Nothing beats a good conspiracy theory. Except one that turns out to be true. Here are a few candidates from last night’s budget
Nothing beats a good conspiracy theory. Except conspiracy theories that turn out to be true. Here are a few candidates from last night’s budget
Almost everyone will have the top line on the key health-budget items by now:
- The phased lift of the Medicare rebate freeze over three years
- A Medicare guarantee levy to secure Medicare into the future
- $375 million for the opt-out MyHR roll-out
- Virtually nothing on After Hours items in terms of a mooted government crackdown – did someone get to them?
- Health Care Homes will be delayed a bit and funding still isn’t clear, or is it?
- The GP pathology rents issue remains up in the air
- Pharmacists get $600m for “expansion of community pharmacy programs”.
But what lies beneath? Here are a few not so half-baked conspiracy theories that underpin what we guess the government might be thinking is a bunch of measures that are suitably non controversial (an overriding theme running through the budget).
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The DoH and the GP corporates are treading a fine line on Health Care Homes
Health Care Homes is a done deal behind the scenes, and the government is in bed with the two large corporate providers, who appear to be the major beneficiaries of a new funding round to run the first trials. Apparently Primary and IPN are getting up to 50% of the initial funding for these trials. This is despite the two groups representing only a small percentage of all GP practices. Both IPN and Primary have strategies that strangely put major emphasis on a “medical homes”-type future. This isn’t so surprising given Malcolm Parmenter, who ran IPN for many years and is now set to run Primary, was a member of the Federal Health Ministers Primary Healthcare Advisory group into chronic and complex illnesses. He’s been front and centre in government discussions and planning around the introduction of the concept. Is this all such a bad thing? Not so much, but is it fair that these two corporates get pole position early on given there are a lot of PHNs out there doing the same or better work on moving towards this type of model? As TMR said in a recent article on Parmenter, his appointment to Primary after a stint at IPN was likely going to see pressure on the government to shift their funding mix towards Health Homes. Looks like it has already occurred.
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The MyHR is officially off the rails again
Here are a few things you might want to think about as a GP now that this budget has given the DoH, the Australian Digital Health Agency and the MyHR a big fat tick with $375 million to roll out an ‘opt-out’ system across the nation.
- The Siggins Miller report on the “opt-out” trials came out only a week ago, but it must have laid the groundwork for a green light on the MyHR funding.
- Every GP needs at least to read the executive summary of the report because it’s horrifying. CLICK HERE if you’re interested.
- Apparently most “individuals” interviewed for this report believed that making the MyHR compulsory was a good idea. Similarly, the report found that making patients “opt out” was a great idea. This is sort of like saying, okay, patients don’t buy it and neither do doctors really, so we’ll just opt all the patients in and then we’ll force the doctors to use it. Neither the DoH or the ADHA have come out and said they support this recommendation. But watch this space. You don’t give out $375 million to this project lightly. We already spend just over $300 million a year on the ADHA alone. I think that puts the MyHR, if you go back to its inauspicious start, at a cost approaching $1.5 billion – with another $400 million or so now committed each year for the next three years. What have we got to show for that so far? In terms of tangible, coal-face efficiencies or savings, our detailed estimate is zero. Read TMR’s report on the topic next week. This $375 million has huge potential downstream implications for GPs, especially if they, as we suspect, wouldn’t be overly welcoming of more ‘red tape’. The ‘mother of all red tape’ we suspect.. And given how our technology and software firms are moving from the ground up on electronic medical records without the help of ADHA and with little or no reference to the grand MyHR, potentially a massive waste of our money.
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The $600 million for pharmacy programs is going to eat directly into GP business
There aren’t any details on what the $600 million is for yet, but the last few months of pharmacy community programs don’t engender a lot of faith that this money won’t be used to target low-hanging fruit that pharmacists might be able to scoop up from patients for stuff like vaccinations, diabetes testing, stroke checks and so on. I think it’s safe to assume this conspiracy has legs. The worst part of it is that the big discount chains will take this money and run for the hills. They will systematise their programs and do it well. Pharmacists are far more business-minded than GPs and they’re getting increasingly organised. Should $600 million really be used to subsidise the likes of Chem Mart and Chemist Warehouse to take the work of GPs? We predict an escalation in this age-old problem in the coming year or two.
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The publisher of Medical Republic needs to eat at least a third of Australian Doctor?
Is the Medicare freeze lifted or not? If you read last night’s Australian Doctor, you’d think nothing happened. “The widespread rumours of the end of the rebate freeze this year all proved false”, states deputy editor Paul Smith. We, as one of the parties spreading the rumour, beg to differ. Mainly because we don’t relish eating a newspaper on Youtube. But also because clearly there is wriggle room given that the lift is commencing on July 1. We checked the major newspapers and polled our usual GP friends and the prevailing view is that the freeze has been lifted –sort of. In any case, we’ve decided to eat a third of Australian Doctor on the strength of last night’s announcement. A YouTube clip will follow.
exec summary of Siggins Miller Report
