Friday, August 29, 2014

Another Example Of Definite Success In The Use Of EHR. Basic Medication Management Really Making A Difference.

This appeared a little while ago:

Meaningful use medication measures reduce ADEs by 35%

Author Name Jennifer Bresnick   |   Date August 18, 2014   |  
Hospitals that adopt all five of the core medication management measures inherent in meaningful use experience fewer adverse drug events (ADEs), says a new study funded by the Agency for Healthcare Research and Quality, reducing the number of patient safety errors by more than one third.  The use of computerized provider order entry (CPOE) technology, decision support systems that check for drug and allergy interactions, and health information exchange that encourages the sharing of medication lists and allergy information with other providers were key features associated with the significant improvement in the rate of ADEs, explain John White, MD and Judy Murphy, RN, Director of the Office of Clinical Quality and Safety and Chief Nursing Officer at the ONC.
“When the Health Information Technology for Economic and Digital Health (HITECH) Act was passed in 2009 as part of the American Recovery and Reinvestment Act, hopes were high that widespread use of electronic health records (EHRs) would reduce the rate of adverse drug events in hospitals,” Murphy and White write in a blog post for HealthIT Buzz.  “Advocates believed incentives that encouraged hospitals and physicians to adopt EHRs would not only encourage faster adoption, but help to improve patient health.”
The results of this study, conducted in Florida, seem to give EHR advocates something to hang their hats on. 
More here:
All one can say is that this is a really pleasing outcome for those whose instinct is that this should work but have found evidence hard to find.
Good news!
David.

Have We Finally Confirmed That EHRs Do Actually Make A Positive Difference?

This appeared a little while ago.

Ending debate on EMR effectiveness?

Posted on Jul 28, 2014
By Jack Beaudoin, Special Contributor
Health Data Miner
For at least the last decade, the health IT field has seen a scholarly back-and-forth on the effectiveness of electronic medical records. As soon as one study is published that finds technology has little impact on patient outcomes, another emerges that seems to show just the opposite.
These studies are frequently limited by the size of the data set or scope of the analysis. Take, for example, a June 2014 JAMA article that found meaningful users of electronic health records failed to deliver improved care for five chronic diseases. According to one news report, the new study cast “doubt on whether the tens of billions of dollars invested to encourage EHR adoption among healthcare providers is really enhancing patient outcomes.”
The analysis, it turns out, included just three months of data from 818 physicians (about .1 percent of the 834,769 active physicians practicing in the United States) across seven clinical quality measures. By the way, all those physicians were employed by a single hospital or its affiliated practices.
And the variable being studied? It distinguished physicians who qualified for MU1 against those who did not. Considering the low bar set by MU1, the distinction might not signify all that much.
So what if, instead, you had a data set that drew from ALL the hospitals in the United States. And what if that data ranked healthcare IT adoption not on MU1, but on a multi-tiered scale, from no technology use to completely paperless systems? And what if the outcomes studies included 19 patient cohorts in five service lines, from heart failure and pneumonia to sepsis and stroke, with findings adjusted for risk and other differences in patient health status?
That study might be a little more authoritative when it comes to evaluating "whether the tens of billions of dollars invested to encourage EHR adoption among healthcare providers is really enhancing patient outcomes."
And the good news is, that study now exists and it has found that EMRs do have a measurable, positive impact on care as measured by clinical outcomes of risk-adjusted mortality rates.  
…..
One example is mortality from heart attacks. The mortality rate at high EMRAM facilities (9 percent) is half that of heart attack mortality at low EMRAM facilities (18 percent).
More here:
The details of this study will need to be closely followed - especially as it is a study with evidence accumulated from real world use of EHRs. I look forward to further publications on this study to confirm validity.
David.

Thursday, August 28, 2014

Review Of The Ongoing Post - Budget Controversy 28th August 2014. It Just Rolls On!

Budget Night was on Tuesday 13th May, 2014 and the fuss has still not settled by a long shot.
It is amazing how the discussion on the GP Co-Payment just runs and runs. Lots more this week.
Here are some of the more interesting articles I have spotted this thirteenth week since it was released.
This week we see Parliament back and we will all need to keep a close eye on what happens, especially around the health sector.

General.

