Published in SMH on Wednesday, April 25, 2012

Means testing access to services can be a very useful way to fund services. It can also be very mean. The reforms to Aged Care aim to increase the availability of services but at a price, easily afforded by the rich. On an income of $30,000, few Australians would regard themselves as rich. But those on such an income will pay an extra $3,000 to get help to stay at home rather than go to a nursing home. Such people frequently have medical problems in addition to difficulties looking after themselves. Federal Government has ignored the data which indicates that 32% of sick Australians don’t see their doctor when sick or don’t fill out all their prescriptions because it costs too much. Many of these people will be trying to find the extra $3,000 per year. Could the Federal Government really want such people to have even more difficulty accessing medical services? Users pay or they don’t get the services and die. Why are we rich Australians so mean?

Tim Woodruff
Vice President
Doctors Reform Society

31 Davison St
Richmond
3121

PH 0401042619

Published in The Australian on Wednesday, July 18, 2012

THE reason people are dying while waiting to be granted a refugee space in Australia (“In the real world, people die in the queue”, 17/7) is because the government refuses to alter the cap of 13,700 refugees a year. It could increase the cap and regard the 500 to 5000 boatpeople who risk dying each year as a separate group from those who have managed to find the queue. 2005 Young Australian of the Year Khoa Do was a boatperson whose parents couldn’t find the queue. Why are we so afraid of these desperate people who must prove they are genuine refugees and then contribute so much to our society?

Tim Woodruff, Richmond, Vic

Published in The West Australian on Wednesday, October 10, 2012

The rate of caesarian sections in the private sector is a difficult issue and causality is complex. It is, however, very obvious to me as a GP that most patients who use private obstetricians end up with a section, and that the minority who do have a vaginal birth almost invariably have some sort of intervention. It is a concerning fact that obstetricians earn more when they intervene, and that they have to earn enough to pay astronomical indemnity (insurance) fees.

Obstetrics is a very difficult tightrope between watchful cautious waiting and jumping in – one I don’t choose to walk and I admire those who do. Knowing when to have the guts to hold back and wait, only intervening when really necessary, is the most admirable skill of all. Perhaps Medicare and the private funds should recognise this skill and pay the most when a labour is managed totally without intervention?

Dr Jane Ralls

Published in The Age on Saturday, August 5, 2006

RE DOCTORS and the drug industry ( The Age, 4/8). Yesterday, I received an unsolicited gift of a large chocolate cake from a drug company, decorated with its name and product. I presumed the company wished me to share it with my staff, and perhaps my favourite patients of the morning. It’s called marketing.

Despite the Australian Medical Association’s insistence that doctors are superhuman and unaffected by marketing, the evidence points the opposite way. Self-regulation for the drug industry is a farce. Yesterday’s reports demonstrate that self-regulation of doctors doesn’t work. Detailing gifts and perks to doctors on the internet as proposed by the Australian Competition and Consumer Commission is good but tinkering at the edges. It’s time the Federal Government regulated the industry and doctors and/or vastly expanded its paltry $20 million a year spending on drug education for doctors.

How can this compete with the industry’s $1 billion marketing budget?

Dr Tim Woodruff, president, Doctors Reform Society, Richmond

Published in Australian Doctor on Friday, May 31, 2013

Dear Editor

While our growing population is of concern, Dr John Vallentine’s description of our treatment of asylum seekers (in Papua New Guinea) is horrific. We cannot extort other countries (eg China) to follow International Law when we flout it so badly.

Strife and unrest in the world is fuelled by poverty, hunger and the large disparity between the “haves” and the “have nots”, which is increasingly visible to everyone worldwide. Strife and unrest drive Australia’s twin fears of terrorism and boat arrivals. The way to work on these issues is firstly with foreign aid to help impoverished countries become self sufficient: money we are shamefully diverting to the Manus Island detention centre. Secondly, when people do flee, we need to create hope that it is possible to seek asylum through “proper” channels ie increase our humanitarian intake. It was a rare breath of air when the government did this, however Tony Abbott will rescind this increase if he takes power.

Boat arrivals are a tiny fraction of our migrant intake, and are using a legal way to ask for help according to International Law. John Vallentine found refugees to be “open, likeable folk” who were “frightened and bewildered”. We cannot imagine what horrors they have already been through to make them flee their homes. Surely we could make room for them in the community once basic security checks have been done, and save Australia billions of dollars? That money should be spent in reducing poverty worldwide, and we should address our population concerns by looking at the other obvious contributors, not by further traumatising people asking us for asylum.

