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3rd Jan 2014
Proposal for copayment for hospital ed wont work and confirms that there is serious concern about gp copayments acting as a disincetive to gp visits
Proposal for Copayment for hospital ED wont work and confirms that there is serious concern about GP copayments acting as a disincetive to GP visits
The DRS today called on Health Minister Peter Dutton to rule out changes to Medicare including copayments for GP visits and charges for attending the ED department. This is getting sillier and sillier said DRS spokesperson Dr Con Costa. First they say they will introduce a charge to see the family GP, and that it is only a small charge that won’t dissuade people from seeing a GP. Next they are saying that charges should be introduced to state public hospitals to prevent an influx of GP patients who can’t afford to pay the copayment. Which one is it?
The report by Terry Barnes, former health adviser to PM Mr Abbott includes – “We think that $5 or $6 would not be enough to deter people from going to the doctors if they absolutely need to,” he said.
“We’re saying this is quite reasonable to keep the whole system going.
This is sending a price signal to people, there’s no doubt about that… the level of co-payment we’re suggesting is equivalent to a hamburger and fries or a schooner of beer, it’s not a great deal.”
Mr Barnes further promotes the idea of a similar charge to stop people from going instead to the ED departments of their local public hospital.
Health Minister Peter Dutton has not ruled out a fee for patients visiting their doctors, saying in a statement the Government “won’t be commenting on speculation around what the Commission of Audit may or may not recommend”.
This is truly the silly season said Dr Costa.
Proponents of the GP copayment are admitting that such a copayment would be a disincentive for people seeing their family GP and lead to a run on hospital ED’s as people seek to avoid the copayment. This alone would be a strong argument against a copayment ie it would be a disincentive for people attending a regular GP early in an illness or for routine preventive screening. – and our public hospitals are already overcrowded with more serious type emergency cases. The last thing the ED doctors need is an influx of refugee patients from GPs.
Secondly the introduction of a copayment for the GP is cost shifting from federal to state government budgets – and so the states are being encouraged into a tit for tat retaliation ie the states who would be forced to introduce charges in the emergency departments of public hospitals – thus making it difficult for people to access emergency care.
It is not just a question of attempted cost shifting by the federal government. Our hospital EDs cannot take over the role of the family GP. ED cannot provide immunisation or preventive women’s health checks or monitor diabetes or high blood pressure patients. There would be no continuity and no cumulative memory if people are driven to seek their routine medical care in the hospital ED. It would also be a very expensive and inefficient way to run a health system, said Dr Costa.
There is only one fair and realistic way to save money in the health system said Dr Con Costa. We must provide community based care based on early prevention and good management of chronic or advanced illness – in the community where it is more appropriately managed and at much lower cost than hospital care. We have a broken system where most GPs are seeing patients only in their surgeries yet those with complex illness in the community – the elderly in nursing homes, the dying who are in desperate need of palliative care or those who are too sick to get to the doctors office, are simply going without care or end up yo yo ing back and forth to the public hospital EDs in an ambulance.
It is a crazy and heartless statement to portray these patients as needing a price signal to deter them from seeing their GP too often. These patients often do not have a GP or a so seriously under serviced that they have no alternative but to call an ambulance and sometimes on a weekly basis. Why blame the patients when the problem could so easily be fixed with better community based care instead of more expensive hospital based involvement.
We now seem to have a federal government which feels that the simple solution is to make everyone pay for their medical care individually ie not through national health insurance/ Medicare. Eroding bulk billing with up front charges/ copayments forces our patients into rear guard measures including avoiding going to the doctor or seeking community based care – until late in the illness when it is much harder to treat. Instead they present inappropriately to the ED department or simply call an ambulance at great cost to the system – and will create a bureaucratic nightmare for doctors who have to collect the fees as well as encouraging doctors to stop bulk billing. Encouraging a user pays system will make all of those in residential aged care or needing care in the home, worse off. A GP copayment would hit mainly women who are often the principal carers as well as women again missing out on preventive health checks – especially women in outer suburban areas. Eroding bulk billing will worsen access to timely and cheap GP care and will further aggravate a situation where many Australians find it difficult to access a family GP and are forced to use the public hospitals for routine medical care. Charging at the hospital ED is impractical. Our EDs will end up choked with more patients and the public hospital administration burdened with a bureaucratic nightmare of debt collection. What is next in the silly season – means testing of public hospitals? asked Dr Costa.
Dr Con Costa Dr Tim Woodruff
President Vice President
0418400309 or (02) 97978710 Ph 0401042619
]]31st Dec 2013
$5 copayment would increase health costs
$5 COPAYMENT WOULD INCREASE HEALTH COSTS
Prime Minister Abbott’s refusal to reject the introduction of a $5 copayment for GP services opens the door to the destruction of Medicare as we have known it. Medicare was always about free point of service GP visits so that those with chronic illness or preventive health screening such as PAP smears and breast checks, would be available for all women – not just those living in leafy lower north shore suburbs.