Jay Weatherill calls on Senate to help crush funding cuts

Annabel Hepworth

THE only Labor premier plans to meet powerful crossbenchers to urge them to support a campaign against long-term federal health and education funding cuts that are central pillars of the federal budget.
After National Commission of Audit chairman Tony Shepherd urged the Coalition and crossbench senators to reach a compromise on the budget at the weekend, South Australian ­Premier Jay Weatherill said the measures at the centre of this concern were “marginal” compared with the long-term hospital and schools funding cuts outlined in the May budget.
He will seek a meeting with Clive Palmer when he travels to Canberra next week to talk to crossbenchers and other senators about the health and education changes.
-----
19 August 2014, 6.22am AEST

Forgot the co-payment… Seven tips for an affordable, quality health system

Author : Stephen Duckett Director, Health Program at Grattan Institute

Health policy debate over the past few months has been held to a $7 ransom. It’s as if the Medicare co-payment has been deified as the solution to all the health system’s ills.
Of course, the $7 co-payment was not the only policy initiative in the budget: there were also proposals to shift other costs to consumers – by increasing the pharmaceutical benefits scheme co-payment – or onto states, by reducing Commonwealth grants. Shifting costs to consumers has got a bad press, and the proposals to do so may not pass the Senate.
But there are other options. Here are seven tips policymakers can follow for better health reform.
-----

Government Ministers edging closer to budget compromises

  • August 18, 2014 2:59PM
  • Jennifer Rajca National Political Reporter
  • News Corp Australia Network
ABBOTT government ministers are edging closer to offering budget compromises after admitting “adjustments” will be needed to get the green light in the Senate.
Senior Coalition frontbenchers are harking back to the GST negotiations, arguing former prime minister John Howard had to make concessions to appease the Senate he had.
Health Minister Peter Dutton was this morning optimistic he could secure a GP co-payment ahead of its planned start date of July 1 next year.
 “I’m hopeful that the government can do a deal in relation to the GP co-payment because there’s certainly a lot of optimism from the Senators,” he told ABC Radio.
-----

Christine Milne re-enters fray at last

Date August 19, 2014

James Massola

Political correspondent

Christine Milne's decision to write to Labor, the PUP and other crossbenchers and ask for budget meetings is not before time.
The Greens have been sitting on the sidelines since December, when Senator Milne cut a deal with Treasurer Joe Hockey to abolish, rather than raise, the debt ceiling.
The environmental party holds several press conferences a day that doubtless delight its base but which make demands to which the Abbott government, nor the Labor opposition, would mostly never agree.
They have barely been sighted since the debt ceiling deal was done, moving further and further from mainstream political debate.
-----

Joe Hockey wobbly on Budget details but apologises for insensitivity

Date August 19, 2014 - 11:43AM

Peter Martin

Economics Editor, The Age

Joe Hockey has apologised for being insensitive. He hasn’t apologised for having an at times shaky grasp on the budget he is meant to be selling.
Hockey has approached his budget radio interviews as if they were debates – high school debates. His biography says he repeatedly won high school debates, taking out his school’s public speaking prize in almost every year he was eligible to compete.
I reckon the real reason the budget sales job has been faltering [is] because there’s a suspicion the Treasurer is not being open with us. 
But debates are the not the same as salesmanship. They are what experimental economists call ‘'one-off’' rather than ‘'repeated'’ games.
-----

Hockey needs to find reverse gear for budget dead ends

Jennifer Hewett
Joe Hockey is back on the bumpy budget road again, having careered so spectacularly off course. But his humiliating smash over fuel tax indexation is just one of the sillier examples of the government’s budget dead ends. Reversing out of them will be even more difficult than getting Hockey to realise his version of political salesmanship is crashing for good reason.
Not that much of this is about political “fairness” – in the context of the currently most overused word in politics. Consider Labor’s confected outrage on the terrible burden of an extra 1¢ litre on fuel – or a whole 40¢ a week for the average household.
Labor only opposed this increase as a matter of principle because it believed Christine Milne’s word that the Greens would back indexation as some form of environmental measure. (Discouraging petrol use  . . . Get it? Silly old you!)
-----

Clive Palmer and Jacqui Lambie harden opposition to budget measures

Joe Hockey and other ministers use last days of winter break to negotiate GP co-payment and university deregulation changes
Daniel Hurst, political correspondent
Clive Palmer and one of his influential senators appear to have hardened their opposition to the Medicare co-payment and university fee deregulation, as the government prepares to put other contentious budget measures to the parliament.
The Tasmanian Palmer United party (PUP) senator Jacqui Lambie questioned why the government believed it was confident of reaching a deal, saying she would “certainly not” support “putting a death tax on people when it comes to the GP co-payment”.
Lambie also offered advice for the education minister, Christopher Pyne, during an interview with the ABC on Tuesday: “He can go and grab a box of Kleenex because all his education reforms are going down the gurgler – it’s as simple as that.”
Any changes opposed by Labor and the Greens cannot pass the Senate without PUP support.
-----

