Doctors would be paid 30 per cent more by Medicare and health funds but only when they provided quality care under a controversial plan being pushed by private health insurers.
Private Healthcare Australia chief Dr Michael Armitage has presented a plan to the government that shows taxpayers could save billions if Medicare and health funds pay for evidence based care in line with clinical guidelines.
It comes as health funds are poised to this month win approval for a premium rise worth over 6 per cent or three times the inflation rate.
A recent Productivity Commission report found GPs were failing to do their job properly with many not devising asthma or diabetes plans for their patients and prescribing antibiotics for viruses when they don’t work.
Dr Armitage says a study into how doctors took up Heart Foundation guidelines on coronary care showed fewer than five per cent of doctors followed them.
And a Grattan Institute Report found major variations in the way different doctors cared for their patients that cost the health system lots of money.
“We should no longer be relying solely on fee for service and instead pay a fee for the best service or the most appropriate service,” Dr Armitage told News Corp.
The most appropriate service would be determined by clinical guidelines set by doctors themselves, he said.
The health fund lobbyist says his system would ensure governments and health funds “only paid people for doing the right things”.
“The model would reward practices that provide services that improve patient care,” he said.
Australian Medical Association president Professor Brian Owler, however, says it is simply the latest attempt by health funds to introduce the failed US managed care system into Australia.
“Patient care is a matter between the doctor and the patient and the doctor is in the best position to decide what is the best care,” Professor Owler said.
“When the payer interferes because of cost containment patients are denied care or have delayed care.
“The minister would be poorly advised if she accepts this proposal.”
Health Minister Sussan Ley has been consulting the health sector on what to do about the government’s unpopular $5 GP fee the government cannot get through the Senate.
There has been confusion about whether the government is planning to dump the GP fee but Ms Ley says it remains government policy.
And yesterday she hinted the government may be considering a two tier GP fee.
“Bulk-billing is there to protect the vulnerable but those who can pay a bit more need to do that and those who can pay a bit more again also need to,” she said during a visit to a GP in Western Sydney.
The minister must announce health fund premium rises before the end of the month to give the health funds time to notify their members of the increases that take effect April 1.
Source: News.com.au