Radical reforms to health insurance flagged by Turnbull Government

Date
    November 8, 2015
    The Age

Health economist Stephen Duckett​ says that allowing insurers to cover GP visits could undermine access to healthcare.   :(

Private health insurers would be allowed to cover GP visits and common tests such as X-rays under radical reforms being canvassed by the Turnbull government that would shift Australia towards a more US-style health system.   

Health policy experts say the move, flagged in a government survey of Australians about private health insurance, would reduce pressure on GPs to bulk bill their services at the Medicare rate of payment, inflating prices for patients.   :(   

The government has also opened the door to private health insurers charging higher fees for people who smoke or are overweight, and Health Minister Sussan Ley said she may slash subsidies currently provided for health insurance policies that include "extras" such as dental and optical services because "they may not be best value for money".   

"There are all sorts of policy options on the table when we get through this process," Ms Ley said on Sunday after launching the survey.

Health economist and former secretary of the Commonwealth Department of Health, Stephen Duckett​, said allowing insurers to cover GP visits could undermine universal access to healthcare – the fundamental principle of Australia's Medicare system.   :(   

At the moment, Dr Duckett said high rates of bulk billing (around 80 per cent of GP consultations) encouraged other doctors to follow suit. If health insurers could cover GP visits, they may pay doctors more than the Medicare rate, changing the market dynamics.

"About 50 per cent of the population has general insurance, so this may encourage doctors to charge those people higher rates on the function that they will be fully rebated from health insurance. That would be inflationary and it might have a flow-on effect to people without health insurance who will be expected to pay," said Dr Duckett, from the Grattan Institute.


Health policy expert at the University of Sydney, Lesley Russell, said allowing insurers to cover GP visits would be like opening "Pandora's box" on fees. 

"We know that in the hospital sector they (insurers) do deals with specialists around what they will pay, and in many cases they pay more than the Medicare reimbursement rate," she said.

Associate Professor Russell said the change would also reduce efficiency because GPs, radiologists and pathologists would be dealing with a raft of insurers with different rules, rather than just Medicare.   

At the moment, private health insurers are not allowed to cover community based health services such as GP visits, pathology services such as blood tests and diagnostic imaging which includes X-rays, CAT scans and MRIs.

The government's survey, launched on Sunday, asks: "If insurers were permitted to extend coverage to health care services not currently covered, and knowing that this would lead to an increase in the price of premiums, which services should be covered?"

It also asks people if higher insurance fees should be charged based on age, gender, health conditions, smoking status and other "health risk factors".

Health insurers are currently not allowed to discriminate against people based on their health history or behaviour, so everybody pays the same premium for the same product, and insurers must provide cover to anybody who seeks it. About 50 per cent of Australians have health insurance, making it a $19 billion industry.

Ms Ley said that while she did not want any Australians to be excluded from health insurance, she wondered if people should be rewarded for avoiding unhealthy behaviours such as smoking.

"I'm really about incentives, not exclusions. For people that have private health insurance now, they can be reassured that we won't be changing the way we look after them in a whole of community sense," she said.   

"We understand that sometimes you get sick and it's not your choice, but when I talk to young people who say 'Well I'm going to keep fit and I don't want to pay as much for my private health insurance because I'm going to do everything right. Is there a way I can get some incentive?', these are the sorts of things we want to explore".

Opposition health spokeswoman Catherine King said the move should sound alarm bells for every health fund member in Australia (about half of the population), and would shift more seriously ill patients into public hospitals.

"If the poll endorses charging smokers more for health insurance, how long before the government moves to look at charging people more based on their age, weight, alcohol consumption, general fitness, genetic testing or family history of cancer?" she said.   :(

There was a case in USA of a guy who went to hospital with injury. After 2 hours waiting he walked out. Hospital still tried to charge him $ 200.00 just for registering him.

We don't want the Health Care System we have either! The people who actually provide medical care get only a small percentage of what is charged.