Health policies hit poor: Labor

By Ashleigh Milton

Aug. 19, 2014, 11:30 p.m.
LABOR'S Shadow Health Minister Catherine King and Federal Werriwa MP Laurie Ferguson hosted a forum for Lurnea residents last week, to discuss affordable health under the current government.
The pair highlighted their objections to the Abbott Government's budget proposals, including the $7 co-payment to be paid by all when visiting a doctor.
Mr Ferguson said the proposed budget had received a lot of community interest, specially in areas within south-west Sydney.
"We chose to have the forum in Lurnea, because of its very high proportion of public housing and from the large number of people contacting us," he said.
-----

Cutting waste a priority

20 August, 2014 Christie Moffatt
Cutting wasteful spending in the health system should be the first priority of the Government, instead of a GP and medicines co-payment, according to a senior health economist.
In an article published in The Conversation, Dr Stephen Duckett of the Grattan Institute said that health policy debate over the past few months had been “held to a $7 ransom”, and cutting wasteful spending “should be the first target” instead of shifting costs to consumers.
Dr Duckett listed seven tips for policymakers to follow to achieve better health reform, including the introduction of activity-based funding, improving workforce utilisation and reducing the “excessive prices” the Government pays for pharmaceuticals.
-----

Medical research fund will ‘improve balance sheet’

Joanna Heath
The $20 billion medical research future fund can be counted in the budget as a savings measure to offset debt, finance minister Mathias Cormann has claimed, with only net earnings being distributed for medical research.
The fund, to be resourced from the $7 GP co-payment, will be built up to a $20 billion cap by 2020. Previously the capital-protected future fund had been thought to be effectively “off-budget” until that date, after which savings from the health portfolio would be ploughed back into Medicare.
But Senator Cormann said it was a positive for the budget from day one, as it would help to reduce debt.
-----

Mathias Cormann stokes debt fears in attempt to transform budget debate

Date August 20, 2014 - 6:52AM

James Massola

Political correspondent

Finance Minister Mathias Cormann has moved to reset the budget debate, calling for a fiscal "reality check" about the state of the nation's economy and warning of a serious corrective action in future to protect Australians' living standards.
In an address to the Sydney Institute that builds on Treasurer Joe Hockey's warning of "emergency" action and a Queensland-style austerity budget if structural reforms such as the $7 GP fee, higher education and welfare changes are not passed, Senator Cormann said the budget debate should not be a "spectator sport" and that "this is no game".
The Finance Minister pushed back against media "noise" about the budget timetable, pointing out that crucial appropriation bills had passed, as had a $7.6 billion, four-year cut to foreign aid and the tax levy on high-income earners.
-----

Senator confused by backflip on budget talk

Phillip Coorey Chief Political Correspondent
The federal government’s shift in its budget rhetoric has confused the very senators it has been lobbying to pass more than $45 billion in stalled revenue and savings measures.
With Parliament to resume next week, the government has abandoned the language of crisis, and now says there is no rush.
“A few weeks ago we were led to believe the budget was on life support, now we find out it’s on a banana lounge in Hayman Island,’’ said South Australian Senator Nick Xenophon.
He was responding after the government furnished figures showing that only 1 per cent, or $20 billion, of the $1.9 trillion in expenses over the next four years is being held up.
-----

Budget sales job ‘unfortunate’, Treasury says

Jacob Greber Economics correspondent
Treasury secretary Martin Parkinson has conceded the federal government’s marooned budget strategy should have canvassed tax reform to counter complaints over its claimed unfairness.
Dr Parkinson, who will leave the job in December, said the government should have spent more time linking its first budget to broader changes likely to be outlined in a white paper on tax, which could cut tax breaks on superannuation for the wealthy.
“In hindsight, having seen how this has gone, it’s unfortunate that we didn’t spend more time talking about tax reform and spending reform and saying [the budget] is in a sense a first part of it,” he said.
-----

Government to blame for health policy mess

Comment
Laura Tingle Political editor
It was Tony Abbott who personally asked the Australian Medical Association to come up with an alternative proposal to the budget’s $7 Medicare co-payment.
It should hardly be surprising that the doctor’s association has responded with a proposal that would put more money in GP’s pockets.
The doctors’ plan, therefore, has perhaps even fewer friends than Joe Hockey’s budget.
But it is too easy to simply dismiss the AMA’s proposal as a “cash grab” as Health Minister Peter Dutton did on Thursday afternoon, even as AMA president Brian Owler was still on his feet outlining the policy.
-----

