Message from the consumers health forum of Australia

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This issue’s foreword is written by spokesperson for the Consumers Health Forum of Australia Mark Metherell.
During the federal election, the health policy debate was becalmed as both sides steered clear of the dangerous waters of booming health costs and patient unrest. It appeared the politicians and voters had tired of reform talk after years of rhetoric had resulted in unobtrusive, if mildly significant changes.
Now the dam wall seems to have broken. We have entered the new year with signs that the torrent of pressures in health care funding have swept back stronger than before. The harbingers are the Christmas Eve announcement of a 6.2 per cent rise in health insurance premiums, the disclosure that the new Government’s Commission of Audit had received a proposal for a $6 co-payment for GP patients, and a health fund’s incursion into primary care.
All of these may be argued as necessary to meet the requirements of providers and business. None, however, are good news for patients in general, nor for Medicare’s creaking claims to financing a universal health system.
The swelling impact of health services costs on both taxpayers and consumers seem to result inevitably in just one default option: yet more costs to taxpayer and consumer. Hit by galloping hospital and doctor costs, the funds’ premiums continue to rise at above inflation rates, forcing members to prune back their coverage, exposing them to yet more out of pocket costs.
The drive by the Government’s soon-to-be -sold health fund, Medibank Private, to pus into the primary care sector, comes at a time when the health funds struggle to meet the needs of their core business, hospital insurance. Given the 80 per cent GP bulk billing rate, it might seem a curious move. Admittedly there is a logic to the fund’s argument that the most effective health coverage will only come if the fund can cover for both primary and hospital care.
The development would introduce into primary care one of the less attractive aspects of health insurance : the impact on uninsured patients of participating doctors who presumably would have to downgrade access to that group to ensure the preferment of eligible patients.
The scheme also appears to give little attention to the existing if fledgling development of Medicare Locals which are open to all patients and aim to lift us all into more effective and coordinated care.
The nagging feature of all of the proposed schemes is not only the absence of a comprehensive strategy to drive a better national health system but the lack of focus on how best to serve patient needs.
While both sides of politics with varying enthusiasm support health insurance and private care, there is little in the way of coordinated thinking by state or federal governments to work out how to exploit Australia’s somewhat unique public-private setup.
The result has often meant that the uninsured majority get second place, while private health insurance appears to struggle to remain affordable to many who feel obliged to keep it.
The elephantine hole in the health reform process was the previous Government’s refusal to include the private sector in the reckoning, even though it was and is responsible for more than half of elective surgery.
An example of the public-private bifurcation and the split in the health effort is the bizarre amalgam of private care in public hospitals created by public hospital financial rigours and .The squeeze on health fund benefits combined with the pressure on public hospital budgets has meant an increasing number of people seek to have their private care performed in a public hospital.
It’s an issue that few of the ‘stakeholders’ - federal and state governments, hospitals, doctors and health funds - seem keen to talk about.
But, what about the central stakeholders - the consumers and taxpayers?
It is time surely to do away with the wink and nod that veils major health funding decisions and for a candid debate about what is best for patients and consumers.
Mark Metherell
Mark Metherell is spokesman for the Consumers Health Forum of Australia, the pre-eminent advocate for consumers on health policy. CHF has more than 100 affiliates representing a total of two million Australians.