Australia has a complex system with multiple different health insurers who have different priorities, says Professor Stephen Robson, president of the Australian Medical Association (AMA).
He said, “At the moment, it is a mishmash of different systems that is poorly regulated.”
He pointed out that Australia lags significantly behind many other countries in out-of-hospital care. He said, “It is really a dog’s breakfast at the moment, with two patients having the same operation, the same surgeon, in the same hospital, (and) depending on their private health insurer, one being able to have safe out-of-hospital care, and the other not having access to this. It’s not equitable for patients, and it removes a lot of the incentive to actually have private health insurance.”
Thus, the AMA wants to encourage Australian private health insurers and the system generally to embrace safe, appropriate out-of-hospital care. “It will keep patients out of hospitals, it will ease pressure on our hospital system and it’s likely to save money,” said Prof Robson.
The AMA argues its case for more out-of-hospital care to be offered by Australia’s private health system in a report released last week which is titled “Out-of-hospital care models in the private system”.
Call for private health authority to be established
Prof Robson said, “It’s absolutely critical that we put patient safety at the forefront of out-of-hospital care, and the only way that you can do that safely is to have an independent, arms-length, private health authority to oversee the implementation of these systems.”
He also said, “It’s really important that we look to systems that work and processes that work as we see overseas, and look if we can incorporate them into Australia’s health system.”
Nearly half a million Aussies waiting for planned surgery
Prof Robson said, “Australia at the moment is under an unprecedented amount of pressure for its hospital system. There are close to 2m planned operations in Australia every year across public hospitals and private hospitals. But in Australia, private hospitals conduct almost two-thirds of all planned operations. That is causing incredible stress, and the (COVID-19) pandemic has made everything worse. The AMA has calculated that close to half a million Australians are now waiting for planned surgical procedures.”
