Reports today that Treasury has repeatedly told the Rudd Government that the Private Health Insurance (PHI) rebate is inefficient is hardly surprising news, said Dr Tim Woodruff, President, Doctors Reform Society.

It’s very obvious to us as doctors and to patients and relatives across the country that the private/ public divide is inequitable, said Dr Woodruff. Public patients wait years on crutches or in wheelchairs for their hip replacements whilst private patients are treated within weeks. The PHI rebate encourages queue jumping of public waiting lists by those who, with taxpayer support, can afford PHI. The rebate has also funded the growth of the private sector, taking doctors out of the short staffed public sector.

The Government’s National Health and Hospitals Reform Commission claims principles of efficiency and equity. They didn’t address the PHI rebate.

We call on the Prime Minister to fulfil his promises of a root and branch analysis of the health system and evidence based policy and include the PHI rebate in the current review of the health system, said Dr Woodruff. Without such inclusion the review is badly flawed from the beginning.

Dr Tim Woodruff
President
Doctors Reform Society

Dr Con Costa
Vice President
Doctors Reform Society

]]

“The Doctors Reform Society welcomes the many positive ideas presented in the interim report from the National Health and Hospitals Reform Commission,” said Dr Tim Woodruff, President, Doctors Reform Society, “but we wonder how their stated commitment to the principles of equity and efficiency has allowed them to ignore the inequitable and inefficient Private Health Insurance (PHI) rebate. Is choice more important than equity?”

“The belated recognition that dental care should be universally available is a huge step forward for many Australians who until now have had no choice but to live in pain, unable to eat properly, waiting years for treatment,” said Dr Woodruff. “The disappointment is that, even if the Government took the advice, those in rural and remote Australia will continue without dental care because fee for service funding will not get dentists into such areas. Denticare also guarantees that those who have the money for private insurance can get faster access. That’s choice before equity. It should be the opposite.”

“It is encouraging to see that primary health care, care in the community, is given such a high priority in this report, and that the funding for this care will no longer be spread between local, State, and Commonwealth authorities, thus potentially improving the integration of care in this sector. It is disappointing however, that there is no clear vision of how the recommended Comprehensive Primary Health Care Centres would be funded, governed, and staffed.”

“The report clearly identifies inequities in funding and recommends regional block funding for rural and remote areas, based on need,” said Dr Woodruff, “but the report ignores this issue for inner and outer regional areas where many more Australians regularly miss out on their fair share of Government spending. They have no choice.”

“Our public hospitals are struggling, burdened by inadequate Commonwealth funding. The drift of doctors from public to private hospitals and the inequity of access to public hospitals is clearly identified in the report but the contribution of the PHI rebate to this inequity is ignored. Choice remains a taxpayer subsidised option for the minority of Australians who can afford PHI and can queue jump public hospital waiting lists, whilst the most needy just wait. They have no choice. Vested interests remain untouched.”

Dr Tim Woodruff
President
Doctors Reform Society

Dr Con Costa
Vice President
Doctors Reform Society

]]

“The scare tactics of the Australian Medical Association (AMA) about the decrease in private health insurance cover fails to mention that any decrease in private hospital work for its members means less money for them. Perhaps that underlies their tactics but it also clearly demonstrates that the AMA believes a safety net is all that most Australians deserve if they aren’t ‘good enough’ to have sufficient money to afford private health insurance (PHI),” said Dr Tim Woodruff, President, Doctors Reform Society.

“The AMA’s scaremongering tactics, suggesting that eg patients may not get radiation therapy for their cancer treatment, is unconscionable for an organisation which claims to be interested in patients but is in fact primarily interested in the profits for its private specialist members,” said Dr Woodruff. ‘If public patients cannot access public services but private patients can, it indicates a basic flaw in our health system which the AMA supports, ie that private health should be subsidised so that rich people can have better care than the rest of the population.”

“Public health insurance is what Medicare is based on: everyone pays through taxes and the Medicare Levy, and everyone has the right to access the care in public hospitals. The AMA wants a return to the past when public hospitals were for the desperate, private care was for the rich, and those in the middle went bankrupt trying to afford private care”, said Dr Woodruff.

“It also ignores the reality that when you are put in an ambulance, you will almost certainly finish your journey in a public hospital. Destroy the public system by spending much needed taxes supporting private hospitals, and your journey could well be an avoidable fatal trip. It’s worth remembering,” said Dr Woodruff, “that the victims of the Bali bombing, many of whom had PHI cover, were saved in public hospitals.”

