Category: News

RAMSAY CALLS FOR CORPORATE INSUERS TO PASS ON GAINS

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[vc_row][vc_column][vc_column_text]Australian healthcare company, Ramsay Health Care, has called on corporate health insurers to pass on the more than $1 billion in gains back to communities.

In a story covered by The Australian, Ramsay Health Care’s chief executive, Craig McNally, discussed the healthcare provider’s $284 million fall in net profit, which has been impacted greatly due to the COVID-19 pandemic.

Despite the sizable impact the pandemic has had on Ramsay Health Care and other health providers, corporate health insurers have continued to rake in profits during the elective surgery hibernation period.

To help mask the appearance of their profits during the pandemic, corporate health insurers have decided to bring forward “deferred claims” totalling $1.4 billion, which, thanks to clever accounting, reduced their reportable profits, despite elective surgery claims being suspended.

Data released by the Australian Prudential Regulatory Authority (APRA) revealed that during the pandemic corporate health insurers have raked in gross mega-COVID-profits of $1.03 billion, while cutting the actual benefits paid to policy holders to $20.3 billion, down $600 million from 2019.

Mr McNally said the APRA data shows corporate health insurers have saved over $1 billion in claims costs for the last quarter.

“Their windfall gains put them in a very strong financial position and it would be unreasonable of them not to look at what the broader impact on the system is,” Mr McNally told The Australian.

The relationship between corporate health insurers and others in the health sector have become increasingly tense. As many health industries have continued to make cuts to support the Government’s COVID-19 response, impacting their bottom lines, the private health insurance industry has been accused of profiteering on the back of the once-in-a-generation health crisis.

The association representing medical technology innovators, MTAA, has also called out the corporate insurers, urging them to reverse their premium increases and return windfall profits to their customers.

“If private health insurers in Ireland, and even car insurers in Australia, can return premiums to their customers in this crisis, why can’t corporate health insurers give back some of their windfall profits to struggling Australian families? Why can’t they put people before profits?” Mr Burgess asked.

Many in the health sector will be keeping a keen eye on corporate health insurers to make sure their customers will actually receive the value for these deferred claims.[/vc_column_text][/vc_column][/vc_row]

Boost Primary Care To Help Patients In Need

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[vc_row][vc_column][vc_column_text]In December 2019, the RACGP released its 2020-21 federal pre-budget submission. Following policy and funding decisions in response to the COVID-19 pandemic, the RACGP has raised matters for urgent consideration in its 2020-21 pre-budget update submission.

The RACGP has called on government to:

  • extend Medicare subsidies for telehealth and telephone consultations beyond 30 September
  • implement voluntary patient enrolment to enhance continuity of care
  • help GPs care for patients with chronic and complex conditions via longer consultations
  • provide additional Medicare subsidies for mental health RACGP spokesperson Dr Bruce Willett said that now was the right time to give general practice a shot in the arm.

“The long-term health consequence of the COVID-19 pandemic are unknown but likely to be severe. That includes the effects of patients delaying or avoiding care, an increase in mental health concerns and the impacts of the virus itself on long-term physical and mental wellbeing.

“Primary care will be absolutely essential in managing the health of our communities in the months and years ahead but GPs need the right support to do so.

“Each year, GPs provide care to nearly 90% of Australians, yet general practice represents less than 13% of federal government health expenditure.

“This must change now because GPs provide the long-term care needed to improve the health trajectory of patients, keeping them well and out of hospital. The pandemic has placed an enormous strain on our healthcare system and led to many people suffering from poorer health outcomes – if we want to get on top of these problems we need to boost investment in primary care.”

Dr Willett said that the right investments would make an enormous difference for many patients.

“Many aspects of healthcare policy are complicated, but this is strikingly simple – a boost to primary care funding would allow more people to access quality care from their GP and lead to better health outcomes for patients as well as reduced healthcare expenditure.

“We have clearly laid out where government should provide greater support for general practice and improve patient health.

“During the pandemic many patients have avoided seeing their GP for new symptoms or serious existing conditions. Expanded telehealth and telephone consultations are proving crucial for many patients so we need flexible telehealth services to be widely available beyond 30 September this year.

“Ensuring patients have continuity of care with a usual GP is essential. It results in more patients addressing their health concerns at first instance before they become more severe and require secondary care.

