Doctors warn Australia’s private health sector is heading towards a US-style system
“Have you got insurance?”
It is one of the first questions any patient is asked when they walk into an emergency room in the United States, no matter how sick they are.
And now Australian doctors are warning our own health system is shifting towards a similar US managed care model — a patchwork of private and public systems, where health insurers hold an increasing amount of power.
The president of the Australian Medical Association (AMA), Dr Tony Bartone, made the comments as he addressed the group’s national conference in Brisbane on Friday.
It was the first time Dr Bartone has spoken since the Coalition was returned to power, and he gave an unusually scathing assessment of Australia’s health system and the Federal Government.
He called for further private health reforms, telling doctors the increasing corporatisation of the private health system had given insurers unprecedented power within the health sector.
Dr Bartone warned that could lead to a system similar to the model in the US, where patients experience significant variations in care depending on their insurance cover.
“Insurers should not determine the provision of treatment in Australia, they should not interfere with the clinical judgement of qualified and experienced doctors,” he said.
“Australians do not support a US-style managed care health system, and neither does the AMA.”
‘Our public health system should be better than this’
The AMA has consistently called for more money for public hospitals, and on Friday Dr Bartone went even further as he accused the government of “making a choice” to constrain the supply of public hospital services.
“Let me be clear. Public hospital capacity is determined by funding,” he said.
“The consequences are significant. They can include increased complications, delayed care, delayed pain relief, and longer length of stay for admitted patients.”
Dr Bartone said the system was “stretched so tight” elective surgeries were being cancelled.
“Our public health system should be better than this. It is unacceptable our public hospitals have been reduced to this,” he said.
“Our public hospitals are struggling and require new funding to be better tomorrow than they are tomorrow.
“Demand for public hospitals is not going away.”
In a statement, a spokeswoman for the Health Minister Greg Hunt said the Coalition had increased funding for public hospitals by almost $7 billion in six years.
“The new national hospitals agreement will provide an additional $31 billion in public hospital funding from 2020-21 to 2024-25, taking overall funding during this period to $131 billion,” she said.
The spokeswoman said private health insurance was “an integral part of our world class health system” and that the Coalition was currently implementing reforms to make it more affordable.
“The Liberal National Government has worked closely with the AMA on all fronts and will continue to do so,” she said.
Doctors ‘scapegoats’ for out-of-pocket costs problem
The AMA declared it had “heavy lifting” to do in terms of reducing out-of-pocket costs for Australians.
More than 1 million Australians put off seeing a doctor in one year because they cannot afford it, according to the latest figures from the Australian Institute of Health and Welfare.
And while the Morrison Government is always keen to point out bulk-billing rates are at a record high, Australians are still being slugged with $3 billion in non-hospital out-of-pocket expenses each year.
Dr Bartone told the conference “we must be honest” about the reasons why out-of-pocket costs arise, saying the conversation was not limited to the fees doctors charge.
He instead blamed the five-year freeze on the MBS rebate, which left patients paying more to offset rising practice costs.
“We must do better,” he said
“We cannot scapegoat one group and expect the problem to be resolved.”
The AMA Conference runs until Sunday, and will also examine Australia’s mental health system and ways to improve aged care services.