What is the AMA interested in, the profits of its members and their rich patients, or the interests of all patients, even the 56% of Australians who can’t afford to see private specialists in private hospitals?”

The AMA wants second rate care in public hospitals for the desperate, first rate expensive private care for the rich, a continual struggle for those in between, and plenty of private work for its members.”

Dr Tim Woodruff
President
Doctors Reform Society

Dr Con Costa
Vice President
Doctors Reform Society

Dr Tracy Schrader
Vice President Qld
Doctors Reform Society

]]

“The response of the Australian Medical Association (AMA) to the increase in the Medicare Levy Surcharge threshold demonstrates clearly that it believes only those Australians able to pay their doctors privately deserve decent health care. The AMA’s President today became more desperate suggesting that patients may not get radiation therapy for their cancer treatment if they drop out of PHI, is self interested scaremongering at its worst,” said Dr Woodruff. “The reality is actually the other way around. When you are put in an ambulance, you will inevitably end up at a public hospital. This is no different if you are a member of the Packer family or a victim of the Bali bombing.”

“The first Rudd budget is a move in the right direction for the public health system. It partially addresses the need for increased funding and support for our valuable public system. It also acknowledges the reality that all Australians depend on the public health system which provides a high standard of care at much more efficient levels than the private system and a step towards rekindling confidence of the public, nurses and doctors in our great public health system.”

“What is probably NOT surprising is the venom coming from the private vested interests and their false moral imperative that people who do not take out PHI or use the inefficient, expensive private system, are bludging on the public system. People have every right to pick which system they prefer without being penalised for NOT picking the system which most rewards the doctors” said Dr Woodruff. “The government is to be congratulated in its early show of sound economic decision making on health and meeting the needs of the public, rather than those of the vested interests

Dr Tim Woodruff
President
Doctors Reform Society

Dr Con Costa
Vice President
Doctors Reform Society

Dr Tracy Schrader
Vice President Qld
Doctors Reform Society

]]

“Suggestions that there will be further money for public hospitals in today’s budget on top of the $1 billion already promised will go some way to restoring the 50/50 Federal/State split of funding which the previous Coalition Government allowed to degenerate to a 42/58 split,” said Dr Tim Woodruff, President, Doctors Reform Society.

“The raising of the Medicare Levy Surcharge threshold is also a small signal that the grossly inefficient private health insurance (PHI) industry will not have everything it demands as it sucks the heart out of the public system,” said Dr Woodruff.

“It’s a tiny step in the right direction. It will take a maximum of $120 million in taxes from the PHI industry. That leaves them with an extraordinary sum of about $3 billion, and the vested interests are still whinging.”

“Ten years age we predicted that this taxpayer support for PHI would fail to decrease premiums, fail to unload the public system, and lead to a decline in public hospital access. We were correct.”

We now predict that this minor change will lead to the industry demanding approval for higher premiums, however unjustified, and that there will be no obvious increased burden on public hospitals because those who drop out will be low users of hospital care”.

Dr Tim Woodruff
President
Doctors Reform Society

Dr Con Costa
Vice President
Doctors Reform Society

Dr Tracy Schrader
Vice President Qld
Doctors Reform Society

]]

“The proposed increase in the threshold for avoiding the Medicare Levy Surcharge may well mean a decline in private health insurance (PHI) cover,” said Dr Tim Woodruff, President, Doctors Reform Society. “This will mean less tax support for the private health insurance industry and perhaps less work for private specialists in private hospitals.”

“It’s no wonder then that the PHI industry and the Australian Medical Association are complaining,” said Dr Woodruff. “They both have a vested interest in taxpayer support for the private health system which has been helping to tear the heart out of the public health system for a decade.”

“Whilst more people may now say ‘PHI is not worth it’, that’s the PHI industry’s problem. If they can’t make it a worthwhile and affordable product, even with the Federal Government’s annual 3 billion dollar subsidy of PHI, and its neglect of the public system for the last decade, they should be on their own”

“Whilst the Government’s decision appears to be based on correcting the threshold because of inflation, it really should be asking why the rich can avoid paying the Medicare Levy Surcharge just because they are rich enough to afford PHI,” said Dr Woodruff.

“Indeed, one has to ask why the Federal Government’s support for PHI which was called ‘a monumental waste of money’ by the then Labor leader 10 years ago is any less wasteful now,” said Dr Woodruff. “It has failed to put downward pressure on premiums, and failed dismally to help correct the appalling waiting times for elective surgery in public hospitals. It is so unfair on working families and on the 56% of Australians who cannot afford PHI. It’s time to do more than fiddle with thresholds.”

