Australia's universal health care to become a market driven system

[Heracles 417]

This is a very important lesson for the US and they should learn for a country which has had universal coverage since 1984.

I like the idea of service providers competing for people. This way the providers delivering the best service yet most cost effective coverage will survive.

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Radical overhaul of Medicare urged

Nick Miller, Mark Metherell and Ari Sharp

July 28, 2009

MEDICARE could be transformed into a more market-driven system, in which everyone chooses between competing health service providers, as part of an overhaul to be considered by the Rudd Government.

Dubbed Medicare Select, the new scheme would require every Australian to join a ‘‘health and hospitals plan’’ offered by government or public or private organizations, with each plan providing a broad range of taxpayer-funded services.

The proposal is a key part of the National Health and Hospitals Reform Commission’s final report on the health system, released yesterday by Prime Minister Kevin Rudd.

The report — the product of 16 months of deliberations by 10 health policy experts — will provide the blueprint for the largest reforms to health care system since the introduction of Medicare in the 1980s.

The report proposes a partial Commonwealth takeover of health services from the states, with Canberra to assume control of all primary health care services outside hospitals, including out-patient services, community health centres, as well as basic dental care and aged care.

In dental care, it proposes a new universal scheme for access to basic dental services, titled ‘‘Denticare Australia’’, in which everyone would have the choice of getting basic dental services either through a private health insurance plan or through public dental services.

The report recommends separating elective and emergency services in public hospitals, an idea it says will lead to better access and greater efficiency in providing planned surgery and procedures.

And it says that by 2012, every Australian should have an electronic health record — part of broader growth in ‘‘e-health’’ measures, which could radically change the experience some patients have with their doctors, eventually leading to activities such as electronic prescribing.

The report also recommends the creation of a new National Aboriginal and Torres Strait Islander Health Authority to be the single purchasing body for health care services for indigenous Australians.

‘‘The case for health reform is compelling,’’ the report states, arguing that Australia has a ‘‘fragmented health system with a complex division of funding responsibilities and performance accountabilities between different levels of government’’.

The commission has estimated that its reform plan could increase overall recurrent costs by up to $5.7 billion a year and capital investment by up to $7.3 billion over five years.

Mr Rudd said the commission’s recommendations were the most significant since the introduction of Medicare and had ‘‘massive implications’’ for all Australians.

‘‘Fundamental decisions about the entire system must not be taken lightly and we don’t intend to do so,’’ he said.

The commission’s report said ‘‘Medicare Select’’ would make the health system more flexible, efficient and give people new choice as to the health service they get for their ‘‘Medicare dollar’’. Under the new system, the Federal Government would pay health plan providers for individuals’ Medicare entitlements, adjusted according to their risk level — more for the old and sick, less for the young and well.

The plan providers would use the money to fund a range of publicly-funded services from public and private hospitals, doctors and specialists.

Christine Bennett, chair of the commission and chief medical officer for insurer BUPA, said Medicare Select would not carry the same risks and limitations as US-style ‘‘managed care’’, because it would come with guaranteed universal service levels. ‘‘The central idea is you don’t lose, you only stand to gain,’’ she said. ‘‘We are backing the idea that quasi-market forces, and the power of consumer choice, will lead to a better and more responsible delivery (of health services).’’

Dr Bennett said Medicare Select was still a ‘‘concept’’ rather than a fully-developed idea.

All Australians would automatically belong to a government-operated plan, run either nationally or by state governments. But other plans could be put together by private insurers, not-for-profit organisations, or regional centres.

They will contract with public and private health service providers such as hospitals, GPs, pathology labs and allied health groups. The blueprint anticipates that this contracting process would create competition between providers, who would offer better cost or quality guarantees to the plan provider.

These benefits would be passed on to plan membersToday Mr Rudd and Health Minister Nicola Roxon will be at the Royal North Shore hospital in Sydney on the first of 25 planned visits to major teaching hospitals ‘‘to hear from those in the front-line of health and hospital care — warts and all’’.

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Edited August 10, 2009 by haza

[one...two...tree 2,762]

Interesting.