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…)
In this two part article, I am reviewing the basis for the serious problem we have in providing adequate health care for Australians who live in rural, and particularly, remote areas. Good intentions are, as ever, intertwined with political machinations which make policies for solutions harder to implement. Currently, yet another government review is soon to be released. Here is the background needed for judging the results. (more…)
In this two part article, I am reviewing the basis for the serious problem we have in providing adequate health care for Australians who live in rural, and particularly, remote areas. Good intentions are, as ever, intertwined with political machinations which make policies for solutions harder to implement. Currently, yet another government review is soon to be released. Here is the background needed for judging the results. (more…)
Every year the Australian Competition and Consumer Commission reports on competition and consumer issues in private health insurance (PHI), and recent reports show increasing consumer dissatisfaction with PHI. Most complaints relate to unexpected charges when claims are made and confusion over terms and conditions. (more…)
“Sick doctors will delay seeking help because of fear of stigmatisation and a threat to their professional status and livelihood through premature and unjustified reporting by treating doctors who themselves are made to feel insecure by the legislation. The distress and harm resulting from an inappropriate mandatory notification cannot be underestimated.” (more…)
A groundbreaking collaboration between Walpiri Elders, cultural historians, technologists and a clinical psychologist aims to tackle youth suicide using traditional knowledge and mobile technology. (more…)
It is increasingly evident how pernicious the privatisation myth is. Two recent examples have underlined it: the failings in Australia’s privatised energy grid and the usurious pricing in airport car parks. Both examples demonstrated that it is folly to expect a public benefit to inevitably emerge from private profit seeking. (more…)
The article from David Scott and Peter Seal (‘Medical specialists – maintaining a high standard and duty of care‘) is not an unexpected response from the organisation they represent – the Royal Australian and New Zealand College of Anaesthetists. However one is minded of those words of Adam Smith who said of ‘craft ‘ groups “ People of the same trade seldom meet together, even for merriment and diversion, but the conversation ends a conspiracy against the public, or in some contrivance to raise prices.” (more…)
In recent times, several articles have appeared in the print and electronic media about the alleged ‘high fees’ and ‘poor accountability’ of medical specialists. A few weeks ago on his ‘Pearls and Irritations’ blog, John Menadue posted one such piece titled ‘Medical specialists – high fees and poor accountability’. The Australian Society of Anaesthetists (ASA) believes that some of John Menadue’s strongly asserted claims merit a measured response, and wishes to address some misconceptions that have arisen. There are almost 5000 specialist anaesthetists in Australia, and they comprise approximately 4.5% of the nation’s medical workforce. The ASA has been supporting, representing and educating anaesthetists in this country since 1934.
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If all [of the above] fail to work perhaps a review of what Pierre Trudeau and his government 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. This 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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Nicholas Kristof of the New York Times on March 16, 2017, writes about a ‘discussion’ between Jesus and Paul Ryan, the Republican Speaker of the US House of Representatives. Ryan claims that Catholicism has shaped his political views. Is Nicholas Kristof’s account a parable or a parody. John Menadue. (more…)
Alcohol and sport sponsorship is a toxic marriage, an ill-fitting and dangerous partnership. Like sport and tobacco sponsorship before it, it is anachronism; a throwback to a less enlightened era. (more…)
The comprehensive investigation, published as The Adani Files (adanifiles.com.au), provides a litany of stories of pollution, failed clean-ups of damaged environments, and allegations of corruption and of abuse of workers. (more…)
The Labor Party has released a summary of the proceedings of its ‘National Health Policy Summit’, held in Canberra on 3rd March. Good on the ALP for holding the summit. Trouble is, the ‘communique’, while summarising the views of the quite diverse range of participants, gives no clear indication of where Labor might be heading. (more…)