All things remaining equal, the future of Medicare will look pretty much exactly as Medicare today.
The snapshot version is that Medicare will continue to support a 19th century craft style model of medicine, underwritten by a 20th century ‘command and control’ payment system.
This means Medicare will primarily continue to pay doctors for delivering a defined medical service, which takes the form of one-off episode of GP or other specialist and hospital care, on a fee-for-service basis.
The problem is that the traditional model of medical care supported by Medicare was more suited to the time when the bulk of the community’s health care needs consisted of short term treatment for acute illness.
It is far less suited to dealing with the number one health challenge of the 21st century — the effective management of the rising burden of chronic disease in an ageing Australia.
If my snapshot is accurate, the future of Medicare will mean less national wellness and less national prosperity.
Health expenditure will continue to escalate on the high-cost hospital treatment of increasing numbers of chronic patients.
The fundamental problem is that Medicare doesn’t make healthcare providers accountable for managing the healthcare of patients across the care spectrum in a cost effective manner.
But under a ‘pooled’ and ‘capitated’ funding model — which might combine existing federal and state health and hospital funding — the incentives would be different.
Healthcare providers would have the incentive to develop innovative models of non-hospital based primary care to manage chronic disease more effectively in the lowest cost setting, because they would be financially responsible for funding the care of patients across the full service spectrum.
Reducing costs and improving outcomes by preventing chronic patients from needing admission to hospital sounds good in theory. But the key question remaining is how it can be implemented to overcome the formidable political obstacles posed ‘Mediscare’ campaigns.
There is a political feasible way to initiate much needed reform of the Medicare service and payment systems — the Health Innovation Communities proposal as set out in Medi-Vation report the CIS published last November.
This is an edited version of a speech Dr Jeremy Sammut delivered at ‘The Future of Medicare’ session at The Melbourne Institute/The Australian Economic and Social Outlook Conference in Melbourne last week.
Home > Commentary > Opinion > The future of Medicare
The future of Medicare
The snapshot version is that Medicare will continue to support a 19th century craft style model of medicine, underwritten by a 20th century ‘command and control’ payment system.
This means Medicare will primarily continue to pay doctors for delivering a defined medical service, which takes the form of one-off episode of GP or other specialist and hospital care, on a fee-for-service basis.
The problem is that the traditional model of medical care supported by Medicare was more suited to the time when the bulk of the community’s health care needs consisted of short term treatment for acute illness.
It is far less suited to dealing with the number one health challenge of the 21st century — the effective management of the rising burden of chronic disease in an ageing Australia.
If my snapshot is accurate, the future of Medicare will mean less national wellness and less national prosperity.
Health expenditure will continue to escalate on the high-cost hospital treatment of increasing numbers of chronic patients.
The fundamental problem is that Medicare doesn’t make healthcare providers accountable for managing the healthcare of patients across the care spectrum in a cost effective manner.
But under a ‘pooled’ and ‘capitated’ funding model — which might combine existing federal and state health and hospital funding — the incentives would be different.
Healthcare providers would have the incentive to develop innovative models of non-hospital based primary care to manage chronic disease more effectively in the lowest cost setting, because they would be financially responsible for funding the care of patients across the full service spectrum.
Reducing costs and improving outcomes by preventing chronic patients from needing admission to hospital sounds good in theory. But the key question remaining is how it can be implemented to overcome the formidable political obstacles posed ‘Mediscare’ campaigns.
There is a political feasible way to initiate much needed reform of the Medicare service and payment systems — the Health Innovation Communities proposal as set out in Medi-Vation report the CIS published last November.
This is an edited version of a speech Dr Jeremy Sammut delivered at ‘The Future of Medicare’ session at The Melbourne Institute/The Australian Economic and Social Outlook Conference in Melbourne last week.
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