Budget retreat a signal of defeat

The Australian Financial Review
In the context of Australia’s budget problems, the Abbott government’s defensive new talking point that almost 99 per cent of the money bills in its budget have been passed is beside the point. No one had ever claimed that Australia was going to go bust next week, or indeed that Parliament would suddenly give up spending money.
What has stumbled before the Senate are the structural reforms that rein in still-rising spending, which close the entrenched gap between revenue and outlays and which wind back expectations of what government can do in the future. Only half of the four-year structural savings in Joe Hockey’s budget have been passed. If resource boom spending habits do not correct now, it will have to be done more painfully in the future – and it is the less well-off who will suffer the most if that happens. As Reserve Bank governor Glenn Stevens told the House of Representatives standing committee on economics this week: “I think we would get away with that for a while, but then we will find that the day will come and it will be much harder . . . that is when you do get really draconian measures almost forced upon you.”
-----

Medical research fund put off limits

David Crowe Stefanie Balogh

Bad ideas holding back the budget

PLANS for a $20 billion medical research fund are being locked into the Abbott government’s budget strategy despite growing concerns about the idea, as ministers insist on keeping the scheme, as well as a controversial GP co-payment to pay for it.
Fighting off calls to scrap the idea, Finance Minister Mathias Cormann is arguing for the fund as a vital structural reform that will cut net debt and pour money into long-term research without deepening the deficit.
“That fund will not be spent but invested, generating a regular return,” Senator Cormann writes in The Australian today. “That capital fund becomes an asset on the government’s balance sheet, reducing government net debt by $20bn once fully accumulated.”
-----

Budget office says health not a long-term spending issue

Date August 23, 2014 - 9:46AM

Peter Martin, James Massola

The independent Parliamentary Budget Office has called into question claims health spending is spiralling out of control, noting government spending is projected to grow in line with the economy over the next decade and that health will account for only a small amount to that growth.
The PBO projected government spending would climb from $384 billion to $682 billion over the coming decade and warned that "elevated community expectations are likely to put ongoing pressure on governments to increase discretionary spending on major programs over the medium term".
The PBO report also found spending on medical benefits accounts for just 1.8 per cent of the projected growth in government spending over the next decade, while spending on public hospitals accounts for just 1.4 per cent.
-----

GPs are valuable enough to pay for

David Leyonhjelm
Popular thinking about the role of government is all over the place. Nothing exemplifies the muddle more than the widespread support for massively increased government spending on medical research, and the noisy opposition to the proposed reduction in Medicare rebates to doctors.
Everyone supports medical research. What’s not to love? But that fact is the very reason governments shouldn’t fund it. People give freely and generously to medical research charities every day. They direct their money to the fields of research they care most about. They give when they know where the money is going. And they give to organisations that they trust.
-----

Medicare GP Trials.

Medibank scheme may lead to US-style 'disaster', warns Australian Medical Association

Date August 21, 2014 - 6:41AM

Harriet Alexander

Health reporter

Private health insurance customers are being given preferential treatment at certain GP clinics in a trial that poses a threat to univeral healthcare, a Senate inquiry has heard.
Medibank is piloting a scheme in Queensland that gives its customers same-day appointments, after hours service and free consultations at 26 general practices run by the Independent Practitioner Network, with plans to roll it out nationally by November.
The insurance company pays the GP clinics an administration fee and they bulk bill their patients, but it does not subsidise individual doctors, which is prohibited under the Private Health Insurance Act.
-----

Private funds follow Medibank into GPs clinics

Date August 22, 2014 - 12:00AM

Harriet Alexander

Health reporter

A controversial scheme that gives Medibank customers preferential access to GPs' clinics is part of a broader move by private insurers to extend their reach into primary care.
NIB is about to pilot a system that compensates general practitioners for certain activities, including disease management, overseeing home-based care and arranging advanced-care plans.
NIB chief executive Mark Fitzgibbon said the aim was to lower health costs by preventing chronic disease.
-----