Yours in hope,

Dr Jane Ralls

Published in The West Australian on Monday, June 10, 2013

Claims of “third world” conditions at Princess Margaret Hospital, echoed prominently in the West’s headlines (5 June), are reportedly based on such problems as some staff having been unavailable when families needed them, and some old furniture provided for parents being unpleasant. These concerns are very real for parents of children with cancer, but are they really like the “third world”?

Internationally, 80% of children with cancer live in low- and middle-income countries, and their survival rate is about 25%. In high-income countries, including Australia, the survival rate from childhood cancer is about 80%. This means that most children dying of cancer in the “third world” would be expected to live if they had access to the health resources available in Australia.

Our health system should heed PMH cancer specialist Angela Alessandri’s call (6 June) for more help to meet the growing demand for children’s cancer services. But we should also do what we can, as individuals and a society, to reduce global inequality. While hundreds of thousands of children with cancer are dying worldwide because of poverty, and while our federal government continues to stall on its commitments to international aid, likening PMH to the “third world” is a particularly unhelpful piece of hyperbole.

Dr Brett Montgomery

(Note: this letter was in response to several articles such as this.)

Published in The Age on Tuesday, January 7, 2014

The proposal that ‘we need a system of individual contributions’ for health care continues to be promulgated even by those who recognise that a $5 GP copayment is harsh on the most needy and probably an administrative disaster(Editorial 4/1/14). This proposal however is still about user pays. We don’t have user pays to get a police or fire service response, or to use most roads. We already have individual contributions for all these services. They are called taxes. Everyone pays according to their capacity to pay. Those who are healthy and or rich contribute and receive only the assurance that when they struggle with illness, they will also be helped by their own and others contributions. That was the idea behind Medicare – a single efficient public insurer.

The second myth being promulgated is that individual contributions are necessary for patients to value the service. My bulk billed patients still bring me their homemade marmalade, smoked eel, and wine. They value the service I provide. Some may not, but some who pay also sometimes don’t appreciate the service.

Tim Woodruff

Vice president

Published in The Australian on Wednesday, January 8, 2014

WHILST agreeing with Martin Laverty that GP visit fees are no solution (“GP Visit fees no solution to health funding, 7/1), I was intrigued by his claim that the Productivity Commission found that “non-government hospitals deliver healthcare services at less cost and with better infection control than comparable government hospitals”. In its key points the Commission report stated that “at a national level, public and private hospitals have similar average costs”, and “limited available evidence suggests that private hospitals have lower infection rates than public hospitals, but this result could be misleading because private hospitals on average treat patients who have a lower risk of infection.” Perhaps there is some selective misrepresentation from a major stakeholder of private hospitals.

Tim Woodruff, Vice-President

Published in The Australian on Saturday, January 11, 2014

PRIVATE health insurer Australian Unity funds a centre to produce a proposal for a GP co-payment to give a price signal to consumers and reduce overuse and Medibank Private funds a scheme to avoid GP co-payments (“Fund to pick up costs in trial”, 10/1). Confusing? The former is directed at all patients but will have minimal impact on the well-off.

The latter is directed only at those who can afford insurance and are unlikely to be much affected by co-payments.

Thus the claim that this will improve primary care for insurance holders is probably false. Premiums are likely to rise, more taxes will go to the insurance rebate, and the divide between those who can afford insurance and those who can’t will increase.

Just what a good neoliberal might want.

Tim Woodruff, vice-president

Published in The Age on Friday, February 20, 2015

The GP co-payment of $20 has been abandoned. The Health Minister says however, that she would be “persistent and persevering” in achieving the government’s plan to set a price signal for GP visits. Price signals are the Abbott Government’s obsession. They are designed to stop lower income Australians from seeing GPs whilst leaving the rich unaffected by what to them is a small co-payment.

But it gets worse. The Government is currently encouraging private health insurance companies to cover co-payments for their members. The Government is saying that if one can afford private insurance, price signals aren’t necessary.

This policy sows the government believes either that it is only the poorer half of the population who use doctors too much or that it simply does not want such people to have adequate health care. It is saying that the rich don’t need price signals and the poor don’t count.

Tim Woodruff

Vice president