The introduction of a $5 copayment – which could then be increased annually until the copayment ended up paying the majority of the GP visit – would hurt those with chronic illness who need to see the GP more frequently including the elderly – and would reduce the likelihood for preventive screening for those who need it most.
It would increase overcrowding in our hospital ED emergency departments and would be inevitable followed by the State governments introducing a charge for ED services.
Introducing a $5 copayment is false cost savings as people would stop seeing their GP, ending up sicker and going to hospital – which costs thousands of dollars a day versus current $36 to see a GP bulk billed.
Introducing a $5 copayment for GPs would be followed by copayments for pathology and radiology services – further placing health services out of the reach of the less well off and the sick.
The DRS calls on Prime Minister Abbott to reinforce his previously stated support for Medicare and reject this crazy idea – the false savings by leaving people sick at home until they have to call an ambulance and go to hospital.
Dr con costa Dr Tim Woodruff
President Vice President
0418400309 Ph 0401042619
02 97978710
]]29th Dec 2013
Coalition health policy: ignore the big problems
COALITION HEALTH POLICY: IGNORE THE
BIG PROBLEMS
“The release yesterday of the Coalition’s Health Policy is a sad indictment of the lack of interest in addressing the many problems facing ordinary Australians trying to access quality health care”, said Dr Tracy Schrader, president, Doctors Reform Society
‘The policy paper is 16 pages of not much substance, ignoring the big picture. Where are the details on Indigenous Health and Mental Health? Where is a policy on preventative health and health promotion? There is nothing of substance on Primary Health Care, which state LNP governments have been trying to pass over as a federal responsibility.”
“The policies outlined ignore cost barriers to access, co-ordination of care and long waiting times to access public hospitals”, said Dr Schrader. “The policies also ignore the recommendations of the all party Senate Inquiry on Social Determinants of Health ie all the non health factors affecting health outcomes such as education, housing, poverty.”
“People and families are struggling to find their way through the maze of different health services such as GP services, physiotherapy, podiatry, specialist services, dental services, aged care packages, public or private hospital care. Patients are struggling to afford
the increasing out of pocket costs for good health care. Patients are waiting years to get life changing health care such as joint replacements.”
“Frontline services need to be protected but need administration and coordination to run efficiently. Having different services completely unaware of what other services are doing is both a disaster for patients and a huge waste of resources. Co-ordination costs money and Medicare Locals can play a major role in co-ordinating frontline services if given the
resources. This does not seem to be understood by the Coalition.”
“Restoring the private health insurance rebate for those in the top 20% of income earners is a clear indication of the intentions of this Coalition. PHI coverage has increased since the means test was introduced. This would be a gift to the rich”.
“As Health Minister in the Howard Government, Tony Abbott said the health system was ‘a dog’s breakfast’. Clearly it would be more of the same.” Dr Tracy Schrader Dr Tim Woodruff
President Vice President
Ph 0408892610 Ph 0401042619
]]23rd Aug 2013
Fair go for health care depends on how much you earn
FAIR GO FOR HEALTH
CARE DEPENDS ON HOW MUCH YOU EARN
Major political parties continue to ignore the fact that poor people are sicker because they are poor, said Dr Tracy Schrader, president, Doctors Reform Society. Neither the Federal Government or the Coalition have acknowledged or responded to the findings of the recent Senate Inquiry into the Social Determinants of Health ie all those things, many of
which are outside the health system, thath have huge impacts on whether people
die or suffer from all manner of diseases.
As John Brumby says in his covering letter to the PM on the COAG Reform Council report on healthcare performance””Australians are also continuing to experience health inequities based on who they are, how much they earn and where they live…”
This is not new news. Patients suffer and die because they are poor. They can’t afford copayments, they have to wait too long for care, they put off seeking care, they can’t afford proper food, can’t get the education which helps them get a well paying secure job, can’t afford a good roof over their heads.
Why is it then that the ‘greatest health reforms since Medicare was introduced’ as the Government claims regarding its reforms, have ignored cost barriers to access care and all the other social determinants of health?. Why is the Coalition so silent on these issues in the lead up to anelection?
We call on the Government and the Opposition to acknowledge these issues as crucial to achieving a fair go for the health of all Australians, and tell us what they propose to do about these issues over the next 3 years.
Dr Tracy Schrader Dr Tim Woodruff
President Vice President
Doctors Reform Society Ph 0401042619
Ph 0408892610
]]24th May 2013
Out of pocket costs for health care not a fair go: copayments kill
Out of Pocket Costs for Health Care Not a Fair Go: Copayments Kill
“The report today that Australians pay over $1000 per year in copayments for health care indicates that despite good health statistics compared to most countries, we still have a
long way to go to achieve the ‘fair go’ we often talk about in Australia,” said Dr Tracy Schrader, President, Doctors Reform Society.