Medibank under fire over GP pilot

21 August, 2014 Antonio Bradley
The top brass at Medibank Private have faced a barrage of criticism at a Senate inquiry for paying GP practices to bulk-bill its customers.
The private health insurer launched a controversial pilot trial in January in conjunction with six Brisbane IPN clinics, offering free and prioritised GP consults for its members.
The pilot, which has been accused of side-stepping a law that bans insurers from funding GP consults, has since spread to 26 practices across Queensland, where 145 doctors have completed more than 20,000 consultations.
-----

Dentists warn GPs against letting insurers into primary health

21st Aug 2014
THE nation’s dentists have warned that GPs would regret letting private health insurers move into primary healthcare, comparing the result in their experience to a rigged horse race.
Dentists’ experience of working with the private health insurance industry points to bad outcomes for patients and practitioners and a model of care where profit is the sole motivator, the Australian Dental Association (ADA) says. 
ADA CEO Robert Boyd-Boland told a senate inquiry on Wednesday that private insurers compromised the care of patients by interfering with established patient-practitioner relationships and directing fund members to preferred-provider networks.
-----

GP Co-Payment.

Health Minister hopes negotiations don't kill GP co-payment

Adam Davies | 18th Aug 2014 3:31 PM
FEDERAL Health Minister Peter Dutton said he hoped the controversial GP co-payment fee did not fall victim in the latest round of negotiations between the government and crossbenchers.
The negotiations are scheduled to be held again this week in the government's latest bid to get the budget through the upper house.
The controversial $7 co-payment fee was one of the most contentious items announced in this year's budget.
-----

Dutton hopeful on GP co-payment

  • AAP
  • 18 Aug, 7:53 AM
Federal Health Minister Peter Dutton says the government still has a long way to go to get its budget measures through, but is hopeful a proposed GP visit co-payment won't fall victim to negotiations with crossbenchers.
Discussions about the co-payment with the Australian Medical Association and other key medical bodies had focused on "who's in and who's out" rather than on the proposed $7 fee, he said.
Mr Dutton said $7 was quite modest when compared with countries like New Zealand and discussions with senators over the budget measure had so far been productive and optimistic.
"I'm hopeful the government can do a deal in relation to the GP co-payment," he told ABC radio on Monday.
-----

AMA to reveal secret $7 GP fee compromise deal if government can’t get a resolution

  • August 20, 2014 12:00AM
  • Sue Dunlevy National Health Reporter
  •  News Corp Australia Network
A COMPROMISE deal on the controversial $7 GP fee will be made public later this week as doctors pressure the Health Minister to resolve the issue.
It comes as the welfare lobby says it will not agree to any compromise on the fee and consumers demand a seat at the negotiating table.
“Exemptions don’t go far enough, they don’t recognise that many working families will still face cost barriers if they have a chronic illness,” ACOSS Acting Deputy CEO Rebecca Vassarotti.
“It is unacceptable that the minister is restricting his negotiations to the powerful doctors’ union, whose members stand to benefit most from any deal, while those who will have to pay, consumers and taxpayers, are kept in the dark,” said chief executive of the CHF Adam Stankevicius.
-----

GP fee will pass: Tony Abbott stands firm on contentious budget measure

Date August 20, 2014 - 10:35AM

Lisa Cox

National political reporter

Prime Minister Tony Abbott is standing firm on introducing a fee for visits to the doctor, saying that he expects the measure will pass the parliament.
Mr Abbott has also refused to canvas what ground the government might be prepared to give on the $7 GP fee policy as it continues its efforts to woo crossbench senators for their support for a suite of unpopular budget measures.
The Prime Minister told Brisbane radio on Wednesday that a GP co-payment was one measure that he believed the government would win approval for because it "makes sense".
-----

GP co-payment: AMA's plan must not be self-serving, expert warns

PM’s former adviser says counter-proposal must be assessed to ensure if benefits all Australians, not just medical association
Daniel Hurst, political correspondent
The health consultant who kickstarted the debate over a Medicare co-payment late last year has called for scrutiny of the Australian Medical Association (AMA) counter-proposal to ensure it is “not self-serving”.
The AMA, which has led criticism of the government’s decision in the budget to introduce a $7 co-payment for GP visits, plans to release its alternative proposal to the media on Thursday.
It is understood the proposal includes blanket exemptions for pensioners, children under 16, and people with chronic illnesses. The AMA model would not include the government’s proposal to cut by $5 the Medicare Benefits Schedule (MBS) rebates received by practices – a key plank of the budget plan to raise money for a medical research future fund. The amount patients would pay may also be lower in the AMA model.
-----

Tony Abbott signals compromise on $7 co-payment as crossbench takes Treasurer to task

