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Private Health Insurance in Primary Care: an overview of the issues

The GP co-payment may be ‘dead, buried and cremated’ but controversy over its primary health care policies is not over for the Abbott Government.  The introduction of private health insurance into the primary health care sector was flagged by previous Minister for Health Peter Dutton in a number of speeches and media interviews and was also recommended by the Competition Policy Review.

While the exact role the Government has mind for PHI in primary health care is not clear, both BUPA and Medibank have already started to expand their activities in this sector. However, this move has been criticised by a number of groups within the health sector, including the Nurses and Midwives Association of NSW which wrote to Dutton last year, stating that keeping PHI out of primary health care had successfully “contained costs and supported equity in access for GP care”. The AMA has also warned that the Medibank Private trial could undermine the clinical autonomy of GPs and erode equity of access for consumers.

The following article by Amanda Biggs from the Parliamentary Library, provides useful context for the current debate and an excellent analysis the policy implications of a role of PHI in primary health care.  If Health Minister Sussan Ley wishes to neutralise Medicare as an election issue she should pay close attention to Biggs’ concluding statements about the significant challenges involved for the Government in progressing this policy.

This article first appeared in the Parliamentary Library’s Flagpost publication and is re-published here in full, with permission.

While the Government’s proposed patient co-payment for GP services has focused debate on whether some kind of ‘price signal’ for GP services is needed, private health insurers have been exploring options to provide their members with free or expedited access to GPs. Under current legislation, health insurers cannot provide insurance for which a Medicare benefit is payable. Despite these legislative restrictions, Medibank Private and other health insurers have been trialling different approaches to improve access to GP services for their members.

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FRANCES GILHAM | March 03, 2015 | CHOOSING WISELY | 1 |

The Health Wrap: NSW election, new smoking findings, and other health policy news

By Frances Gilham NSW election news With a NSW state election coming up in March, discussion of state health policy has started to creep into the news. SMH journalist Amy Corderoy reported on a public health debate held between NSW Health Minister Jillian Skinner, Labor’s opposition spokesman on health Walt Secord, and Greens’ spokesman John [...]

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JENNIFER DOGGETT | March 03, 2015 | CHRONIC DISEASES | |

Trading health? The role of health in foreign policy

In contrast to the widespread criticism of Australia’s response to the West African Ebola outbreak, our lack of action in combatting the chronic illnesses in developing countries receives little or no attention. In the following piece, Samantha Battams, Program Director of Public Health at Torrens University, discusses the role of health in foreign policy and [...]

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JENNIFER DOGGETT | March 02, 2015 | CONFLICTS OF INTEREST | |

Primary Health Networks: key questions and challenges

While the media has been focussed on the Government’s proposed GP co-payment, there have been potentially bigger changes to primary health care progressing behind the scenes. The transition from Medicare Locals to Primary Health Networks (PHNs) may not appear significant, as the functions and objectives of both organisations are very similar. However, there are some [...]

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JENNIFER DOGGETT | February 27, 2015 | INDIGENOUS HEALTH | |

Celebrating some success in Tackling Indigenous Smoking

 Dr Tom Calma AO, National Coordinator, Tackling Indigenous Smoking, responds to new smoking research with an update on the promising progress being made to tackle Aboriginal and Torres Strait Islander tobacco use and a reminder that more needs to be done if we are to close the health gap between Indigenous and non-Indigenous Australians.  He writes: 

New findings published this week in the international journal BMC Medicine indicate that up to 1.8 million of our 2.7 million smokers in Australia will die from their habit if they continue to smoke. This is a stark reminder of the benefits of quitting, or not taking up smoking at all.

The research provides an important reminder that while we have had some significant wins in the war on Aboriginal and Torres Strait Islander smoking rates in recent times; the war has not yet been won. Evidence suggests that great work has been undertaken in Aboriginal and Torres Strait Islander tobacco control, as illustrated with the significant reductions in Aboriginal and Torres Strait Islander tobacco use.

The reduction in Aboriginal and Torres Strait Islander smoking rates by 10 percent over the last decade (1), as well as the marked increase in the number of Aboriginal and Torres Strait Islander people not taking up smoking (1), demonstrates that efforts to cut smoking rates are working and that further gains are possible.

