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24th May 2009
Fiddling the phi
Published in The Age on Sunday, May 24, 2009
Last year even Treasury was predicting some decrease in coverage following the changes to the Medicare Levy Surcharge last year. They and all the stakeholders were wrong (Sunday Age 17/5). As we told the Senate Committee at the time, increasing the price of Private Health Insurance does not mean people drop out. Trying to predict human behaviour is as inaccurate as trying to predict a global recession. Premiums have been rising well above inflation since the PHI rebate was introduced, and the numbers have been reasonably stable except for the initial rise following the Government funded industry scare campaign against public hospitals.
If, instead of fiddling at the margins with PHI, the Government transferred to the public hospitals all the over $3 billion tax dollars which currently support the private industry, we might finally see a return to equity and efficiency for all Australians.
Dr Tim Woodruff
President
Doctors Reform Society
14th Oct 2008
Hospital performance
Published in The Age on Tuesday, October 14, 2008
Public hospitals are too full and unless that issue is addressed any reasonable performance measures for public hospital performance cannot be met. It would help if the Federal Government matched the State Government’s huge injection of funds into public hospitals to address the increased demand, sorted out the lack of Aged Care places for patients waiting in public hospitals, and addressed the issue loss of specialists from the public to the private hospitals which are funded through the taxes of the private health insurance rebate. It would also help if the State Government stopped spin doctoring the figures, and admitted that the figures are really worse than they appear. Waiting times for surgery ignore waiting times to be first seen by a surgeon which could add a year to real waiting times. ‘Virtual’ wards have existed to disguise prolonged waiting times in emergency departments. Unrealistic and misleading performance indicators only compound the problems.
Dr Tim Woodruff
President
Doctors Reform Society
3rd Aug 2008
Double standard
Published in The Age on Sunday, August 3, 2008
There is a shortage of vacant public hospital beds in Victoria and we should welcome the Australian Medical Association’s (AMA) call for more public hospital beds (letters 2/8). The AMA also call for a continuation of the $3 billion Private Health Insurance rebate which finances the growth of the private hospital industry. That industry can only grow if specialists are available. Such specialists can only come from public hospitals and State Government figures show that specialists are moving from the public to the private system. In the interests of all patients, the AMA should be calling for the abolition of taxpayer support for private health insurance, but is faced with the dilemma of the competing interests of patients and AMA members. For the doctors’ union the choice is simple and sad. Members’ interests are paramount. Patients miss out.
Dr Tim Woodruff
President
Doctors Reform Society
15th Apr 2008
Inverse care law
Published in The Age on Tuesday, April 15, 2008
As predicted (Australian 14/4), the funding of psychologists through fee for service is demonstrably inequitable with only 30% of consultations being bulk billed. The most needy are missing out despite the clear benefits to some. Additionally, the money for psychologists can only go to areas where there are doctors and psychologists so the least money goes to areas of workforce shortage which is just where the most needy patients are. The inverse care law: the most money goes to the least needy, the least money goes to the most needy, is alive and well. It’s time to look at how we fund not just psychologists, but doctors, physiotherapists, and other health providers. It’s time to recognize the basic inequity flaw underlying fee for service distribution of government health spending.
Dr Tim Woodruff
President
Doctors Reform Society
14th Apr 2008
Too many x-rays
Published in The Australian on Monday, April 14, 2008
We should not be surprised at suggestions that too many x-rays are being performed (age 12/4). The profit motive is alive and well in the health industry. Some doctors have been asked to repay over $100,000 for overservicing. If that kind of doctor works in a for-profit corporate medical centre which has its own pathology and xray facilities, then we shouldn’t be surprised if unnecessary pathology and xrays are done. We can trust most doctors to do the right thing but when Governments allow for-profit vertically integrated health business to employ any kind of health professionals, it is setting the scene for overservicing, and fraud units will only pick the very worst offenders.
Dr Tim Woodruff
President
Doctors Reform Society
13th Apr 2008
Hair safety net
Published in The Australian on Sunday, April 13, 2008
The Medicare Safety Net was supposedly designed to help people in difficult financial straits afford much needed care. Cross subsidizing interstate travel to a hair restoration clinic through profits gained from the ‘safety net’ are just one more way of ripping off this crazy Government initiative which is a gold mine for doctors and health businesses. The Government’s own figures show how unfairly it is distributed across the country, with the richest electorates getting about $60 per voter per year and the poorest only about $10 per voter. There must be a better way of making health care more affordable for everyone.
Dr Tim Woodruff
President
Doctors Reform Society
26th Mar 2008
Doctors leaving public hospitals
Published in The Age on Wednesday, March 26, 2008
Doctors are leaving public hospitals as predicted years ago for four reasons, all related to Federal Government policy. Firstly, the taxpayer funded private hospital industry has expanded hugely with help from $3 billion in private health insurance (PHI) rebates. Secondly, the public hospitals are unable to cope because of federal underfunding of hospitals, aged care, and primary care, the latter two factors resulting in patients being in hospital when they don’t need to be. State Governments are in a muddle, increasing resources to public hospitals after deliberate underfunding a decade ago, but not catching up because they cannot address the Federal issues. The new Rudd Government plans to tackle only three of the reasons, It ignores the PHI rebate which, apart from being patently unjust, will continue to kill off the public system in favour of the profit driven private hospital industry. All Australians are at risk when our public hospital system fails, it’s where we will all go in emergencies.
Dr Tim Woodruff
President
Doctors Reform Society
23rd Mar 2008
Hospital bosses making it up as they go
Published in SMH on Sunday, March 23, 2008
When financial rewards are given to large organisations such as hospitals for achieving performance targets that can’t be met, because the hospitals don’t have the resources, we should not be surprised that “gaming” occurs. Falsification of records, invention of virtual wards in order to get patients out of the real ward, and any other means of achieving those targets are likely to be used by bureaucrats who need every resource available.
It is wrong, but it happens everywhere. Audits may diminish such behaviour, but they do not address the real problem: unrealistic performance measures and inadequate resources
Dr Tim Woodruff
President
Doctors Reform Society