Real health policy required

The federal Government’s forays into health policy show no signs of becoming realistic. The 2014 budget foreshadowed that the Commonwealth might get out of the funding of hospitals in favour of the states accepting a higher and broader GST.

The problem here, as Gillard pointed out in her book, is that health expenditure expands faster than the GST revenue.

Then we had $7 co-payments for GP visits in an effort to keep poor people out of doctors’ surgeries.

This was followed by the fiasco of proposing and dumping the $20 cut to the rebate for short GP visits. According to recent news reports, the plan was originally opposed by Joe Hockey and then health minister Peter Dutton. Abbott insisted and then unaccountably backflipped.

Now Joe Hockey reckons we are living too long. Some kid just born somewhere is bound to live to 150.


John Dwyer, Emeritus Professor of Medicine at the University of NSW, has long been an advocate for preventative health care. He says in a paywalled article in the AFR that many hospital admissions (costing $5000 each) could be prevented by primary care intervention in the three weeks prior to admission.

Medicare expenditure of $19 billion each year is dwarfed by hospital expenditure of $60 billion.

There is now an abundance of evidence that a focus on prevention in a personalised health system improves outcomes while slashing costs. Some systems have reduced hospital admissions by 42 percent over the last decade.

The Brits have just been presented with a review that concluded that an extra $132 million (in our money equivalent) spent on improving primary care would save the system $3.5 billion by 2020.

Worth a look, I would think!

There is another problem in the works. Only 13% of young doctors express any interest in becoming a GP.

The discrepancy in income potential for GPs when compared to that of other specialists is now huge. Young doctors looking at the professional life of our GPs are uncomfortable with the current “fee-for-service” model that encourages turnstile medicine that is so professionally unfulfilling. Many GPs join corporate primary care providers preferring a salary.

New Zealand has facilitated 85% of GPs away from fee-for-service payments. The same is true in the US for 65% of primary care physicians.

Finally, says Dwyer, we could take the $5 billion cost of the private health insurance rebate and spend it on all of the above.

Once again we are embarrassed by the incompetence of our politicians.