The 7 Wonders of health funding

Jennifer Doggett

CHF Workshop August 2014

jdoggett@grapevine.com.au

@JenniferDoggett

‚Our Medicare system is unsustainable. Australia's health spending is heading to a point where it will become unmanageable."

‚If our health and welfare and education systems stay exactly the same, Australia is going to run out of money to pay for them.‛

The Colossal Health Funding Myth (of Rhodes)

Source: NCOA

Ian McAuley, University of Canberra

‚…even if health care expenditure were to rise from 10 per cent of GDP to 20 per cent of GDP between now and 2050, the remaining 80 per cent of GDP in 2050 would still be higher than 90 per cent of GDP in 2013‛

‚In other words, we could double the proportion of our national income that we spend on health care over the next 35 years and still be better off, in economic terms, than we are today. ‚

• PHI rebate ($5.5 billion)

• Poor value procedures ($500 million/26) Elshaug

• Generic pharmaceuticals ($1.3 billion) Duckett

• Hospital funding ($1 billion) Duckett

• MBS/PBS reform ($2-3 billion) Webber

Compare: $7 GP co-pay $700m/4 years

The Low Hanging Fruit (of Babylon)

• PCEHRs

• National Joint Replacement Registry

• Doctors’ performance

• Unnecessary hospital admissions

• Adverse events

• Improved decision making

The Lighthouse of Data (at Alexandria)

The Great Primary Care Pyramid (of Giza)

Investing in primary health care:

• Promotes efficiency

• Increases access

• Strengthens equity

• Focuses on prevention

• Addresses complex health needs

• Reduces unnecessary hospital admission

• Increases consumer satisfaction

We’ve come a long way………but…….

• Practice nurses

• Nurse practitioners

• Physicians’ assistants

• Aboriginal health workers

• Health coaches

• Coordinators of care

• Patient advocates

• Peer educators

The Mausoleum of archaic workforce practices (at Halicarnassus)

Wurli-Wurlinjang Health Service Katherine

The Temple of the AMA (at Ephesus)

• Fee-for-service

• Professional boundaries

• ‘Gatekeepers’ to Medicare

• ‘Secret’ negotiations

• Geographical need

• Performance-based pay

• Caps on fees

The Statue of You, the Consumer (at Olympia)