Published by the Medical Observer
It’s about time for Canberra to commit to evidence-based health policies.
We’ve been hearing it over and over again: healthcare costs are out of control, but the only solutions brought forward to rein in expenditure are a Medicare rebate freeze and the introduction of a compulsory GP co-payment.
Those measures are short-sighted, but even worse, they are neither evidence-based nor logical. Plainly, those suggestions are nonsensical.
Looking at the facts, one can easily establish that general practice accounts for less than 7% of the total healthcare expenditure (that includes GP items of the Medicare Benefits Schedule as well as GP Practice Incentive Payments and the cost of Primary Health Networks).
The federal government allocates $338 per person per year to general practice, less than $28.50 per month.
In real terms, that sum has been steady and the argument that we spend more and more on healthcare is based on the plain fact that we also have four million more people living in Australia than 10 years ago.
It’s self-evident that GPs not only have a proven track record as the true gatekeepers of the health system, but also that general practice is the only profession that has the demonstrated capability to rein in health care costs.
Just as a reminder: that sum of $338 above has remained pretty much constant over the decade, whereas the federal contribution to fund public and private hospitals has tripled in the same time.
So, the political discussion about reining in health care costs has been influenced by a mighty dose of political spin and selection bias. Not a good basis for any policy — let alone health policy.
You may ask then, are there any new, revolutionary ideas in health policy to further control health care costs? No. Not really.
The dogma stipulated by Professor Brian Abel-Smith, from the London School of Economics, still stands: “The only way to organise and pay for health services well is to change the system every second year so that nobody feels comfortable in it.”
What he meant was that one has to shake things up on a regular basis, so nobody feels complacent, nobody feels safe.
Well, that worked. We GPs have been shaken and stirred for good.
Despite us having a track record of keeping the health system together, despite demonstrating that we GPs contain, not expand, the cost of health care, the political approach to GPs has been to undermine our substantive role as the gatekeepers of the system and to make us a convenient scapegoat of spiralling health care costs — caused by others. That has to stop.
The blame game has to stop. The politicising of healthcare in Australia has to stop. We need a commonsense approach to developing and implementing health policies. And there has to be a commitment for those health policies to be logical and evidence-based.