Category: Health Reform

WORLD CANCER DAY MARKED WITH $375 MILLION

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[vc_row][vc_column][vc_column_text]Health Minister Greg Hunt said: “As we mark World Cancer Day, this investment will allow patients to access Medicare-subsidised lifesaving scans for cancer as well as stroke, heart and other medical conditions.”

  • Tell me more: an MRI is a commonly used medical scan that gives a detailed view of the soft tissues of the body such as muscles, ligaments, brain tissue, discs and blood vessels.

In September last year the Federal Government announced that first ten locations to receive this Medicare support and opened a competitive public application process to determine the location of a further 10 Medicare eligible MRIs.

  • How successful was the application process? The Government received an overwhelming 490 applications. As a result of the demand Minister Hunt announced the Government will invest a further $150 million into the MRI program, taking the total investment to $375 million, over the forward estimates.

KEY INSIGHT: In late 2017, the Government launched the Australian Brain Cancer Mission – a $105 million fund to fight brain cancer.[/vc_column_text][/vc_column][/vc_row]

Health Minister Challenged

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[vc_row][vc_column][vc_column_text]You may have heard that former Liberal-turned independent MP Julia Banks confirmed, this week, her intention to challenge Federal Health Minister Greg Hunt for his Mornington Peninsula electorate of Flinders.

  • Here’s what you mightn’t have heard: Former ABC journalist Tracee Hutchinson has flagged her interest in also challenging Minister Hunt for his seat, as the Labor Party’s candidate. The Age has reported that the ALP is sharpening its focus on “snatching a slew of formerly safe Liberal seats from the Morrison Government” at the next election – including Minister Hunt’s seat.

Minister Hunt’s electoral margin has changed from a high of 11 per cent to its current margin of 7 per cent (on a two-party preferred basis) leading into the 2019 election. While still considered a “safe” seat, left-wing activist group GetUp has been mobilising its supporters in a coordinated effort to unseat Minister Hunt and cause a headache for the current government.

  • Son of a Turnbull! It was also revealed in The Australian newspaper that the son of former prime minister Malcolm Turnbull will be involved in helping Ms Banks with her campaign to unseat Minister Hunt. “I’m involved, I’ll leave it at that,” Alex Turnbull told Nine newspapers.

The challenge to Minister Hunt may see the Morrison Government direct valuable resources and funding to protect the seat, that would have otherwise gone to sandbagging more marginal seats in Victoria and Queensland.

KEY INSIGHTS: The Age reported that the Labor Party had held the seat for just three of the past 80 years (2 years in the 1950’s and 1 year in 1983).[/vc_column_text][/vc_column][/vc_row]

FUNDING CRISIS IN HEALTH

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[vc_row][vc_column][vc_column_text]According to the ABC, President of AMA, Tony Bartone, said while the Government gave almost $50 billion to public hospitals last financial year, it had not been enough to turn the tide against chronically underfunded hospitals.

  • Here’s the gist: The AMA believe the April 2nd, 2019-20 Federal Budget is the ideal opportunity for the Commonwealth Government to unveil the details of its long-term vision for the Australian health system. AMA has stressed the need for this Budget, and any election policies, from both the Government and Opposition, to contain significant, long-term funding commitments to primary health care, led by general practice.

AMA’s pre-budget submission has focused on 9 (nine) areas:

  1. General Practice and Primary Care
  2. Public Hospitals
  3. A Future-proofed Medicare
  4. Medical Care for Older Australians
  5. Private Health
  6. Diagnostic Imaging
  7. Pathology
  8. Health and Medical Research
  9. Mental Health

KEY INSIGHTS: According to the ABC, the latest figures from the Australian Institute of Health and Welfare showed approx. 874,000 patients were added to the public hospital elective surgery waiting list in 2017-18, an increase of 70,000 people since 2013. Only 871,000 were removed from the list, showing hospitals are struggling to keep up with demand for surgery.[/vc_column_text][/vc_column][/vc_row]

PRIVATE HEALTHCARE SIDESTEPS BLAME

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  • Here’s the gist: Industry association, Private Healthcare Australia (PHA), has proposed a number of key reforms it believes will “address the rising costs of healthcare and stem the movement of members to an already overburdened public health system”.
    PHA wants to:

    • cut the number of items listed on the Medicare Benefits Schedule (MBS);
    • permit health insurers to fund specific out-patient services;
    • increase home-care and community-based treatments – removing people from hospitals; and
    • implement international reference pricing and price disclosures, and assessments of new health products to further cut the prices of medical devices in Australia.

As of June 2018, 54% of Australians had private health insurance. But without further reforms, PHA believes this number could plummet to 30% by 2030/35.

  • Why do this? Like any industry association group, PHA’s primary goal is to represent and defend the interests of its member health insurance companies. Ensuring a viable private health insurance sector in Australia is a core goal for PHA, but so too is ensuring their members don’t face adverse financial impacts due to public policy decisions and reform.

PHA CEO, Rachel David, said “wasteful costs in the health system are not unique to the private sector… Often this is down to health system design and regulations, which are not fit-for-purpose”.