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JENNIFER DOGGETT | February 25, 2015 | CO-PAYMENTS | 2 |

What is the value of a Medicare price signal?

Health Minister Sussan Ley has re-affirmed the Government’s commitment to the GP co-payment, arguing that it is necessary so that people ‘value’ the health care they receive.  In the following piece, the Consumers Health Forum CEO, Adam Stankevicius, questions the Government’s association of price signals with value, given the fact that Medicare has provided Australians [...]

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JENNIFER DOGGETT | February 24, 2015 | CHOOSING WISELY | 1 |

Choosing Wisely with The Naked Doctor

In his latest post for Croakey, The Naked Doctor, Justin Coleman, previews the Choosing Wisely campaign, due to launch in Australia in April.  This campaign focuses on cutting down the numbers of unnecessary medical tests and treatment and has been successful in the USA and Canada in reducing non-evidenced based interventions.  While a number of medical colleges have been involved in developing the Choosing Wisely campaign in Australia, this post discusses the Royal Australian College of General Practitioners’ input which focuses on primary health care and will identify five treatments routinely provided in general practice which are not supported by evidence.     

This post is the first in a series that Croakey will be running on Choosing Wisely which, as the Naked Doctor suggests, may make some controversial and confronting recommendations about current medical practices but which has the potential to both increase patient outcomes and save resources.  He writes:    

The Naked Doctor has always prided himself on choosing wisely – except perhaps his clothing choice in inclement weather – so it comes as no surprise that he has embraced Australia’s very own Choosing Wisely campaign, as others might embrace their warm jackets in winter.

This doctor has long recognised the imperative to strip his practice bare of any habit that research demonstrates is probably unhelpful to his patients. He is by no means alone, although, as we shall see, to go naked is to expose oneself to the pricks and barbs of one’s heavily insulated colleagues.

The NPS MedicineWise Choosing Wisely Australia initiative imports the 2012 US Choosing Wisely concept, where medical colleges are invited to highlight tests and treatments that are used widely despite evidence to the contrary. 

Canada’s Choosing Wisely (CW) campaign followed their Southern neighbour’s, and the movement is now spreading to 12 countries, including both England and its former convict outpost down under.

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MELISSA SWEET | February 22, 2015 | CONFLICTS OF INTEREST | |

Is the Dietitians Association of Australia in the pocket of Big Food?

Public health lawyer, author and blogger Michele Simon has been investigating conflicts of interest and the Dietitians Association of Australia.  Simon, president of Eat Drink Politics, a corporate watchdog consulting firm in the US, has released an Australian edition of “And Now A Word From Our Sponsors”, detailing close links between the food industry and DAA. [...]

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MICHELLE HUGHES | February 21, 2015 | INDIGENOUS HEALTH | |

Time as a social determinant of health

Daniel Reeders is a research officer with the What Works and Why project (w3project.org.au) at the Australian Research Centre in Sex, Health and Society. In this post he discusses a recent forum at Vic Health  on ‘Time as a social determinant of health’ and relates it to his personal experience working with a diverse range of communities.

Daniel writes:

On Tuesday, I spent my lunch break at a ‘Talk with your fork’ at VicHealth on ‘time as a social determinant of health’.  I jumped at the invitation to come along and cover it for Croakey, because the core concept – time pressure – had already showed up in my practice in health promotion with different communities.

Whether doing health promotion around HIV and sexual health on ‘African time’* at a freezing church hall in Shepparton, consulting with refugees about when’s the right time after settlement to start talking about sexual health or talking with bicultural community educators about how they support their communities and patch together a living out of casual roles with community organisations. Time was a key factor in all of these discussions. 

In this piece I make a case study of time pressure as a social determinant of cancer screening – but first, let me tell you a bit about the presentations I heard on Tuesday.

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MICHELLE HUGHES | February 20, 2015 | CLIMATE CHANGE | |

In brief: Global divestment day

Earlier this month a consortium of health organisations published ‘Unhealthy Investments’ which articulates the strong case for UK health sector (and one could argue all businesses engaged in improving health) in divesting in fossil fuels. In a type of ‘valentine to the planet’, February 13-14 marked global divestment day, celebrating the success of the movement encouraging divestment from fossil [...]

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