Hospital Financing. Jim Butler ACERH, ANU A presentation to the ACERH 2008 Policy Forum, Brisbane, 22 February 2008. Overview. Background to current arrangements Turning to 2007 … Why reform? Medicare Hospital Benefits Scheme – General Features Some specifics Financing Criticisms.
Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.
A presentation to the ACERH 2008 Policy Forum,
Brisbane, 22 February 2008
In the second half of the century, Commonwealth financing of health services increased markedly, primarily as a result of:
1) Constitutional amendment in 1946 regarding ‘sickness and hospital benefits’
2) Medibank national health insurance program in 1975
Even before 1946, the Commonwealth’s Hospital Benefits Act of 1945 provided for payments to States for hospital services
Choice of s.96 grants to States, rather than hospital benefits scheme, has characterised Labor administrations since Chifley government in 1945 (embraced by Whitlam, Hawke, Keating and have been retained by Howard – and Rudd?)
Why did Labor administrations favour s.96 grants rather than hospital benefits?
“Australia conservatively wastes $14 billion in tax each year due to the combined effects of
(Australian Health Care Reform Alliance, Media Release (Reform Directions), 31 July 2007)
Duplicate coverage:If insurance cover for private hospital treatment is purchased, insurance cover for public hospital treatment as a public patient is still compulsorily retained
43-45% of population have PHI for hospital and/or general treatment insurance
PHI funds 8.7% of health exp. (excludes exp. funded by individuals
Private health insurance only
Public health insurance only
“Following US experience, there is widespread agreement that passive indemnity insurance is a powerful engine of inflation, fuelling medical incomes and the proliferation of cost-ineffective technologies”
Response: Proposed Medicare HBS is very far removed from the US health insurance arangements
“The two basic weaknesses are:
(a) The abolition of ‘public patient’ status would result in a version of the Canadian system but without two distinctive features of that system that are absolutely critical to its performance …”
“Hospital care in general, and inpatient care in particular, are treated in isolation from other components of health care …”
Agree that substitution of less expensive modes of care for inpatient care may be efficient – but Scheme gives C’wealth a much finer degree of control of relative rebates across IP/OP settings