Date August 21, 2014

James Massola, Lisa Cox

The federal government has been taken to task by key crossbench senators for a confused budget sales job, as Prime Minister Tony Abbott signalled a compromise deal on the $7 GP co-payment could be in the offing to ease the burden on pensioners.
The Prime Minister's comments came as the government shifted its budget narrative away from one of ''crisis'' and as it released modelling that showed only about $20 billion of $19 trillion of expenses over four years contained in the budget had not been passed.
Treasurer Joe Hockey stressed that most of the day-to-day budget had passed the Parliament. Finance Minister Mathias Cormann said that budget negotiations would be a ''marathon, not a sprint'' and called for a ''reality check''.
-----

AMA wants $7 co-payment cut to $6.15

Joanna Heath and Jessica Gardner
Health Minister Peter Dutton all but ruled out a compromise with the Australian Medical Association on reducing a planned $7 charge for doctors’ consultations, sending negotiations over what may be the most controversial budget measure back to square one.
In a counter-attack to the AMA’s proposal, which asks for concession-card holders and children under 16 to be exempted, the government released modelling which showed it would deliver GPs an extra $100 million but wipe out the majority of planned ­savings.
“It’s important for Australians to understand the proposal put forward by the AMA eliminates about 97 per cent of the savings proposed by the government in the budget,” Mr Dutton said. “There is obviously a windfall that goes to doctors out of the AMA ­proposal.”
-----

GP co-payment a 'windfall': Dutton

  • AAP
  • August 21, 2014 6:15PM
Children and pensioners would have their GP co-payment paid by taxpayers under a proposal floated by doctors.
But the Abbott government has dismissed the idea as a $580 million windfall for GPs, saying it would erode 97 per cent of planned budget savings.
The Australian Medical Association (AMA) on Thursday released an alternative model to the government's $7 co-payment.
It proposes a minimum co-payment of $6.15 but, unlike the government's plan, none of it will go to a medical research future fund.
-----

GP fee: Tony Abbott rejects AMA proposal to exempt pensioners

Date August 22, 2014 - 6:59AM

Dan Harrison, Kate Hagan

Prime Minister Tony Abbott has rejected a proposal by doctors to exempt pensioners from a $7 GP fee, but has left open the possibility of negotiating over whether children's visits were charged.
Speaking to reporters in Melbourne on Thursday, Mr Abbott said pensioners already paid about $7 for prescriptions subsidised by the government under the Pharmaceutical Benefits Scheme.
"I don't think it's unreasonable for a comparable amount to be paid for visits to the GP," he said.
-----

GP visits down on $7 co-payment fears

20 August, 2014 AAP
Confusion about the introduction of a $7 co-payment for GP visits appears to be putting some people off going to the doctor and others from having pathology tests.
Australia's largest medical centres and pathology services operator, Sonic Healthcare, has noticed a drop in the number of diagnostic tests it has been asked to carry out since the controversial co-payment was announced in the May budget.
The Federal Government is in talks about possible concessions for the planned co-payment, which it wants to introduce in July 2015, but faces stiff opposition in the Senate.
-----

Abbott joins Greens, ALP, PUP in rejecting AMA's co-payment

APN Newsdesk | 22nd Aug 2014 2:46 PM
THE Australian Medical Association's answer to the contentious GP co-payment scheme the Government is trying to get through the Senate, may not be much of an alternative after all.
Yesterday, Prime Minister Tony Abbott joined Labor, the Greens and the Palmer United Party in rejecting the plan which would see pensioners, children and the disadvantaged excluded from the payment.
Mr Abbott is of the opinion that since pensioners already made a co-payment for prescriptions, it was not "unreasonable for a comparable amount to be paid for visits to the GP".
-----

Patients to pay up to $300 more for prescription medication over four years if Abbott Government legislation passes

  • SAMANTHA MAIDEN
  • The Sunday Telegraph
  • August 23, 2014 10:59PM
PARENTS seeing a GP to vaccinate their children will be ­exempt from the planned $7 co-payment under a compromise option designed to secure crossbench support.
As new figures reveal price hikes for prescription drugs and the GP co-payment will hit every Australian with ­increased health costs of up to $300 over the next four years, a carve-out plan for children is being considered.
The proposal would reduce the costs for families of the $7 co-payment — and the savings for government — but would ­encourage vaccination and may help secure crossbench support in the Senate.
-----

It’s about the wellbeing of all of us, not just doctors: concerns re AMA copayment deal

