Why Bring Back 1750 BC? – 28 November 2006

“Rather than look forward to sensible models of health care financing the health fund lobby group, Australian Centre for Health Research (ACHR) have gone backwards to the Code of Hammurabi of Babylon in 1750 BC where fees were paid when intervention succeeded and penalties were imposed when they failed. Penalties such as cutting off the hands of doctors were part of the code,” Stephen Milgate, Executive Director of the Australian Doctors’ Fund said in Sydney today.

<p “>In their recent paper entitled, “Making Medicare Better” former Australian Health Insurance Association, CEO, Mr Russell Schneider advocates replacing fee for service medicine and the current referral system with “the development of healthcare businesses, which aim at treating particular conditions, such as various types of cancer, and pay them on the basis of their results.” The paper is endorsed by the past Federal Health Minister, Dr Michael Wooldridge.

Taken to its logical conclusion, ‘payment by results’ (as determined by health funds) would see any doctor or hospital treating a cancer patient who subsequently died, punished through non payment or financial penalty. This would inevitably result in other ‘high risk’ (by health fund standards) patients having difficulty obtaining affordable medical care. I’m sure no-one would want this.

The health funds are essentially saying, “let us control the doctors and we’ll do it right for you”.

It is a matter of whom you trust, the doctor or the health funds.

The push for patients to be discharged from hospitals sooner is in the financial interest of health funds.

It is therefore no surprise that managed care is back on the health fund’s agenda. It was never off it.

The Australian Health Insurance Association (AHIA) is a long time advocate of managed care, the system used in the United States where managed care corporations control doctors and patients are treated according to the insurance company protocols at the insurance company price. “AHIA supports the development of managed care initiatives.” (Ref: Working with Medicare paper 1993, section 57)

“New Private Health Insurance Legislation to be introduced into the Federal Parliament in December needs careful examination to ensure that the blights of US style managed care are not visited on the Australian public,” Mr Milgate said.