Four Corners a sobering insight into why Medicare Review necessary

Last night’s sobering Four Corners episode exposing a real – not perceived – waste in health spending demonstrates the need for a peaceful and constructive national conversation about how to fix the system for health professionals and patients.

Page last updated: 29 September 2015

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Last night’s sobering Four Corners episode exposing a real – not perceived – waste in health spending demonstrates the need for a peaceful and constructive national conversation about how to fix the system for health professionals and patients.

Eminent medical specialists and health researchers put their professional reputations on the line to provide important insight into billions of dollars being spent on unnecessary, outdated, inefficient and even potentially harmful procedures for conditions such as back pain, knee pain and heart problems in Australia.

Some people were of course quick to denounce the program as ‘another’ attack on the medical profession. However, whether or not you agree with the content of last night’s program is not the point.

The point is there is clear evidence demanding a national debate about how best to deliver – and fund – contemporary clinical practice for Australian patients through Medicare. To ignore it would be a mistake.

Last night’s Four Corners program hasn’t come out of the blue; neither has the Federal Government’s review of all 5700 items on the Medicare Benefits Schedule and the rules and regulations around their use.

Over the past nine months, I have consulted hundreds of doctors and patients – and many of their representative groups – about how to proceed with improving Medicare for patients, health professionals and taxpayers. The issue of unnecessary and inefficient procedures was front and centre. This has been both the catalyst, and the foundation, around which we are building our review of the MBS.

It makes sense when you consider Medicare was introduced in the 1980s and there has never been a wholesale review of the benefits it pays.

As reflected on Four Corners last night, it has only been in recent years that an evidenced-based review process has been introduced to assess new items coming on to the MBS.

As such, you may be surprised to learn that the average age of all 5700 items on the MBS is 19 years and 97 per cent of these items have never undergone consideration to determine whether or not they are actually clinically-effective, cost-efficient or safe.

Think about the amount of technological advancement we’ve seen since the 1980s and 1990s and tell me that it is acceptable we have thousands of taxpayer-funded medical procedures that have never been assessed, updated or amended in all that time?

For the record, I do not consider it an attack on the medical profession to talk about the issues at hand, because it’s clear that Medicare is not supporting them appropriately to deliver optimal care to patients.

Australia’s health professionals have a long history of being trusted members of our community and I understand the frustrations many have with the current system.

That’s why this review is clinician-led with support from health economists and consumers. It’s also why we have opened the floor to doctors and patients at the coalface throughout Australia to lodge their personal views and opinions with just the click of a button.

And, to be clear, this review has the ability to recommend new and amended items to replace outdated procedures. That’s why I have been upfront throughout my dealings that if efficiencies are found they will be divided between investment in new treatments and addressing the budget bottom line so we can keep Medicare sustainable.

Nor should it be considered an attack on the medical profession to ask patients their views and thoughts.

It is patients who are able to tell doctors, and to tell us as policy makers, whether they feel a Medicare-funded service or procedure has helped improve their health or lifestyle.

In recent days we have seen significant public support for the Government’s review from medical groups and colleges, consumer groups, health insurers and the Greens, despite attempts by some determined to frame this as a ‘war’ with doctors.

I am not interested in engaging in megaphone diplomacy, scaremongering or political grandstanding.

I strongly believe good policy makes good politics and this structural reform will deliver much needed value, integrity and confidence for the $20 billion taxpayers will invest in Medicare this year.

It is clear there is much goodwill and acceptance in the broader community that doing nothing is not an option.

For the good of patients, medical professionals and policy makers, it’s important we all collectively embrace this opportunity to have a mature conversation about building a healthier Medicare.
The health of our nation depends on it.

To have your say, visit: Medicare Benefits Schedule Review Taskforce.

Sussan Ley is the Federal Minister for Health.

ENDS

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