Public hospitals and Medicare Review on the AMA’s Budget wish list

Medical politics

By Michael Woodhead

20 Feb 2019

The AMA’s pre-Budget submission is calling on Prime Minister Scott Morrison to commit to adequate public hospital funding and guarantee the integrity of Medicare.

In its submission for the 2019-20 Federal Budget ahead of the May election, the AMA says there is an urgent need to lift public hospitals out of their funding crisis and to avoid the controversial MBS Review recommendations being used as a cost-cutting exercise.

On public hospitals, the AMA says the Budget should be used to:

  • Stop penalising hospitals for adverse patient safety events, and fully fund hospitals so they can improve patient safety and build their internal capacity to deliver high value care in the medium to long term;
  • Include an explicit ongoing Commonwealth contribution above and beyond the activity-based formula, to fund the obligations on jurisdictions to deliver integrated care post discharge to prevent avoidable re-admissions; and to reduce potentially avoidable admissions for patients with complex and chronic disease.

On Medicare, the AMA says it is essential the Budget does not use the ongoing MBS Review as a pretext to divert funds. It calls on the government to:

  • Establish a Medicare Reinvestment Fund – one that ensures every cent taken out of the MBS Reviews is reinvested in new and improved items recommended by the Committees, and kept separate from the funding needed to fund indexation and increased volume; and
  • Ensure there is a robust and transparent implementation process, with appropriate time to ensure decisions taken in the MBS Review do not have unintended consequences for patients, and that the MBS Review does not become a mechanism for shaping the scope of practice.

On private health the AMA says the Budget must go beyond the current “ Gold, Silver, Bronze, and Basic” labels for health cover and ensure that reforms to address out-of-pocket costs also require transparency on insurance industry rebates as well as doctors’ fees.

It calls for the government to increase the lead time it provides before new MBS items take effect and provide the methodology and logic behind the changes, to give the funds the chance to consider and make appropriate changes, and to guard against funding reductions.

The Budget should also be used to end the 20-year Medicare freeze on diagnostic imaging and pathology rebates, the AMA argues, and include measures such as a billing system to allow patients to pay just the gap up front.

The submission calls for scrapping of the MRI licensing system and more investment in genomics. And in medical research, the Federal Budget should reverse cuts to the NHMRC, whose funding now lags behind CPI, and restore the $328.5 million cut from the Research Block Grants scheme, the submission says.

The Budget must also address funding of primary care, mental health, disability services via the NDIS and aged care, as well as e-health and telemedicine, the AMA submission advises.

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