KEY INSIGHT: An agreement, struck between the Commonwealth Government and the medical technology industry in 2017, to cut prices on the Prostheses List was a major contributor to last year’s health insurance premium increase being the lowest in 18 years.[/vc_column_text][/vc_column][/vc_row]

CHF SAYS HEALTH RECORD ENSHRINES CHOICE

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  • What’s different now? A change in the law enabling people to permanently delete their My Health Record should strengthen public trust in the system. The Australian Digital Health Agency has confirmed that as of 24 January 2019, the permanent delete function has been activated to allow users to wipe their record and its backups at any time.

CEO of the Consumers Health Forum, Leanne Wells, said she believes “this change will reassure those people who were concerned that their decision to opt-out of the MHR would not prevent their record being accessed by an official at some later time”.

The Consumers Health Forum has strongly supported a secure national health records system for some time, stating their belief in the potential benefits it offers to consumers and health providers.

KEY INSIGHT: Approx. 1 million people have already chosen to opt-out of having a MHR created for them by the government. The deadline for people to opt-out of the MHR is January 31.[/vc_column_text][/vc_column][/vc_row]

Queenslanders get a new (Safe)Mate

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  • Here’s what you need to know: Queensland Minister for Ambulance Services, Steven Miles, launched the SafeMate program, which is a new digital system housing a patient’s medical and personal information that they themselves have entered online. Paramedics will be able to use their operational iPads to tap a patient’s SafeMate card or device and access their information right there on the screen.

The Queensland Government believes this new program will eliminate the time it would normally take a paramedic to ask the patient a range of questions in order to obtain their medical history and other pertinent details.

KEY INSIGHT: Medibank has partnered with SafeMate to pilot the system with customers living with chronic illness in Queensland as part of its chronic disease program, CareComplete.[/vc_column_text][/vc_column][/vc_row]

WE NEED A NATIONAL PRIMARY HEALTHCARE DATA SET

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[vc_row][vc_column][vc_column_text]”The Commonwealth Government and individuals invest considerable sums of money every year in primary healthcare—typically GPs and Aboriginal Medical Services”, says AHHA Chief Executive Alison Verhoeven.

“But, to date, no comprehensive ongoing national data set exists that can give insights into why people use and access primary healthcare services, what occurs in individual consultations, and the outcomes of those services.”

The AHHA has released an Issues Brief today, Call for the establishment of a primary health care national minimum data set, by Maddy Thorpe and Sharon Sweeney (Brisbane South Primary Health Network). The work was undertaken as part of the Jeff Cheverton Memorial Scholarship hosted by the Deeble Institute for Health Policy Research at AHHA.

“What is needed is what is called a National Minimum Dataset (NMDS)—that is, a set of data items, using the same definitions, that every General Practice in every state and territory commits to collecting as a minimum.”

“We think the primary healthcare NMDS needs to include standardised data on:

  • Provider demographics—to help workforce planning
  • Patient demographics
  • Patient health status and health-related behaviours
  • Patient encounters—to understand why people are using GPs and other primary healthcare providers
  • Health outcomes—to evaluate how efficient and effective services are.

“Fortuitously a national mechanism has been recently set up to lead national primary healthcare data development—the National Primary Health Care Data Unit at the independent statutory agency, the Australian Institute of Health and Welfare (AIHW).

“Accordingly, we call on the Australian Government to capitalise on this initiative and back the AIHW to the greatest extent possible to lead the development of a Primary Health Care National Minimum Data Set.

“In so doing the Institute will need to be crystal clear on why the data are being collected and be mindful of the practicalities associated with collection of the data, the need for workforce development and training, the need to address consumer issues, and the need to assure privacy and security of the data.

“There is also a strong need for alignment with other national data sets in health through a national data governance framework”, Ms Verhoeven said.[/vc_column_text][/vc_column][/vc_row]

HEALTH INSURERS SLASH BENEFITS

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[vc_row][vc_column][vc_column_text]Companies including Medibank, NIB, Bupa and other health insurers have been informing their members that the cuts to their benefits are as a result of the Commonwealth Government’s new private health insurance (PHI) reforms set to roll out from 1 April 2019.

News Corp Australia reports Medibank has already emailed their members with mid-range corporate hospital products to warn they will axe benefits for 70 treatments, including some weight loss and fertility treatments.

Representing the PHI industry, Private Healthcare Australia’s CEO, Dr Rachel David, said “One third to one half of health fund members will be receiving letters indicating some change”.

“There will be inclusions as well as exclusions,” Dr David said.

Speaking to News Corp, Australian Medical Association president, Tony Bartone, said “anything which makes private health insurance more expensive or less value for money will continue the exodus from insurance and build up the stress on the public system to the detriment of patients on long-waiting lists”.

Shadow Minister for Health, Catherine King, has promised that Labor, if elected, would establish a Private Health Insurance Inquiry, as well as imposing a 2 percent cap on private health insurance price rises for two years.

