.”
“One senior Conservative politician in Britain put it to me that my agenda is closer to Social Democrat than to Conservative thinking …… I make my case on the evidence, not on prior political beliefs.”
These quotes are from Michael Marmot’s book, The Health Gap. Some may find them controversial, or at least provocative. (more…)
A new report comparing health systems in eleven countries gives Australia a pat on the back but not for equity. What’s going on? (more…)
The Medicare Benefits Schedule, or MBS, is the basis for Medicare payments made for medical care in the community. It runs to over 900 pages and contains 5,700 items. Well over $2Ob pass through its ledger each year. It includes long and short clinical consultations and surgical procedures ($17b), pathology tests ($2.65b) and x-ray and other imaging ($3.2b) that form the bulk of out-of-hospital care, mostly but not entirely ($1b not) provided by doctors. (more…)
‘Perhaps [we could consider] a review of what Pierre Trudeau and his government (in Canada) did in 1984 when they took on a system not dissimilar to ours – uncontrolled fee for service – and legislated that doctors could charge what they liked BUT unless they adhered to the fee negotiated between the provincial government and the profession (on an annual basis) the doctor lost all access to a Medicare reimbursement. The system still works today in Canada and few doctors opt out of it. Now there is a thought and a significant game-changer.’
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The Victorian Government has announced that it will extend existing poker machine licences until 2042, freezing the total number of machines available in pubs and clubs at 27,342 (there are another 2,658 at Crown Casino). The Minister made much of this in her announcement, lauding this as a ‘harm minimisation’ measure. Yet these ‘reforms’ may impose significant opportunity costs on the Victorian population. (more…)
Now you can find out who’s wining and dining our doctors, nurses and pharmacists with publicly available data of drug company funded events. (more…)
The recently-released second Australian Atlas of Healthcare Variation reveals marked variations in the rates of common procedures across the country. It’s a valuable source of data to guide better allocation of health care resources through more appropriate, equitable and patient-centred care. (more…)
Ronald Reagan once famously quipped that the nine most terrifying words in the English language are ‘I’m from the government, and I’m here to help’. But that doesn’t, for one moment, stop Michael Horrocks, Professor of Postgraduate Surgery at the University of Bath and a former President of the Vascular Society of Great Britain and Ireland, relaying precisely that message to a room full of vascular surgeons and interventional radiologists. ‘We are here to help,’ he says. ‘We are not the Care Quality Commission. We are here to serve. …There will be plenty of chance to comment as we go through,’ he says as the team [of clinicians and managers] wants to provide answers to what they can see are their less-good figures. ‘We are not here to catch you out. We are here to help.’
In 2015 Sussan Ley, then the Minister for Health, established a review of the schedule of fees for medical benefits. The review of the schedule’s 5700 items, involving a rigorous evidence-based process, is now around half way through. When completed it will provide an opportunity for more cost-effective health care and a saving of public revenue. (more…)
Our research has shown that some private hospitals are safer than others, but from the data we analysed we couldn’t tell which. Governments should balance commercial interests against the public’s right to know which hospital is providing safe, high-quality care. (more…)
In the lead up to the recent Federal Budget, the Australian Healthcare Reform Alliance (AHCRA) ran a campaign to highlight the inefficiency of using health resources to subsidise private health insurance (PHI). The campaign focussed on calling on the Government to re-direct funding for the $7 billion private health insurance (PHI) rebate to address key areas of inequity and under-performance (while some estimates of the cost of the rebate are larger, AHCRA decided to use the most conservative figure for our campaign). (more…)
John Menadue and Peter Brooks have mounted powerful critiques of private specialist medical practice in a series in Pearls and Irritations. The nub of their positions is the high fee structure in (private out-patient) specialist practice is out of kilter with community expectations. (more…)
Achieving recognition of general practitioners as medical specialists in our own right has been an uphill battle for decades. We only achieved vocational recognition as specialists in the 1990s. For many years we were seen as #JustaGP, a term that symbolises the academic and professional discrimination our members are still subjected to today. (more…)
A 37-year-old Sudanese woman has been sentenced to 26 years in jail for murdering three of her children by deliberately driving her car into a lake. The story is a tragic one and has nothing to do with criminal behaviour. It raises, yet again, the appalling way in which we treat those with a seriously mental illness who, while ill, break our laws. (more…)
Bad drug policy has been good politics for several decades. We can thank US President Richard Nixon for this discovery. (more…)
Police, prison officers and politicians are standing side-by-side with drug users to call for law reform. They say the current practice of jailing people for personal use and possession instead of focusing on their health and safety leads to unacceptable outcomes: lives lost and lives ruined. But it’s hard to get your head around the idea that making drugs more easily available could actually reduce the risks. Here are answers to some frequently asked questions about drug law reform. (more…)
In the SMH of May 29, 2017, Adam Gartrell reports that ‘The private health insurtance rebate would e abolished, consumers would be charged more for extra cover and the states would be forced to find more money for public hospitals under radical funding changes being considered by top government officials. Documents obtained by Fairfax Media reveal the nation’s most senior health bureaucrats are part of a secret task force developing a proposal for a “Commonwealth Hospital Benefit” – a new funding formula for public and private hospitals.’
See below, my post from April 12 2016, about a possible ‘Commonwealth Hospital Benefit’. John Menadue. (more…)
The war on drugs has failed.
There was a buzz across Australia in March 2017, when former premiers, police chiefs, prison officers and lawyers stood side-by-side with drug users and their families, to throw down the gauntlet on drug law reform. They called for an end to criminal penalties for personal use and possession and a new focus on addressing the health and social issues associated with drug-taking. (more…)