Marie McInerney | Aug 21, 2014 8:43AM | EMAIL | PRINT
(This post has been updated to link to include the AMA’s co-payment proposal and some Twitter reaction)
“When it comes to health costs, no decision about us should be taken without us.”
The national peak community and health consumer groups – the Australian Council of Social Service (ACOSS), Consumers Health Forum, and Public Health Association of Australia, have called on the Parliament to reject any deal struck by the Health Minister and the Australian Medical Association (AMA) on the proposed Medicare co-payment.
The “AMA model“, finally released today after weeks of talks with the Federal Government by AMA President Brian Owler, was hailed on its website (see pic below) as serving to “protect vulnerable people” but widely seen by public health advocates as protecting doctors’ own business interests and further eroding the principle and practice of universal health care in this country. Here’s the transcript of the media conference announcing the proposal.
-----

GP fee a barrier to necessary treatment, Senate committee warns

Date August 24, 2014 - 12:15AM

Kate Hagan, Matthew Knott

A $7 GP fee would make the health system less sustainable by preventing patients from seeking treatment for chronic illnesses, requiring more expensive hospital care in the future, a Senate committee has found.
The Labor and Greens-dominated committee recommended the government abandon plans for the $7 fee and a $5 hike in prescription medicines, in a report into out-of-pocket costs in Australian healthcare.
The recommendation comes ahead of a scheduled Senate debate this week on the government's pharmaceutical benefits bill, which would increase co-payments on subsidised medicines by $5 for general patients (to $42.70) and by 80¢ for concession card holders (to $6.90).
-----

NFPs Reject Secret Co-Payment Talks

Posted: Thursday, August 21, 2014 - 09:05
National peak community and health consumer groups claim they have been left out of what amounts to ‘secret talks’ on the Federal Government’s proposed Medicare co-payment.
The Not for Profit groups have called on the Parliament to reject any deal struck by the Health Minister and the doctors union, declaring that a Medicare co-payment posed an unwarranted burden on the chronically ill and the most vulnerable in our community.
“Health and illness concerns us all and Health Minister Peter Dutton should be listening to voices in the community and groups representing all users of the health system,” CEO of the Australian Council of Social Service, Dr Cassandra Goldie said.
It’s understood that the Australian Medical Association has proposed an alternative co-payment arrangement to the Federal Government including exemptions for some patients, which the Minister for Health is having costed by his Department.
-----

AMA backs reduced GP co-payment

Medical association also calls for blanket exemptions for concession card holders and children under 16
Daniel Hurst, political correspondent
The Australian Medical Association (AMA) has called on the government to cut the proposed $7 co-payment for GP visits to $6.15, with blanket exemptions for concession card holders and patients under 16.
The government’s proposal to cut $5 from Medicare Benefits Schedule (MBS) rebates received by GPs would also be axed under the AMA’s plan, which was released on Thursday amid considerable uncertainty over the fate of the contentious budget measure.
The AMA’s solution, if adopted, would threaten the $3.5bn that the government had budgeted over five years for the medical research future fund.
-----

Co-payment comparison

Bulk billing without restrictions has been a feature of the Australian health system since the introduction of Medicare in 1984. It is particularly important in general practice, as it means any Australian can see a primary care doctor without having to pay out-of-pocket costs. In 2012/13, 81% of GP consultations were bulk billed.
The 2014 budget introduced the notion of a co-payment to apply to the first ten GP visits. This has been one of the more unpopular budget measures, largely on the basis of the effect on the disadvantaged. The AMA today released its awaited alternative.
-----

GP fee a barrier to necessary treatment, Senate committee warns

Date August 24, 2014 - 12:15AM

Kate Hagan, Matthew Knott

A $7 GP fee would make the health system less sustainable by preventing patients from seeking treatment for chronic illnesses, requiring more expensive hospital care in the future, a Senate committee has found.
The Labor and Greens-dominated committee recommended the government abandon plans for the $7 fee and a $5 hike in prescription medicines, in a report into out-of-pocket costs in Australian healthcare.
The recommendation comes ahead of a scheduled Senate debate this week on the government's pharmaceutical benefits bill, which would increase co-payments on subsidised medicines by $5 for general patients (to $42.70) and by 80¢ for concession card holders (to $6.90).
-----

Hospital Impacts.

