'If you've got the money, you're universally covered'
While the National Commission of Audit makes much of the predicted increases in health expenditure it makes no recommendations that encourage a greater focus on health promotion and disease prevention, according to Alison Verhoeven, AHHA Chief Executive.
The two key areas are clearly an effective approach to reducing costs and improving the health of the community, she said in a recent statement.
A "bonanza" for private health insurance
"The proposed opportunity for private health insurers to cover basic health services currently covered by Medicare will be a bonanza for the private health insurance industry, and will assist in driving up the value of Medibank Private. But it is unlikely to do anything positive for the average Australian and certainly doesn't align with the Commission's rhetoric about the necessity of universal health coverage," Verhoeven said.
"In particular, the recommendation that higher income earners be required to insure for basic health services 'in place of Medicare', yet continue to pay a Medicare levy, appears to suggest they would pay to support a Medicare that they are not allowed to access and then be hit again with a premium to a private insurer. This proposal must fall into the major structural reform basket – it requires extensive discussion and public debate before any implementation.
"The Abbott government did not take this proposal to the electorate, and clearly has no electoral mandate for such radical change to the health system.
Universal health coverage
"As widely touted in the media over recent months, co-payments are recommended, albeit at a much greater cost of $15 for general patients and $5 for concession card holders, with a recommendation that the states implement co-payments in emergency departments for people triaged as categories 4 and 5.
"These triage categories relate to urgency, not to appropriateness of treatment in an emergency department.
"A country that requires the injured and ill to present their credit card for payment in order to receive treatment in an emergency department is not a country that has universal health coverage.
"With co-payments in both general practice and emergency departments, we are likely to see many Australians, particularly those with low incomes and with chronic disease, simply not seeking medical care until they are in the higher triage categories and requiring very high cost emergency care.
"The best value-for-money health systems internationally have large public components: Australians are already amongst the highest co-payers across the OECD.
"Accepting the co-payment recommendations would be a very negative move by the Abbott government."