Dr Tim Woodruff
President
Doctors Reform Society

Dr Con Costa
Vice President
Doctors Reform Society

Dr Tracy Schrader
Vice President Qld
Doctors Reform Society

]]

The unfortunate demise of Heath Ledger should be a warning for us all. His death is not thought to be due to suicide but what seems the “accidental” ingestion of a combination of strong prescription medications. Certainly these drugs would have contributed to his untimely death.

Increasing use of strong morphine derivative medications – which are promoted widely by Big Pharma – poses a real risk to our community. It is well known that such medications can depress the respiratory system and are also very addictive, particularly so for depressed and susceptible patients.

There has been a strong marketing push for such medications over recent years and they are now in widespread use throughout the community. The Public Health Authorities have been slow to make it clear about the dangers posed by such wide spread use of strong Morphine derivatives for control of pain within the community.

“These drugs are not just very addictive” said Dr Con Costa, National Vice President of the Doctors’ Reform Society. “They are becoming the new designer drugs i.e. designer analgesics for the modern lifestyle, but they do come at a terrible cost – a cost which is often unnoticed until it affects someone rich or famous”.

These medications depress the respiratory system in even moderate doses and are highly addictive. Once you have been taking them for even several weeks it is very difficult to stop. The combination of strong morphine derivative analgesics eg OxyCodone, MS Contin etc when taken together with strong hypnotics such as Rohypnol becomes an even more lethal and deadly cocktail with effects much greater than when taken alone – and the combination of multiple of such medications will also lead to newer and more toxic side effects which are unpredictable and not present when using either drug alone,” said Dr Costa

“The bottom line is that Heath Ledger’s death was not just an unfortunate accidental overdose. Such deaths are unnecessary in that they could have been prevented – particularly with much stronger public health controls and public warning on the use of these medications – and restriction on the promotion on such prescription medications by pharmaceutical companies”.

“As stated by his father, Heath Ledger’s death should serve as a warning to us all. Heath Ledger’s death was a tragedy waiting to happen – but it would be an even greater tragedy should our Public Health Authorities now fail to act,” Dr Costa said.

Dr Con Costa
Vice President
Doctors Reform Society

]]

Doctors call on sporting heroes to support ban on junk food and alcohol advertising to kids in order to fight obesity epidemic and alcohol damage

The Doctors Reform Society notes with concern that amidst an obesity epidemic and calls for easier access to obesity surgery for teenagers, and increasing abuse of alcohol by our young, we see our sporting heroes advertising daily for products which feed directly into these major problems in our society.

“Our young people look up to these sporting heroes but our television screens are awash with these same heroes promoting alcohol and fat or sugar laden fast food,” said Dr Tim Woodruff, President of the Doctors Reform Society.

“Whilst there is a place for advertising of such products to adults, noted Dr Woodruff, “there is no one who would dispute the fact that many teenagers and younger children will be glued to the cricket this summer and cannot possibly miss their heroes advertising both alcohol and fat/suger laden fast food.”

“These problems will not be addressed by obesity surgery, which is best reserved for the more severe and resistant cases of morbid obesity – and often accompanied by serious risk of side effects, including death. We call on the Australian Medical Association, which does support a ban on junk food advertising to kids, to support our campaign to control advertising of alcohol and fast food by our sporting heroes. We also ask that these sports leaders and their associations consider the effects of their promotional activities on our youngsters who are our future”.

Dr Tim Woodruff
President
Doctors Reform Society

Dr Con Costa
Vice President
Doctors Reform Society

Dr Tracy Schrader
Vice President Qld
Doctors Reform Society

]]

The Doctors Reform Society today released a scorecard assessing the health policies of the parties.

“We have a unique situation at the upcoming election”, said Dr Tim Woodruff, President, Doctors Reform Society, “in that there is no possibility of the Labor Party gaining an outright majority in the Senate. Thus even should they win the elections they will be powerless to pass legislation through the Senate to fix our ailing Public Hospitals and health system.”

“Our world class health system is in danger,” said Dr Woodruff. “A 50% increase in out of pocket costs over the last 10 years, combined with lack of access to quality health care for disadvantaged and geographically remote patients is leading to increasing disparities in health outcomes between rich and poor.”