Some years ago my former employer offered Plan A and Plan B medical insurance. Plan A was what everyone expects coverage to be. Plan B was a simple pool of money collected to pay the medical bills with a minimal staff. and because so much of the bureaucracy was cut out it was cheaper. There was even a period of several months when no premiums were charged because the fund had built up a surplus. It was eventually phased out and everyone placed in the only plan still offered at a higher monthly charge.

I haven't heard anything about medical savings accounts lately so maybe they were too successful to survive because they kept the money in the wrong pockets. Why let the people benefit when we can feed the bureaucracy. If service was just between the Patient and the medical staff we could afford most of our medical care by paying as we used their services. 


http://www.theblaze.com/stories/2015/11/07/obama-announces-obamacare-competition-this-is-reality-this-is-healthcare-in-america/


Read the comments at the end, they are the best part!

We cant all afford private health insurance.   :(

wrote on Nov 9^th, 2015 at 5:31am:

We cant all afford private health insurance.   :(

No,  not now but before the industry grew a huge non medical bureaucracy you could!

The issue I have with private health insurance is that if I pay for insurance I actually like to be insured...

Whilst paying a "excess" is understood and at least partially acceptable, the "gap" is much more arbitrary... Therefore, health insurance does not actually insure one...

In America if you don't have health insurance they'll let you die in the car park.

red baron wrote on Nov 9^th, 2015 at 6:44am:

In America if you don't have health insurance they'll let you die in the car park.

Not really, that is illegal. If you can't afford care you will be stabilized and sent to a charity hospital!

Sicko is a 2007 documentary film by American filmmaker Michael Moore. The film investigates health care in the United States, focusing on its health insurance and the pharmaceutical industry. The movie compares the for-profit, non-universal U.S. system with the non-profit universal health care systems of Canada, the United Kingdom, France and Cuba.
Get the sicko DVD    :)   

Sun Tzu wrote on Nov 8^th, 2015 at 8:12pm:

There was a case in USA of a guy who went to hospital with injury. After 2 hours waiting he walked out. Hospital still tried to charge him $ 200.00 just for registering him.

Sounds just like an appliance repairer... :D

According to Sicko, almost fifty million Americans are uninsured while the remainder, who are covered, are often victims of insurance company fraud and red tape. Furthermore, Sicko points out that the U.S. health care system is ranked 37 out of 191 by the World Health Organization with certain health measures, such as infant mortality and life expectancy, equal to countries with much less economic wealth.[6] Interviews are conducted with people who thought they had adequate coverage but were denied care. Former employees of insurance companies describe cost-cutting initiatives that give bonuses to insurance company physicians and others to find reasons for the company to avoid meeting the cost of medically necessary treatments for policy holders, and thus increase company profitability.   :(

medicare is a fairly good system and there is not nearly as much paper shuffling as there would be with multiple insurers.

i am philosophically opposed to private health insurance as it MUST encourage doctors to do too much.

imagine if you had an old beaten up car and the insurer said the mechanic would get paid for "whatever repairs he thought might help"
The mechanic would rub his hands with glee and milk it, and i believe this is what will happen with private insurance and specialists.

but then we have the other problem.

public hospitals have no real incentive for staff to be motivated. they are on a salary and if they want to cancel operations and have a long lunch hour or sit in the tea room , then , in a way, this almost suits the bean counters running the hospital.
a doctor who cancels operations doesnt cost as much to their bottom line as a doctor who wants to do joint replacements til 11 pm at night.

i actually like the mixed model that sort of applies in qld and that campbell started.

you get assessed by a public hospital doctor (who is under no financial incentive to recommend surgery) and then the ops are sub contracted out to the private sector (who arent nearly as unionised and run a much leaner and more efficient practice ).

i would imagine, you could say book a private hospital to do 1000 cataract operations and get a bulk deal.

now you have the best of both worlds, 
patients get on the list only after someone with no incentive recommends it and the more efficient system does the work.