“Thirty two percent, or one in every three sick Australians are delaying or not seeing their doctor or not filling their prescriptions because it costs too much, according to the Commonwealth Fund, a Harvard based health research institute. How can this happen in a country as rich as ours?” , asked Dr Schrader.
“The Federal Government has introduced health reforms that ignore these out of pocket
costs, said Dr Schrader. It tells us of life saving medicines approved for subsidy, but then charges copayments which stop patients getting such drugs. If copayments stop patients accessing drugs and doctors, it is more than just denying a fair go”, said Dr Schrader. “These copayments kill”
“Why is there total silence from the Federal Government and the Opposition, the alternative Federal Government, on the issue of killer copayments?”, asked Dr Schrader.
Dr Tracy Schrader Dr Tim Woodruff
President Vice President
Doctors Reform Society Ph 0401042619
Ph 0408892610
]]15th May 2013
Patients miss out as the big pharmaceutical rip off exposed
PATIENTS MISS OUT AS THE BIG
PHARMACEUTICAL RIP OFF EXPOSED
“The report yesterday from the Grattan Institute showing Australians
are forced by Government agreement to pay over $1 billion per year more than we
need to for prescription drugs should be a clarion call for the Federal
Government and the Coalition to address this issue”, said Dr Tracy Schrader,
president, Doctors Reform Society.
“We don’t need to pay highly inflated prices for drugs, said
Dr Schrader. “Whilst the Federal Government has already saved billions through
changes there is a long way to go and there doesn’t seem to be an interest in
fixing the problem”.
“This means that we can’t afford to spend as much on new
drugs or other aspects of health care like hospitals because we are wasting
money maintaining the huge profits of the pharmaceutical industry. “
“It’s well known that the industry is a very generous
political donor to both parties,” said Dr Schrader. “It would be sad to think
that the politicians are wasting our taxes paying 5-10 times the real cost of
drugs just to keep on good terms with one of the most profitable industries in
the world, whilst denying Australians better health care”.
Dr Tracy Schrader Dr Tim Woodruff
President Vice President
Ph 0408892610 Ph 0401042619
http://www.facebook.com/DoctorsReformSociety
]]
30th Apr 2013
Future fund: investment tobacco industry
GREAT NEWS: WE TAXPAYERS ARE NO LONGER INVESTING IN KILLER TOBACCO INDUSTRY
“The announcement that the Future Fund is choosing to stop
investing in the killer tobacco industry is welcome,” said Dr Tracy Schrader,
President, Doctors Reform Society. “The Future Fund invests Federal Government
money ie our money, to secure extra money for future spending for us. To date some of that money has been invested
in the tobacco industry because the industry is profitable”.
“Meanwhile the Federal Government has pursued a very strong
anti tobacco policy including the major battle to introduce plain packaging.
The inconsistencies were stark”, said Dr Schrader. “Taxpayers’ money has been invested
in the tobacco industry and at the same time taxpayers’ money is spent fighting
legal challenges against the tobacco industry.”
“Tobacco kills. Taxpayers’ money should not be supporting
the tobacco industry through investment. The Future Fund, independent of the
Federal Government but with strong pressure from the Greens, has finally
recognised this is not the appropriate way to invest taxpayers’ money and
should be commended.”
Dr Tracy Schrader Dr Tim Woodruff
President Vice President
Doctors Reform Society Ph 0401042619
Ph 0408892610
]]18th Mar 2013
Fear keeping private health insurance coverage up
FEAR KEEPING PRIVATE HEALTH INSURANCE COVERAGE UP
“Private Health Insurance (PHI) coverage is not falling despite the Coalition’s fear campaign against means testing the PHI rebate and the change in the Medicare Levy Surcharge threshold”, said Dr Tracy Schrader, President, Doctors Reform Society. “It is quite correct for the Health Minister Tanya Plibersek to point out how wrong the Coalition was but it is important to recognise that the reason PHI coverage is not falling is that people fear being dependent on a public hospital system they don’t trust will serve them well. The Government should be ashamed that it is fear that is maintaining these figures, and that it has not addressed that fear.”
“Some of this fear is based on the incorrect judgement that the quality of care in public hospitals is inferior,” said Dr Schrader. “There is no evidence of that. Some of this fear relates to concern about having to wait for care. In the case of life saving care this is also not justified, but for elective surgery like hip replacements that fear is quite justified.””
“The great thing about fear is that it doesn’t need to be based on evidence”, said Dr Schrader. “Politicians of both sides use it for their own purposes. Meanwhile patients either pay for PHI or wait and suffer.”
Dr Tracy Schrader Dr Tim Woodruff
President Vice President
Doctors Reform Society Ph 0401042619
Ph 0408892610
]]