Medicare: Is it Achieving the
Objective of Universal Health
Care or is the System in Need
of an Overhaul?
Maiy Aziz
Consum...
The CHF agenda
• Achieve better outcomes for the people who
pay for and use the health system – health
consumers
• Make he...
Why involve consumers?
• Consumers can influence and drive
demand in the system – they should
be drawn on to do that effec...
Why involve consumers? (cont’d)
• Consumers need to be involved in
MBS item reviews and other
discussions about sustainabl...
Ways of partnering with consumers
• Consumer friendly documents
• Consumer impact statements
• Surveys
• Focus groups
• Fo...
CHF Medical Benefits Policy Project
• Ophthalmology
• Colonoscopy
• Obesity surgery
• Pulmonary artery catheterisation
• C...
Prioritising items for review
• High risk items or items about which
safety and quality concerns arise
• High cost items
•...
What should reviews consider?
• Is the item meeting its objectives – does it
work? Does it offer comparable outcomes to
ot...
Independent and unbiased reviews
• Attempts to remove or change MBS items
have resulted in major outcries in the past,
pri...
Are the MBS reviews enough?
• Australia faces widening gaps in both
health outcomes and ability to access
healthcare
• Som...
Barriers facing health consumers
• The barriers to accessing necessary health
care include:
• out of pocket costs;
• lack ...
A broader conversation
• We need to have a major community
discussion about the true cost of
healthcare and the finite nat...
m.azize@chf.org.au
www.chf.org.au
(02) 6273 5444
Maiy Azize, Consumers Health Forum - Medicare: Is it Achieving the Objective of Universal Health Care or is the System in ...
Maiy Azize, Consumers Health Forum - Medicare: Is it Achieving the Objective of Universal Health Care or is the System in ...
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Maiy Azize, Consumers Health Forum - Medicare: Is it Achieving the Objective of Universal Health Care or is the System in Need of an Overhaul?

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Maiy Azize, Senior Policy Officer, Consumer’s Health Forum delivered this presentation at the 15th Annual Health Congress 2014. This event brings together thought leaders and leading practitioners from across the Australian health system to consider the challenges, implications and future directions for health reform.

For more information, please visit http://www.informa.com.au/annualhealthcongress14

Published in: Health & Medicine
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Transcript of "Maiy Azize, Consumers Health Forum - Medicare: Is it Achieving the Objective of Universal Health Care or is the System in Need of an Overhaul?"

  1. 1. Medicare: Is it Achieving the Objective of Universal Health Care or is the System in Need of an Overhaul? Maiy Aziz Consumers Health Forum of Austral
  2. 2. The CHF agenda • Achieve better outcomes for the people who pay for and use the health system – health consumers • Make health care more accessible • Make health services more flexible and responsive to health consumers’ needs • Drive reform in work practices, information sharing and consumer engagement • Improve safety and quality • Make the health system accountable for achieving better health
  3. 3. Why involve consumers? • Consumers can influence and drive demand in the system – they should be drawn on to do that effectively • Consumers recognise the need for a sustainable system, and many support regular reviews as essential to the sustainability of Medicare
  4. 4. Why involve consumers? (cont’d) • Consumers need to be involved in MBS item reviews and other discussions about sustainable health funding • Consumer input provides valuable additional information • Involvement can be supported in a range of ways
  5. 5. Ways of partnering with consumers • Consumer friendly documents • Consumer impact statements • Surveys • Focus groups • Forums and community briefings • Citizen’s juries • Websites (e.g. MSAC, MBS, CHF and the Our Health, Our Community website)
  6. 6. CHF Medical Benefits Policy Project • Ophthalmology • Colonoscopy • Obesity surgery • Pulmonary artery catheterisation • Cardioverter defibrillator services • Carotid surgery • Vulvoplasty/labioplasty • Inguinal hernia surgery • Botulinum toxin injections • Lipectomy • Cardiac perfusion • Rhinoplasty • Diagnostic knee arthroscopy • Varicose vein surgery • Wrist ganglia surgery • Skin services • Paediatric surgery • Ear, nose and throat surgery • Radiation oncology • Vitamin D testing • Vitamin B 12 testing
  7. 7. Prioritising items for review • High risk items or items about which safety and quality concerns arise • High cost items • Items that have been on covered by Medicare for longest • Items that are used very rarely or very frequently • Drawing on stakeholder consultation
  8. 8. What should reviews consider? • Is the item meeting its objectives – does it work? Does it offer comparable outcomes to other options? • Is it linked to positive health outcomes? • Is it relatively safe? • Is it still being used? • Does it provide value for money – is it sustainable? • Could the service be safely provided by another health professional at a lower cost?
  9. 9. Independent and unbiased reviews • Attempts to remove or change MBS items have resulted in major outcries in the past, primarily from health professionals concerned about potential loss of income • MBS reviews need to take place without undue influence from powerful interest groups
  10. 10. Are the MBS reviews enough? • Australia faces widening gaps in both health outcomes and ability to access healthcare • Some groups suffer a disproportionate share of poor health outcomes • Is Medicare meeting its core objectives?
  11. 11. Barriers facing health consumers • The barriers to accessing necessary health care include: • out of pocket costs; • lack of health care professionals or facilities where and when people need them; and • rationing of those services that are available – where demand for services exceeds those which are made available. Waiting lists are the most obvious example of the rationing of services.
  12. 12. A broader conversation • We need to have a major community discussion about the true cost of healthcare and the finite nature of health funds, and identify what the community wants to fund and how this funding should be delivered. • Otherwise we could be prioritising the wrong things.
  13. 13. m.azize@chf.org.au www.chf.org.au (02) 6273 5444
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