imagine the paperwork and wastage having 1000 cataract people having to negotiate with private health companies and then be slotted in.
my system would allow them to be done like a production line almost and would introduce real efficiencies

wrote on Nov 9^th, 2015 at 7:20am:

According to Sicko, almost fifty million Americans are uninsured while the remainder, who are covered, are often victims of insurance company fraud and red tape. Furthermore, Sicko points out that the U.S. health care system is ranked 37 out of 191 by the World Health Organization with certain health measures, such as infant mortality and life expectancy, equal to countries with much less economic wealth.[6] Interviews are conducted with people who thought they had adequate coverage but were denied care. Former employees of insurance companies describe cost-cutting initiatives that give bonuses to insurance company physicians and others to find reasons for the company to avoid meeting the cost of medically necessary treatments for policy holders, and thus increase company profitability.   :(

Anything put out by Michael Moore is going to  be biased, everything he turns out serves his personal agenda. Don't think his movies are a fair representation of any subject he claims to investigate.

Medicine is a business like any other and people in that business charge what the market will pay. People from all over the world come here to be in the medical field because the pay is better. People with the ability to pay come for treatment including some former Canadian government officials.

We don't have an American health care system.  But then again, the report comes from Pravda on the Yarra.

Mortdooley wrote on Nov 9^th, 2015 at 6:32am:

wrote on Nov 9th, 2015 at 5:31am: We cant all afford private health insurance.   :( No,  not now but before the industry grew a huge non medical bureaucracy you could!

A lot of people love huge parasitical beuracracy, crookinthehead is one of those people.  ;)

We want the doctor that does the bulk billing.   :(

Quote:

We don't want an American style Health system

Too late... We're getting it.

Thanks to the LNP

wrote on Nov 9^th, 2015 at 8:40am:

We want the doctor that does the bulk billing.   :(

'want'


Do you have any other 4 letter words in your vocabulary like 'give', 'work' et cetera?

How about  ( Cant ) afford.    What part of that do you not understand?.   :( 

wrote on Nov 9^th, 2015 at 11:24am:

How about  ( Cant ) afford.    What part of that do you not understand?.   :(

The answer to 'cant' (afford) is 'work'. Perhaps you've heard of it?  If you want to live off welfare you lose the right to complain - although clearly that doesn't stop you.

Get a job.

One wonders is this another try on, to get rid of, or reduce bulk billing?.   :( 

wrote on Nov 9^th, 2015 at 11:45am:

One wonders is this another try on, to get rid of, or reduce bulk billing?.   :(

Imagine what you could do with $50K every year from a job!  Imagine the possibilities!

comments so far

        No no no. Private insurance should not be there to cover GP's. What we have sufficed. Imagine the cost increase to insurance to cover this. Insurance companies won't be doing it for free.   :(

    Commenter
        Jack
    Date and time
        November 09, 2015, 10:02AM

        Agree. No,No,No! If the LNP pursue this idea they have lost my vote. Just look at the millions in the US who are not insured and ask why?   :(

    Commenter
        sw
    Date and time
        November 09, 2015, 10:17AM

        Just reading this headline leaves me feeling sick... literally.   :(

    Commenter
        SDC
    Date and time
        November 09, 2015, 10:23AM

        NO, No, No, The US health insurance system is one of the worst in the world. For example, it is up to the insurance company, not the doctors to dictate how long a patient can stay in hospital. Usually after one or two days after surgery, a patient has to go home with whatever is attached to him/her. Their system is inhuman. Turnbull is showing what a heartless person he is.   :(

    Commenter
        Vinta
    Date and time
        November 09, 2015, 10:27AM

        I will add a NO Jack.

        WHO ranks Australia at 32 and the US at 37 of the world's health care. Why would we take a step backwards?

        Get rid of private healthcare and bump up the medicare levy to cover the cost of universal health care. The system as it stands is just ridiculously complex and the only real winners are the insurance companies. Wonder who they are donating to?