“A voluntary patient enrolment system, where clinics receive additional payments for ‘enrolling’ a patient with a regular GP, would enhance comprehensive care for more patients and reduce hospitalisations for those who frequently visit GPs.

 

“The delay in rolling out this funding system is unfortunate because the patients who will benefit the most from voluntary patient enrolment are those most at risk of the COVID-19 virus. That includes older Australians and people with chronic disease.

“The pandemic has also put immense strain on many people and led to more patients experiencing mental health concerns. To help these people we need longer consultations so that GPs can take the time to talk through what our patients are experiencing and how we can help them.

“The health impats of the pandemic on the overall health of the population will be long-lasting and GPs on the frontline need all the help they can get. Our plan will provide them with the resources they need to do just that.”

The RACGP’s Vision for general practice and a sustainable healthcare system outlines how greater investment in primary care will reduce the need for more expensive secondary care and enhance the nation’s productivity through a healthier workforce. It will also promote health equity for demographic groups who disproportionately rely on secondary care including treatment in hospitals.[/vc_column_text][/vc_column][/vc_row]

RACGP helping ‘missing’ CALD patients access healthcare during COVID-19 pandemic

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[vc_row][vc_column][vc_column_text]It comes following GP concerns about CALD patients avoiding medical care due to fear of the COVID-19 virus, while also bearing the brunt of the pandemic, including increased mental health symptoms, isolation and loneliness.

The RACGP’s Expert Advice Matters campaign is encouraging CALD patients to keep looking after their heath during the COVID-19 pandemic and consult their GP for any health concerns.

A website for patients has been translated into the most commonly spoken languages other than English, including Arabic, Simplified Chinese, Traditional Chinese, Hindi and Vietnamese. The websites include practical information for patients on how they can safely access care from a GP, including telehealth and telephone consultations featuring free interpreters. You can view the websites here: https://www.expertadvicematters.com.au/

GPs are helping to spread the message by sharing videos of themselves speaking in different languages, urging patients not to delay routine healthcare and explaining how they can safely consult with their GP. You can find the videos on YouTube here: https://www.youtube.com/playlist?list=PLKg37k2DuVFPDvTWVer3SyZBK31R80BvE

RACGP spokesperson Dr Lara Roeske said more needed to be done to reach CALD patients missing out on healthcare.

“Before the COVID-19 pandemic, CALD communities in Australia already faced health inequalities and barriers to accessing healthcare including language and health literacy issues.”

Evidence suggests migrants, particularly those newly arrived, use health services less. The National Health Survey found that of those arriving in Australia between 2009 and 2015, 74%had visited a GP in the last 12 months, compared to the Australian-born population total of 86 per cent.

Dr Roeske said the pandemic had magnified the problems.

“The pandemic has only made matters worse – many patients are avoiding seeing their GP because they’re afraid of the virus and don’t know about or feel comfortable using telehealth.

“With all the rapidly changing health information and changes to the way patients can access care, it’s not surprising that some don’t know how they can safely access healthcare and are putting off important appointments. We need to fix this now.

“I’m very concerned that patients delaying care could face worse problems down the track. Particularly given some CALD communities have higher rates of chronic disease and need regular routine health checks to stay well.

“This is why it’s so important that we get the message to CALD communities that you need to keep taking care of your health during the pandemic, and there are safe ways to get the expert care you need.

“We need to do better to communicate to CALD patients, and provide information that’s translated and culturally appropriate. The extension of the RACGP’s Expert Advice Matter’s campaign to CALD communities aims to do just that.

“My advice for patients is this: if you’ve delayed an appointment or have a new health concern, don’t wait any longer – your GP is here to help, book an appointment today.”

