When did reform in healthcare become a dirty word

NEITHER side of politics can make a virtue of throwing taxpayer dollars at propping up failing health services, like maternity units. The collapse of maternity is a microcosm for a floundering health system, due to government failure to act on well-established problems that need reform.

Politicians love pledging taxpayer dollars on big ticket announcements in election campaigns. Apparently, it shows us how much they care. In reality, it's lazy, often wasteful and rarely fixes anything.

A case in point is the $8.5 billion and $9 billion Labor and the Coalition have, respectively, earmarked to prop-up bulk-billing. While we all support the intent, when doctors say it will not induce them to bulk-bill more often, or at all, we should be questioning government priorities.

"As more private hospital closures loom, whoever forms government after Saturday will likely respond by pushing more public patients through private hospitals," APHA CEO Brett Heffernan said.

"Our discussions with governments and opposition parties show universal recognition of the plight of public patients on waiting lists and the capacity of private hospitals to meet this need.

"For forward-planning and workforce considerations, to be effective this will need to be a commitment over years, not months. But this is not a fix for the funding crisis.

"The next Federal Government must grasp the critical need to reform the funding mess that allows insurance companies to bank record profits and exorbitant fees while dictating inadequate pricing to hospitals.

"In the case of maternity, there are many factors that make maternity care challenging. Birth rates in Australia are at historic lows. Midwives are had to come by. Having pediatricians on-call 24/7 is expensive.

"Another is health insurance companies only include maternity at the Gold level of cover. Despite holding Gold cover, often for years, mothers-to-be are shocked to discover they are not covered for an obstetrician, meaning they can be up for $10,000 in out-of-pocket costs. Faced with these costs, it's not surprising people go public.

"The health insurance industry's recent epiphany that this is a problem is incredulous to say the least. They've been knowingly selling maternity cover at top dollar to young people while being pretty confident it won't be used.

"The upshot has seen private hospital births fall from around 30% a decade ago to 19% today.

"The ability for private hospitals to provide maternity is not a volume or workforce issue. They make it hard, but they can be overcome.

"Even if Australians suddenly had more babies. Even if obstetrics was covered by insurance. Even if more midwives miraculously appeared. These will not stop private maternity units from closing.

"Over the last three years the Australian Prudential Regulation Authority reports that health insurance companies have banked record profits of over $5 billion during that time. They also rake in $3.5 billion a year in rubbery 'management fees'.

"Yet, over those three years they short-changed private hospitals by more than $3 billion on the treatments and care they provide. If left unaddressed, more services, indeed, entire hospitals, will close.

"So whether you have more babies to deliver or extra staff to deliver them, when you're being underpaid for the services you provide, then delivering 100, 1,000 or 10,000 babies each year doesn't help. In fact, you are just compounding the funding shortfall.

"The good news is it's fixable and fixing this funding crisis doesn't cost a cent. It doesn't have to cost taxpayers and patients nothing. It does, however, require a bit of political will to make the insurers pay their way.

"A recent Monash University study noted that the shutdown of private maternity wards could see taxpayers up for $1 billion a year to fill the breach. Meanwhile, the Federal Government has committed $16 million to augment recently closed private maternity services in Hobart and Gosford.

"Naturally, local communities will welcome the funding. But wouldn't a proactive approach to fixing the funding mess in the first place have been a better way to go?

"$16 million, and counting, is a very expensive taxpayer band-aid applied after the fact, that would not likely have been necessary had the Federal Government been engaged in this deepening crisis two years ago, or even six months ago.

"Only recently, in the context of an election campaign, has Minister Butler espoused restoring the funding ratio to private hospitals, noting of insurers:
"There has been a structural shift of where the money is going in the system. There is a shift downwards for private hospitals. There has been a shift up in profitability and management expenses of insurers. There needs to be a lift in the benefit payments ratio".

"Better late than never. But there are scant details on how or what ratio.

"When asked in a recent media interview to match this pledge, Shadow Federal Health Spokesperson Anne Ruston dodged the issue. More alarmingly, she did so parroting the health insurance industry's talking points that they cannot afford it. Codswallop! Clearly, they can and
without increasing premiums."

-ENDS-

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