        If you are unlucky enough to have a major accident you will end up in a public hospital before being transferred to a medical motel when you are stable enough.   :(

    Commenter
        Paul01
    Location
        Riverina
    Date and time
        November 09, 2015, 10:28AM

        This day marks the beginning of trhe end for Turnbull (the man dressed in an Abbott cloak)
        Even Andrew Bolt states today in theTelegraph that Turnbull is now losing the war on words
        ( referring to the farcical GST debate dressed as Tax reform)
        Turnbull is dragging the Abbott chain on so many dud policies, this US Style health system Turnbull is proposing is a continuation of Abbott No 2 (Turnbull) attacking the very foundations of a fair and equitable society.   :(

    Commenter
        Favela Liberal
    Date and time
        November 09, 2015, 10:33AM

Our current system is becoming too expensive and even if we tax the rich 100% then crucify them, as they left would love to do... it would only temporarily solve the problem because it wouldn't address the actual problem that the cost of healthcare is rising uncontrollably, and sooner or later we will be back where we started.

Pantheon wrote on Nov 9^th, 2015 at 1:17pm:

Our current system is becoming too expensive and even if we tax the rich 100% then crucify them, as they left would love to do... it would only temporarily solve the problem because it wouldn't address the actual problem that the cost of healthcare is rising uncontrollably, and sooner or later we will be back where we started.

The US system costs taxpayers more per captia than our system.

Kytro wrote on Nov 9^th, 2015 at 2:09pm:

Pantheon wrote on Nov 9th, 2015 at 1:17pm: Our current system is becoming too expensive and even if we tax the rich 100% then crucify them, as they left would love to do... it would only temporarily solve the problem because it wouldn't address the actual problem that the cost of healthcare is rising uncontrollably, and sooner or later we will be back where we started. The US system costs taxpayers more per captia than our system.

There is virtually no one in the USA that thinks their health system is good and ABSOLUTELY NO ONE outside the country that does.  Even massive fans of the USA such as Howard freely admit that their health system is a total mess.

Kytro wrote on Nov 9^th, 2015 at 2:09pm:

Pantheon wrote on Nov 9th, 2015 at 1:17pm: Our current system is becoming too expensive and even if we tax the rich 100% then crucify them, as they left would love to do... it would only temporarily solve the problem because it wouldn't address the actual problem that the cost of healthcare is rising uncontrollably, and sooner or later we will be back where we started. The US system costs taxpayers more per captia than our system.

Our current system is becoming too expensive, yes not as expensive as the US system, but the cost of our system is rising a lot faster than the american system..Look at sweeden.. they spent per cap 5,297 in 2010 and in 2011 spent 5,881, Compare this to the US where in 2010 the US spent 8,233 and in 2011 spent 8,408.

And as far as i can tell the speed of the increase in our countries are rising, so year on year the cost of our system is rising faster and faster.

Trust me.. Our system is better than the US system and we should take any notes from them, but our heathcare needs reforms... it needed real reform since the 1990s

mariacostel wrote on Nov 9^th, 2015 at 3:01pm:

Kytro wrote on Nov 9th, 2015 at 2:09pm: Pantheon wrote on Nov 9th, 2015 at 1:17pm: Our current system is becoming too expensive and even if we tax the rich 100% then crucify them, as they left would love to do... it would only temporarily solve the problem because it wouldn't address the actual problem that the cost of healthcare is rising uncontrollably, and sooner or later we will be back where we started. The US system costs taxpayers more per captia than our system. There is virtually no one in the USA that thinks their health system is good and ABSOLUTELY NO ONE outside the country that does.  Even massive fans of the USA such as Howard freely admit that their health system is a total mess.