7 Tips for Safer Healthcare

  •  don’t delay healthcare, call your GP for any concerns
  • you can consult your GP on the phone or via video technology. Telehealth appointments are bulk billed for concession card holders, under 16s and vulnerable
  • if you need an interpreter, call the Australian Government’s FREE Translation and Interpreting Service (TIS) Ph 131450.
  • you can get a prescription from your GP on the phone or video and collect the medicine from a pharmacy
  • it’s safe to visit your GP in person if you need to – clinics have made changes to protect you from COVID-19 including physical distancing and regular
  • patients in Victoria must wear a face mask or covering when visiting their GP. Patients living in other areas with community transmission are also advised to wear a mask when visiting the GP
  • if you have COVID-19 symptoms (cough, sore throat, shortness of breath, runny nose, fever or chills or loss of smell or taste) get tested right away and self-isolate until you get the

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HealthEngine to pay $2.9 million for misleading reviews and patient referrals

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[vc_row][vc_column][vc_column_text]HealthEngine admitted that between 30 April 2014 and 30 June 2018 it gave non-clinical personal information, such as names, dates of birth, phone numbers, email addresses, of over 135,000 patients to third party private health insurance brokers without adequately disclosing this to consumers. HealthEngine earned more than $1.8 million from its arrangements with private health insurance brokers during this period.

HealthEngine was also ordered to contact affected consumers and provide details of how they can regain control of their personal information.

“These penalties and other orders should serve as an important reminder to all businesses that if they are not upfront with how they will use consumers’ data, they risk breaching the Australian Consumer Law,” ACCC Chair Rod Sims said.

“The ACCC is very concerned about the potential for consumer harm from the use or misuse of consumer data.”

HealthEngine also admitted that between 31 March 2015 and 1 March 2018, it did not publish around 17,000 reviews and edited around 3,000 reviews to remove negative aspects, or to embellish them. HealthEngine also admitted that it misrepresented to consumers the reasons why it did not publish a rating for some health or medical practices.

“The ACCC was particularly concerned about HealthEngine’s misleading conduct in connection with reviews it published, because patients may have visited medical practices based on manipulated reviews that did not accurately reflect other patients’ experiences,” Mr Sims said.

HealthEngine admitted liability and made joint submissions with the ACCC to the Federal Court. HealthEngine will also pay a contribution to the ACCC’s legal costs.

Background

The ACCC began investigating HealthEngine in July 2018 and subsequently launched legal proceedings.

HealthEngine describes itself as Australia’s largest online health marketplace, which is used by over a million consumers every month.

HealthEngine provides a booking system for patients and an online health care directory that lists over 70,000 health practices and practitioners in Australia. The directory allows patients to search for and book appointments with health practitioners. Up until June 2018, consumers could also access reviews from patients about the quality and services of health practitioners.[/vc_column_text][/vc_column][/vc_row]

MINISTER MUST RECONSIDER PRIVATE HEALTH INSURANCE PREMIUM INCREASES – CHRIS BOWEN

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[vc_row][vc_column][vc_column_text]Australian Prudential Regulation Authority statistics for April to June, released today, show that the proportion of Australians with hospital cover fell for the 20th consecutive quarter.

With premiums up 30 per cent under this Government and many Australians struggling to make ends meet during COVID-19, hospital coverage is now at the lowest level in 14 years.

The Private Health Insurance Act gives the Minister for Health the power to reject premium increases that “would be contrary to the public interest”.

Greg Hunt must now explain why another 2.92 per cent average increase in October would be in the public interest – or cancel that increase altogether.

Another increase would compound the pain that many policyholders felt between April and June, when they were forced to pay for services they couldn’t use. Today’s figures show that benefits fell by more than 20 per cent compared to the March quarter, reflecting COVID-19’s impact on elective surgeries and dental, optical and other visits.

Labor acknowledges that claims are expected to recover in subsequent quarters, and welcomes the steps some insurers have taken in response to COVID-19 – particularly HBF, which has already cancelled its 2020 premium increase.

But with private health insurance already in crisis, and affordability and value further undermined by the pandemic and recession, additional premium relief and comprehensive reform are needed urgently.

Today’s figures follow yesterday’s warning by the Australian Medical Association that the financial impacts of COVID-19 “will result in even more young people giving up their insurance, increasing pressure on an already unstable system”.

The AMA has called for the October Budget to include reforms to improve the affordability and value of private health insurance – consistent with Labor’s longstanding calls for reform.