With Australians already cancelling or downgrading their health insurance policies, the health policy challenges facing State and Federal governments will likely be front and centre during this year’s election campaigns.[/vc_column_text][/vc_column][/vc_row]

Better Data Demands for Aussies

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[vc_row][vc_column][vc_column_text]A collaboration between the Digital Health Cooperative Research Centre, the Capital Markets CRC and Research Australia, the report – Flying Blind 2:  Australian Researchers and Digital Health – found that better access to health data for researchers could save the economy $3 billion and improve health outcomes for all Australians, over 15 years.

In spite of the abundance of digital data that Australia holds, health and medical researchers are continually forced to assemble data-sets for their research themselves – a process which can take months, if not years. These delays can also drain funding and resources, forcing researchers to abandon linked data studies or seek support from other countries’ data-banks.

The report also told of a University of Melbourne researcher having to pay spend $60,000 of her research funding in order to access Victoria’s registry of births, deaths and marriages. This is made even more absurd when it was discovered that the research was government funded, meaning the funds went from the government to the researchers and back to the government.

Fragmentation of Australian health data also proves immensely troublesome, with various State and Federal laws and regulations creating a maze of bureaucracy researchers must navigate.

The Flying Blind report has proposed a series of recommendations for enhanced medical research in Australia, including the creation of Accredited Release Agencies to build data collections suitable for research, and a single national data-rich access point for researchers. The report also suggests creating publicly accessible protocols for all Australians to see how health data is used and how it is making a difference.[/vc_column_text][/vc_column][/vc_row]

THE FIVE FACTORS OF PRICE – APPLES & ORANGES

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[vc_row][vc_column][vc_column_text]Like any product or service, the price for medical devices will vary from one country to another. For example, the price of a Toyota Sedan in Australia is going to be different from the price for the same Toyota Sedan in the United States or Europe due to a range of factors.

So why is this so for medical devices? Well let’s look at the top five factors influencing price:

  1. DIFFERENT HEALTHCARE SYSTEMS

The differences between healthcare systems from country to country, including different political, policy and economic drivers, has a significant impact on the price of devices. Countries, such the UK and Canada, that appear to have comparable healthcare systems to Australia are, when analysed in greater depth, actually quite different.

Let’s take Canada for example. Based on the OECD health expenditure statics (including PHI as a percentage of total healthcare expenditure and the proportion of population covered by PHI), Canada appears to have a similar healthcare structure to Australia’s. However, unlike in Australia, Canada does not have a private market for prostheses due to the fact it does not allow private health insurers to cover services provided by Canada’s public healthcare system, including hospital procedures that include prostheses.

In contrast, Australia’s healthcare system does allow for this, meaning there is a private and a public market for prostheses.

 PURCHASING ARRANGEMENTS AND MARKET SEGMENTATION DIFFERENCES

Purchasing arrangements for medical devices also vary from country to country. The greater a country’s level of market integration, the greater the capacity they will have to purchase devices at lower prices through improved economies of scale and market volume guarantees for MedTech companies.

For example, in Sweden, there is negligible PHI coverage of the population due to the fact Sweden’s healthcare system is integrated to a high degree with county councils being responsible for both the financing and organisation of healthcare services. Counties also own and operate most of the country’s hospitals. With a healthcare system that is essentially 100% publicly owned and operated, Sweden is able to centrally purchase prostheses through a small number of entities.

  1. DIFFERENCES IN VOLUME, MEDICAL PRACTICE AND PATIENT NEED

Some countries undertake certain procedures using medical devices more frequently than others. For example, according to the OECD Health at a Glance 2013, Germany conducts almost twice as many coronary angioplasty procedures per 100,000 compared to Australia – not to mention Germany’s population is four times that of Australia’s. This means the significantly greater volume of devices associated with coronary angioplasty procedures being required in Germany, compared to here in Australia, results in lower prices of those prostheses for Germans.

  1. DIFFERENCES IN ECONOMIES & GEOGRAPHY

Local economic costs can also add to the price difference for medical devices from country to country. Local costs in Australia such as wages, transportation costs (petrol, airfares), facility costs (coupled with the higher need for warehousing in Australia), currency fluctuation and exchange rates can all influence the price of devices.

Geographical considerations can also influence the price of medical devices. Australia’s isolated location, its low population density and vast land mass have a significant impact on the cost of importing devices and distributing them across Australia.

  1. LEVEL OF INDUSTRY SUPPORT SERVICES

The level of service required from a MedTech company can vary from country to country, and from one prosthesis category to the next. This can impact on the price attributed to a particular prosthesis.

For example, in some European countries, companies do not provide post-procedure follow-up technical support services for certain device types. Funding for these services is allocated to clinicians in the hospital with support from highly trained staff. Therefore, these services are provided with little support from MedTech companies. This is also the case in the Australian public healthcare system.

In contrast, the private markets in Australia, United States and in Japan for example, have a high demand for MedTech companies to provide support services. In Australia, the cost of this support over the life-time of a device is factored into the prosthesis’ benefit.[/vc_column_text][/vc_column][/vc_row]