“Our health workforce is at crisis point,” said Dr Woodruff. “The nursing workforce is aging and working conditions and career pathways are deterring many dedicated people from continuing their life saving work. Our medical workforce is inadequate and not distributed to areas of need. Our hospitals are struggling to cope with the increased demands”.

“Our health system is fragmented, inefficient, and hospital and disease focused. We need vision and national planning to address the health issues of the 21st century”.

“This assessment reveals some promising and some very worrying results,” said Dr Woodruff. “It is the minor parties that are demonstrating a much better vision for policies to bring equity, efficiency, universality, and quality to our health system. The Coalition is struggling to score many points on any of the key health issues confronting our politicians and our patients.”
“We note that the Labor Party has scored better than the Coalition on all issues we regard as priorities,” said Dr Woodruff “and we encourage voters concerned about our health system to take this into account when considering their vote for the House of Representatives”.

“The role of the senate, however, will be crucial in achieving the best health system outcomes over the next three years whichever party gains government” said Dr Woodruff. “As the Labor Party cannot possibly win balance of power in the Senate in this election, the choice is between the minor parties and the Coalition. Due to the encouraging scores of the Democrats and Greens, it will be imperative for progressive policies that the minor parties gain this role”

11 Issues, scored on 0-5 scale, maximum points 55.

0 – Policy or statements which conflict directly with addressing issue.
1 – No policy
2 – Vague statements which may address issue or significant mixture of policies which in sum are directed to addressing issue
3 – Appropriate policy suggestions with little detail, or moderately detailed policy suggestions partially addressing issue
4 – Policy suggestions with moderate detail or excellent policy suggestions addressing issue partially
5 – Excellent well thought out policy to address issue

Dr Tim Woodruff
President
Doctors Reform Society

Dr Con Costa
Vice President
Doctors Reform Society

Dr Tracy Schrader
Vice President Qld
Doctors Reform Society

]]

“John Howard’s announcement today of increased Aged Care places which will ‘take the pressure off public hospitals’ is a belated admission that the Federal Government does bear some responsibility for the dire situations in our public hospitals” said Dr Tim Woodruff, President, Doctors Reform Society. “This is after years of saying that public hospitals are a State responsibility and that problems in these hospitals are down to the States.”

This comes on top of an admission by the Federal Government that it has underfunded the public hospitals compared to the States contribution,” said Dr Woodruff

“Mr Howard and Mr Abott (The Minister for Private Health) need to “come clean” and tell us if and how they will reverse their failed health policies.”

“They need to tell the public how they will staff such Aged Care places in a time of crucial nursing shortages across the county,” said Dr Woodruff.

“They also need to act on the 8.7% of admissions to hospitals which would not be happening if there was adequate primary care – for which the Federal Government is largely responsible”, said Dr Woodruff

Thursday, 1 November 2007

Howard still has nothing for Public Hospitals

“Yesterday’s announcement by the Prime Minister that 50 new ‘family medical centres’ will be set up to take the load off our under-resourced emergency departments is a sad indication of how ignorant the Federal Government is about the problems in emergency departments,” said Dr Tim Woodruff, President, Doctors Reform Society. “They will do nothing for our emergency departments.”

“GP type patients do not lead to the problems in emergency departments”, said Dr Woodruff, “Research consistently shows that the single major factor causing problems in emergency departments is a lack of beds in the hospitals for the patients who need admission to go to. There are no beds for them because

1. The Federal Government has admitted underfunding the public hospital system compared to the States by $2 billion per year

2. The Federal Government has not funded adequate GP based primary care to prevent people getting so sick they need admission to hospital unnecessarily. A 2007 Federal Government study suggested this accounted for 8.7% of admissions.

3. The Federal Government has not provided enough Aged Care places for patients waiting in expensive hospital beds

4. The States have not funded hospitals adequately to match the growing demand despite doubling their funding over the last four years”.

“Howard and Abbott remain in denial about their responsibility for the plight of public hospitals,” said Dr Woodruff.

“We’ve heard it all before: ‘we will take the load off public hospitals with the PHI rebate’. It didn’t work, and now the same claim is being made: ‘we will take the load off emergency departments’. It won’t work until there is a re-investment directly in public hospitals rather than in private hospitals and personal tax cuts, and new investment in providing adequate primary GP based care and adequate Aged Care.”

Dr Tim Woodruff
President
Doctors Reform Society

Dr Con Costa
Vice President
Doctors Reform Society

Dr Tracy Schrader
Vice President Qld
Doctors Reform Society

]]