As a starting point, the Minister must reconsider October’s premium increases as a matter of urgency.[/vc_column_text][vc_zigzag][vc_row_inner][vc_column_inner width=”1/4″][vc_single_image image=”4203″ img_size=”full”][/vc_column_inner][vc_column_inner width=”3/4″][vc_column_text]

ABOUT THE AUTHOR

Chris Bowen MP is the Shadow Minister for Health and Labor Member for McMahon[/vc_column_text][/vc_column_inner][/vc_row_inner][/vc_column][/vc_row]

CALLS FOR REFORM OF PRIVATE HEALTH INSURANCE

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[vc_row][vc_column][vc_column_text]The APRA June quarter data shows the percentage of Australians with private health insurance has declined again to 43.6 percent, down from 47.3 percent just five years ago.

Australian Private Hospitals Association (APHA) CEO, Michael Roff, said the Federal Government needed to consider a range of measures in the upcoming Budget to address the significant affordability issues of private health insurance.

“There has been further decline in membership and with increasing pressure on personal finances from increasing unemployment, particularly for young people and women, the Government needs to act to address affordability concerns so people can continue to access private hospitals when they need them,” Mr Roff said.

The data also showed that privately insured hospital services have gone down 19% compared to the same quarter last years and extras have done down 30% compared to the same quarter last year. Corporate health insurers are making massive savings this year as fewer people are claiming insurance.

Also responding to the APRA data, consumer advocacy group, CHOICE, accused corporate health insurers of making massive savings while still raising the prices on Australian families.

CHOICE’s Health Campaigner, Dean Price, said the APRA statistics showed a dramatic drop in the number of surgeries and treatments being covered by private health insurance during COVID-19.

“In the middle of the biggest global pandemic in over 100 years, people have been reminded of the quality of Medicare and our hospital system and have found little reason to stick with this expensive product,” Mr Price said.

“When you’re sick you just want certainty that you will be cared for, but private health insurance makes what should be simple more difficult. Private health insurance is still riddled with confusing policies, ever increasing premiums and shockingly high out of pocket costs.”

Of concern to many in the health sector are the statistics that show corporate health insurers spent $515 million less on people’s healthcare during the first months of COVID-19, despite making struggling families pay full price.[/vc_column_text][/vc_column][/vc_row]

AMERICANISATION OF AUSTRALIAN HEALTHCARE?

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[vc_row][vc_column][vc_column_text]Medibank says the investment is part of the corporation’s broader strategy to “support hospitals and doctors” by having patients recuperate at home, rather than in hospital.

Federal president of the Australian Medical Association (AMA), – the organisation representing Australian doctors – Omar Khorshid, has raised the alarm of Medibank’s acquisition in The Australian newspaper this week.

Mr Khorshid told The Australian he was seeking a briefing with Medibank about the acquisition and how it would protect the clinical independence of the hospital.

“While I’m sure Medibank will give us a lot of assurances regarding clinical independence and the doctors and patients making decisions, the reality is once you own the hospital an insurer has vastly more control of what goes on in the hospital, whether it be who works there, how much is charged and the particular model of care and how patients are treated,” Mr Khorshid told The Australian.

Many Australians do not support the Americanisation of Australia’s healthcare system, which in the United States, can costs tens of thousands of dollars and leave the most vulnerable of society without basic healthcare.

Last year corporate health insurance lobby group, Private Healthcare Australia (PHA) called for the Government to consider to privatising healthcare in Australia by incentivising large corporations to take out health insurance for employees – as is done in the United States – taking away people’s choices about healthcare.

PHA’s Chief Executive, Rachel David, called the proposal “modest” and said it “would put the private health insurance industry within reach of young people who will benefit from healthcare services not readily available to them in the public sector”.

At the time, the Doctors Reform Society (DRF) President, Dr Tim Woodruff, slammed the proposal and questioned why private health insures wanted these changes.

Dr Woodruff said the proposal was an attempt by corporate health insurers to get more taxpayer support for themselves to make more profits.

“The majority of Australians don’t have private health insurance because it’s a bad product,” Dr Woodruff said.

It is unclear yet what effect Medibank’s hospital acquisition will have on clinician choice or patient outcomes, but many still remain concerned and questioning whether Australians can afford to import the type of americanised healthcare that has left so many American families struggling.[/vc_column_text][/vc_column][/vc_row]

APPLES & ORANGES OF PRICE

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[vc_row][vc_column][vc_column_text]Like any product or service, the price for medical devices will vary from one country to another. For example, the price of a Toyota Sedan in Australia is going to be different from the price for the same Toyota Sedan in the United States or Europe due to a range of factors.