Have you spoken to an American? have you been to America? they are so clueless, they actually believe they have the best healthcare system.

mariacostel wrote on Nov 9^th, 2015 at 10:41am:

wrote on Nov 9th, 2015 at 8:40am: We want the doctor that does the bulk billing.   :( 'want' Do you have any other 4 letter words in your vocabulary like 'give', 'work' et cetera?

let me guess..... you give all the time, right?  ;D ;D ;D ;D ;D

and pigs will fly

Pantheon wrote on Nov 9^th, 2015 at 6:36pm:

but the cost of our system is rising a lot faster than the american system..

how much of that is a result of the governments push to get people onto private health insurance? What do the health care rebates cost us? how much do we lose in taxes just for being a member of a health fund that only provides free shoes and sunnies and bugger all else?

John Smith wrote on Nov 9^th, 2015 at 6:50pm:

Pantheon wrote on Nov 9th, 2015 at 6:36pm: but the cost of our system is rising a lot faster than the american system.. how much of that is a result of the governments push to get people onto private health insurance? What do the health care rebates cost us? how much do we lose in taxes just for being a member of a health fund that only provides free shoes and sunnies and bugger all else?

I honestly have no idea..Maybe this is something you could look up.. All i know is that the cost for "free" healthcare in Australia, UK, Norway etc are rising a lot faster and more rapidly than the American system which although for now spends more per cap with a lot less result, seems to be at lest more stable price wise. 

Pantheon wrote on Nov 10^th, 2015 at 12:20pm:

John Smith wrote on Nov 9th, 2015 at 6:50pm: Pantheon wrote on Nov 9th, 2015 at 6:36pm: but the cost of our system is rising a lot faster than the american system.. how much of that is a result of the governments push to get people onto private health insurance? What do the health care rebates cost us? how much do we lose in taxes just for being a member of a health fund that only provides free shoes and sunnies and bugger all else? I honestly have no idea..Maybe this is something you could look up.. All i know is that the cost for "free" healthcare in Australia, UK, Norway etc are rising a lot faster and more rapidly than the American system which although for now spends more per cap with a lot less result, seems to be at lest more stable price wise.

Perhaps, but medical bills are the number one cause of bankruptcy in the US. Their system is truly terrible.

John Smith wrote on Nov 9^th, 2015 at 6:50pm:

Pantheon wrote on Nov 9th, 2015 at 6:36pm: but the cost of our system is rising a lot faster than the american system.. how much of that is a result of the governments push to get people onto private health insurance? What do the health care rebates cost us? how much do we lose in taxes just for being a member of a health fund that only provides free shoes and sunnies and bugger all else?

Or the over-burdening of medical care/hospital systems with over-priced bureaucrats?

Hey - Pantheon - weren't you a teenaged student with a poor family but a business enterprise that you offshored to make heaps on?  How many of you Ahovkings are there?

Grappler Deep State Feller wrote on Nov 11^th, 2015 at 12:20am:

John Smith wrote on Nov 9th, 2015 at 6:50pm: Pantheon wrote on Nov 9th, 2015 at 6:36pm: but the cost of our system is rising a lot faster than the american system.. how much of that is a result of the governments push to get people onto private health insurance? What do the health care rebates cost us? how much do we lose in taxes just for being a member of a health fund that only provides free shoes and sunnies and bugger all else? Or the over-burdening of medical care/hospital systems with over-priced bureaucrats? Hey - Pantheon - weren't you a teenaged student with a poor family but a business enterprise that you offshored to make heaps on?  How many of you Ahovkings are there?

Teenaged Student xD i'm 22 now yes a young adult not really a teenager anymore,

And whats interesting is like i told you.. I offshored because i couldn't afford the high wages in Australia, the result was my product/service can be afforded by everyone including the poor people without it affecting their money for other things like food and power etc ,

You can clearly see your indoctrination, Just because i "offshore" i must be "making a mint" living in a 681 room castle, with my peasants out on the field   

Haha in reality, i'm living in a one bedroom unit and my food bill is barely $100 per week, trust me when i say i am not making a "heap on" with "offshoring"... Im making enough to pay my bills, its great to see lots of both lefties and righties using my product/service and valuing it as a great and must have product/service..

However what does this have anything to do with the subject at hand?