$20m health windfall

By GEORGIE BURGESS

Aug. 21, 2014, 10:24 p.m.
TASMANIA’S health system will get $20 million in extra Commonwealth funding, filling some of the black hole left by May’s tough federal budget.
Federal Health Minister Peter Dutton will visit Launceston today to offer up the extra injection of funds, following constructive talks with state Health Minister Michael Ferguson.
Mr Ferguson and Mr Dutton will appear together at the Launceston General Hospital to make the announcement.
-----

Pharmacy, PBS and Medicine Issues.

PBS cost debate continues

18 August, 2014 Christie Moffat
Debate continues to rage over reducing the cost of the PBS, with health economists claiming that Australia should seek to “bench-mark” the cost of drugs to international prices.
In a submission to the ongoing Senate inquiry into Out-of-pocket costs in Australian healthcare, the Grattan Institute argued that raising out-of-pocket expenses for consumers was “not a good way for the Government to save money” and instead recommended benchmarking medicine prices against other countries.
However, a leading Pharmacy Guild official has dismissed the proposal as "another flawed analysis".
Written by Dr Stephen Duckett, the Grattan Institute’s health program director, and Dr Peter Breadon, a health fellow, the submission said that benchmarking prices would reduce costs overall, thereby saving money for both the Government and patients.
-----

Medicines price rise effect hosed down

Date August 20, 2014

Dan Harrison

Health and Indigenous Affairs Correspondent

There is no evidence to suggest increasing charges for medicines will deter people from filling their prescriptions, health department officials told a Senate hearing on Tuesday.
Appearing as part of an inquiry on government proposals to raise fees for drugs subsidised under the Pharmaceutical Benefits Scheme, federal health department acting deputy secretary Richard Bartlett disputed claims the changes would lead to some people failing to take their medications.
“I have no evidence to give an answer that says I expect it to have an impact on people filling their scripts,” Mr Bartlett said.
In a heated exchange, Greens Senator Richard Di Natale described Mr Bartlett’s testimony as “embarrassing for the department,” suggesting it was contradicted by the evidence from various studies. “We’re with the flat earth society here,” Senator Di Natale said.
-----

Interest groups blamed for lacklustre price disclosure cuts

20 August, 2014 Christie Moffat
Price disclosure has not worked properly to reduce PBS costs, with pharmacy interest groups potentially to blame, a health economist has told the Senate hearing into pharmaceutical prices.
Appearing before the Senate Standing Committee on Community Affairs, Peter Breadon, health fellow at the Grattan Institute, told the Committee that the people losing out from the high cost of medicines were a widely distributed group of patients, whereas those who benefitted from prices staying high were “narrowly concentrated interest groups”.
When questioned as to whether pressure from the “pharmacy lobby” had contributed to medicines not being cheaper, Mr Breadon said it was acknowledged that bringing down the price of medicines had an impact on community pharmacies, and that he could only speculate on the justifications for high prices.
-----

Bureaucrats criticised over denial of PBS co-pay harms

20 August, 2014 Christie Moffat
Claims by a Department of Health official that there is “no evidence” a co-payment will reduce medicine compliance has been compared to a belief in a flat earth.
Health Department acting deputy secretary Richard Bartlett told the Senate Standing Committee on Community Affairs that the data available to ascertain whether the additional cost of a co-payment would have a negative impact on medicine compliance was incomplete, anecdotal or unpublished.
The committee met in Canberra yesterday to conduct further inquiries into co-payment increases under the National Health Amendment (Pharmaceutical Benefits) Bill 2014.
 “The fact is there is very little hard evidence to support this claim. The vast majority of submissions refer to anecdotal evidence or unpublished survey data, which is almost impossible to scrutinise or break down,” Mr Bartlett said.
-----

Guild embarks on media blitz

21 August, 2014 Christie Moffat
The Pharmacy Guild of Australia is launching a media blitz to raise consumer awareness about the vital healthcare role of community pharmacy.
The awareness campaign, entitled ‘Discover more. Ask your pharmacist’, has been delegated to Sydney agency Jack Watts Currie to create television and online advertisements, which will commence in late October, supported by a new website and Facebook page.
The campaign is being funded by the Guild with support from the broader community pharmacy industry. A comprehensive suite of materials for display have been created and will be available to order and customise online.
-----
Comment:
It seems the fuss is not yet settled - to say the least.
Lots to browse with all sorts of initiatives going rather pear shape - think security, sanctions and so on! I also have to say reading all the articles I have no idea what is actually going to happen with the Budget at the end of the day!
To remind readers there is also a great deal of useful health discussion here from The Conversation.
Also a huge section on the overall budget found here:
Enjoy.
David.