Health funding should follow the evidence

Published by The Medical Republic

Preparing the federal health budget is quite similar to making a cake.

It’s got to be very tasty, it should look good and one has to be mindful that everybody wants a rather large slice. But essentially, as the leading patisserie chefs would tell you, it’s all about substantial ingredients and some nice flavour.

I appreciate that the flavours of the 2016 health budget are very political indeed. Some like it – others don’t. But the substantial ingredients of this budget should be evidence-based. And they are clearly not.

Why else would the foundation of our health system, general practice, be defunded until at least 2020?

It looks like the 2016 budget is all about political flavour and not about the evidence, because the evidence that investing in general practice leads to greater savings of the health system at large is overwhelming.

Essentially, health systems focusing on general practice have lower use of hospitals and better health outcomes compared with health systems that focus on specialist care. If medical conditions are managed by GPs, the costs to patients and the taxpayer are significantly lower than the costs of a hospital specialist. Access to a preferred GP is strongly associated with lower emergency department presentations and hospital use across a wide range of acute and chronic medical conditions. And if patients have to be admitted to hospital, the risk of readmission after discharge is significantly less with ready access to their GP.

Do those examples matter? Of course! They reflect the substantial evidence base that general practice not only improves health outcomes but also improves the budget bottom line.

The savings, if we invested in general practice, would be $4 billion per year. Compare that with how much the federal government allocates for general practice per year in the first place: a comparatively measly $6 billion, roughly $250 per person per year. Pretty much the same amount it spends on the private health insurance subsidy, which in the 2016 budget is indexed again at an average 4% per year until 2020.

Those measures are not evidence-based by any stretch of imagination. They stink. Take a bite of that budget cake, and you’ll get sick.

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