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Government faces ballot box pain if no policy shift

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The Federal Government could pay a hefty price at the ballot box unless it changes course on health policy, the AMA President Professor Brian Owler has warned.

As senior Ministers thrash out details of the all-important pre-election Budget behind closed doors, Professor Owler cautioned that how the Government responds to the many reviews it has commissioned across health, particularly regarding Medicare, primary health and private health insurance, “may well have a significant electoral impact, especially if key health stakeholders are not properly engaged”.

Professor Owler called for a fundamental shift away from the Government’s current emphasis on cutting spending and offloading the funding burden onto patients and the states and territories.

 “The Government is on a path of funding cuts and shifting costs to patients,” the AMA President said. “This is not good for the Australian health system or the health of Australians.

He urged it to “change tack…before it is too late”, warning the Government its current approach might m.

Professor Owler’s comments framed the AMA’s Pre-Budget Submission, which includes detailed recommendations across 18 areas of health policy, from Medicare indexation and reform of hospital funding to GP infrastructure grants, palliative care, alcohol and tobacco policy and immunisation.

The AMA President said the submission gave the Government a guide on how to recalibrate its policy to end the current retreat from core responsibilities in funding and delivering health services.

“There is an urgent need to put the focus back on the strong foundations of the health system,” Professor Owler said. “We need a strong balance between the public and private system, properly funded public hospitals, strong investment in general practice, and a priority put on prevention.”

There are already signs that Government decisions are having an adverse effect on health services.

The AMA Public Hospital Report Card released in late January showed that improvements in hospital performance have stalled, and in some instances have gone backwards, since the Government’s decision to 2014 to rip hundreds of millions of extra funding out of the system.

Professor Owler said the cuts, combined with a downshift in the indexation of Commonwealth hospital funding from next year, showed the Government’s preoccupation with funding cuts came at the expense of good health policy.

The Government’s response to the mental health review provided more worrying signs of how it might approach other areas of reform, he said.

Under the new approach, Primary Health Networks will be paid by the Commonwealth to provide tailored “integrated care packages” for patients with mental health problems.

Professor Owler said there was no commitment to a key role for GPs in providing care, and the Government had provided scant other detail.

“The worry is that the mental health approach may be a signal for what is to come with the Primary Health Review,” he said, and added that a proposal for hospital funding to be replaced by a Medicare-style “hospital benefit payment” that would follow patients was also a worrying sign.

The AMA President said the Government had actively demonised doctors in its MBS review process, had encouraged private health funds to play a more active role in all areas of health despite concerns over inappropriate behaviour and poor value products, and showed signs of pursuing a US-style managed care system.

He warned that “this is not a health policy platform to take to a Federal election”.

In its 27-page Budget submission, the AMA proposed the Government immediately reinstate indexation of Medicare rebates; increase indexation of public hospital funding to a rate that reflects growth in the cost of health goods and services; recognise the both the Commonwealth and the state and territories all have a role in funding and providing health services; explicitly address the role of the private sector in delivering care; and give patients the right to assign their Medicare benefit direct to the provider.

Professor Owler said the nation needed a health system built on “modern health policies, not outdated economic policies designed only to improve the bottom line”.

Adrian Rollins