So why is this so for medical devices? Well let’s look at the top five factors influencing price:

  1. DIFFERENT HEALTHCARE SYSTEMS

The differences between healthcare systems from country to country, including different political, policy and economic drivers, has a significant impact on the price of devices. Countries, such the UK and Canada, that appear to have comparable healthcare systems to Australia are, when analysed in greater depth, actually quite different.

Let’s take Canada for example. Based on the OECD health expenditure statics (including PHI as a percentage of total healthcare expenditure and the proportion of population covered by PHI), Canada appears to have a similar healthcare structure to Australia’s. However, unlike in Australia, Canada does not have a private market for prostheses due to the fact it does not allow private health insurers to cover services provided by Canada’s public healthcare system, including hospital procedures that include prostheses.

In contrast, Australia’s healthcare system does allow for this, meaning there is a private and a public market for prostheses.

 PURCHASING ARRANGEMENTS AND MARKET SEGMENTATION DIFFERENCES

Purchasing arrangements for medical devices also vary from country to country. The greater a country’s level of market integration, the greater the capacity they will have to purchase devices at lower prices through improved economies of scale and market volume guarantees for MedTech companies.

For example, in Sweden, there is negligible PHI coverage of the population due to the fact Sweden’s healthcare system is integrated to a high degree with county councils being responsible for both the financing and organisation of healthcare services. Counties also own and operate most of the country’s hospitals. With a healthcare system that is essentially 100% publicly owned and operated, Sweden is able to centrally purchase prostheses through a small number of entities.

  1. DIFFERENCES IN VOLUME, MEDICAL PRACTICE AND PATIENT NEED

Some countries undertake certain procedures using medical devices more frequently than others. For example, according to the OECD Health at a Glance 2013, Germany conducts almost twice as many coronary angioplasty procedures per 100,000 compared to Australia – not to mention Germany’s population is four times that of Australia’s. This means the significantly greater volume of devices associated with coronary angioplasty procedures being required in Germany, compared to here in Australia, results in lower prices of those prostheses for Germans.

  1. DIFFERENCES IN ECONOMIES & GEOGRAPHY

Local economic costs can also add to the price difference for medical devices from country to country. Local costs in Australia such as wages, transportation costs (petrol, airfares), facility costs (coupled with the higher need for warehousing in Australia), currency fluctuation and exchange rates can all influence the price of devices.

Geographical considerations can also influence the price of medical devices. Australia’s isolated location, its low population density and vast land mass have a significant impact on the cost of importing devices and distributing them across Australia.

  1. LEVEL OF INDUSTRY SUPPORT SERVICES

The level of service required from a MedTech company can vary from country to country, and from one prosthesis category to the next. This can impact on the price attributed to a particular prosthesis.

For example, in some European countries, companies do not provide post-procedure follow-up technical support services for certain device types. Funding for these services is allocated to clinicians in the hospital with support from highly trained staff. Therefore, these services are provided with little support from MedTech companies. This is also the case in the Australian public healthcare system.

In contrast, the private markets in Australia, United States and in Japan for example, have a high demand for MedTech companies to provide support services. In Australia, the cost of this support over the life-time of a device is factored into the prosthesis’ benefit.[/vc_column_text][/vc_column][/vc_row]

OPPOSITION BACKS DOCTORS’ CALLS FOR TELEHEALTH EXTENSION

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[vc_row][vc_column][vc_column_text]Opposition health spokesman, Chris Bowen MP, had called for the introduction of Medicare telehealth rebates early in this health emergency, and was said to have consistently supported reforms to the items to improve patient outcomes.

In a statement to the press, Mr Bowen said the AMA and RACGP had reiterated that the pandemic will not end on 30 September – when Medicare telehealth items are due to cease – and has called on the Government to extend the items until March 2021, in line with the JobKeeper extension.

“Medical and allied health services delivered by telehealth have allowed Australians to access health care from home while reducing COVID-19 risks for patients and health care workers alike,” Mr Bowen said in a statement.

“Labor backs these calls by the AMA and RACGP and urges the Government to extend the telehealth program.”

The Opposition believes the extension should include both telephone and video-conference items, to maintain access and choice for patients and providers – including those who can’t access video services.

It is believed the extension period should be used to agree a long-term future for telehealth, as part of broader efforts to boost the quality and coordination of care.

