There is no doubt that the new reviews announced by Health Minister Sussan Ley could lead to some of the biggest changes to the Medicare benefit system since its introduction.
What’s on the table is an investigation into every medical service funded by the Medicare Benefits Schedule to identify what’s effective, outdated or unproven.
In practical terms, it means any of the more than 5,500 services on the schedule may no longer be subsidised by the Federal Government.
Everything on the Medicare website from A–Z , from Acoustic neuroma removal to Zygomatic arch (or cheekbone) reconstruction, is now under review.
The taskforce will be led by Professor Bruce Robinson, Dean of the Sydney Medical School at the University of Sydney.
There is no doubt the review is worthwhile.
Health experts almost universally agree there is waste in healthcare.
It is estimated to consume up to 30 per cent of total healthcare budgets, through the widespread use of ineffective health interventions, administrative inefficiencies, and inefficient pricing.
Academics such as Sydney University’s Associate Professor Adam Elshaug suggested there were more than 150 popular services on the Medicare Benefits Schedule that were either unsafe, ineffective or inappropriate under certain circumstances.
Getting rid of them could save the health system $500–600 million each year.
The good news is that the taskforce reviewing all of the Medicare items will consult widely, not only with GPs and specialists, but consumer and patient groups, academics, the newly created Primary Health Networks, nurses, allied health, states and territories.
But the process to revamp the Medicare Benefits Schedule will not be easy.
If the taskforce recommends removing specific treatments or procedures on the Medicare Benefits Schedule, the Government will in effect be picking fights with powerful medical colleges who will no doubt want to protect their patch.
Remember the campaign ophthalmologists mounted in 2009 when the then-Labor government tried to halve the Medicare rebate for cataract surgery.
After a public outcry, the changes were significantly watered down.
What is likely to be targeted in this review are unnecessary or outdated tests.
Doctors groups are already drawing up lists of those interventions and treatments they see as wasteful or redundant, as part of the National Prescribing Service’s Choosing Wisely program to be launched soon.
The doctor-led initiative identifies commonly used tests, treatments and procedures that often provide little benefit to the patient and in some cases, can lead to harm.
It’s been very successful in the United States not only in saving money but by empowering patients to make better choices when it comes to health care.
Lists of unnecessary procedures and tests have already been drawn up by Australian medical colleges and will be made public next week.
Looking at those lists in the first instance could save the new Medicare taskforce lots of time and effort.