The Opposition has also urged the Government to extend telehealth access for mental health services in consultation with the sector, and to release and response to the Productivity Commission report on mental health urgently.[/vc_column_text][/vc_column][/vc_row]

CSIRO SETS SIGHTS ON NEW ‘TEAM AUSTRALIA’ MISSIONS PROGRAM

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[vc_row][vc_column][vc_column_text]The program of large scale, major scientific and collaborative research initiatives, will be aimed at solving some of Australia’s greatest challenges, focused on outcomes that lead to positive impacts, new jobs and economic growth.

 CSIRO Chief Executive Dr Larry Marshall said the collaboration and goodwill stimulated by the response to COVID-19 can be harnessed and used to accelerate our recovery, create new jobs and stimulate the economy.

“While COVID-19 will undoubtedly continue to disrupt, Australia will come together through this crisis and build a strong future in the process. We are calling for partners to join this Team Australia approach to solving what seem like unsolvable problems,” Dr Marshall said.

On the centenary of CSIRO’s first mission, to eliminate Prickly Pear, it will direct $100 million annually to the co-creation of missions, working with the brightest minds across the research sector and industry, to help Australia achieve these outcomes:

  • Increase our resilience & preparedness against pandemics
  • Mitigate the impact of disasters: drought, bushfires and floods
  • Create a hydrogen industry to generate a new clean energy export industry
  • Accelerate the transition to agile manufacturing for higher revenue and sovereign supply
  • Overcome our growing resistance to antibiotics, so they keep saving lives
  • Create a national climate capability to navigate climate change uncertainty
  • Help our farmers overcome drought, mitigate climate impacts, increase yield and profitability, create a sustainable Future Protein Industry and leverage the world’s love of Australian-grown food to collectively drive our trusted agriculture and food exports to $100 billion
  • Use technology to navigate Australia’s transition to net zero emissions, without derailing our economy
  • Safeguard the health of our waterways by monitoring the quality of our water resources from space
  • Create new industries that transform raw mineral commodities into unique higher-value products like critical energy metals that build Australia’s value added offering, jobs, and sovereign supply
  • End plastic waste by reinventing the way plastic is made, processed and recycled
  • Double the number of small and medium businesses (SMEs) benefitting from Australian science to become a collaboration nation.

Minister for Industry, Science and Technology Karen Andrews welcomed CSIRO’s continued commitment to solving real-world problems.

“Science and technology are our greatest tools when it comes to maximising opportunities and addressing the challenges that face Australia at this time of great upheaval,” Minister Andrews said.

“We need to make sure that our scientists and researchers are working collaboratively with industry to solve real world challenges for the benefit of everyday Australians.”

David Thodey AO, Chair of CSIRO said, “The CSIRO Board fully endorses this Mission-led strategy and is committed to supporting the talented scientists and researchers at CSIRO, our universities and business partners to work together on these challenges for the good of our Nation in these challenging times.”

Dr Marshall said CSIRO was drawing on its 100-year history to develop the missions with its partners across science and industry, to support the nation at a tough time.

“For over a century we have worked with scientists around the country to solve our greatest challenges, and find the opportunities that give Australia her competitive advantage. From our first mission to save our agricultural land from prickly pear, to discovering breakthroughs like fast WiFi, Australia’s first digital computer, our 70-year history in battling bushfires, and our latest vaccine, virus and surgical mask work for COVID-19, CSIRO has always made Australia’s success our mission.”

Dr Alan Finkel, Australia’s Chief Scientist said, “Great science starts with a vision, but vision alone is insufficient. The vision has to be backed by real commitment. That’s what the CSIRO missions are all about, and I hope their rallying call is heard far and wide.”

Dr Brian Schmidt, Vice Chancellor of the Australian National University said, “ANU looks forward to working with CSIRO and its partners to co-design and deliver a national effort to help address some of the globe’s greatest challenges. At this moment, collaborative effort has never been more needed, and ANU will happily answer the call.”

Nick Hazell, v2food Founder and CEO said, “Missions set out a vision for Australia in a future we all can believe in – sustainable and science-led. The Missions are about coming together and using CSIRO science to make the most of Australia’s potential and having a positive impact on the world in light of the challenges we all face.”[/vc_column_text][/vc_column][/vc_row]