(2003), "Australasia", International Journal of Health Care Quality Assurance, Vol. 16 No. 5. https://doi.org/10.1108/ijhcqa.2003.06216eab.009Download as .RIS
Emerald Group Publishing Limited
Copyright © 2003, MCB UP Limited
Keywords: Health-care reforms, Doctor's fees, Australia
In April Prime Minister, JohnHoward, and the Minister for Health and Ageing, Senator Kay Patterson, announced a A$917 million package to make Medicare fairer for all Australians, improve affordable access to GPs, reduce up-front fees for some patients, strengthen safety nets for families and concession cardholders and train more doctors. A Fairer Medicare - Better Access, More Affordable introduces a range of reforms that will benefit all Australians by providing more affordable access to GP services.
The reforms for the first time will improve the availability of bulk billing for concession cardholders, particularly those living in outer-metropolitan and rural areas. Senator Patterson said up to seven million concession cardholders covered by a Pensioner Concession Card, a Health-Care Card or a Commonwealth Senior's Health-Care Card would be eligible to receive medical care at no cost to the patient from doctors who participate in the new scheme. She said the Government was not introducing a co-payment and there would be no means test for Medicare. The universality of Medicare will be retained and everyone will continue to have access to the Medicare rebate when they visit a doctor. Doctors will continue to be free to bulk-bill whom so ever they choose.
Senator Patterson said patients without a concession card visiting participating doctors "those who agree not to charge concession cardholders a gap" who choose not to bulk-bill would have significantly reduced up-front costs and patients attending participating practices which choose not to bulk-bill non-health-care cardholders would only have to pay the gap between the doctor's fee and the Medicare rebate.
She said it would be more convenient because patients would not have to go to a Medicare office to claim their rebate and families would be relieved of the financial burden of paying the full doctor's fee up-front when taking sick children to the doctor.
Depending on their location and the number of concession cardholders they treat, doctors will receive incentive payments averaging A$22,050 for practices in the most rural and remote areas to provide medical care at no cost to concession cardholders.
There is nothing in the package that would cause doctors to increase the fees they charge their patients and stronger safety nets are to be introduced for Commonwealth concession cardholders with high cumulative out-of-pocket costs. Other patients would be protected against high out-of-hospital medical service gap payments with a new private health insurance product.
In any calendar year the Government will pay 80 cents in every A$1 of out-of-pocket expenses over A$500 spent by patients with a concession card on out-of-hospital Medicare services. For the first time, this will include the entire gap between the Medicare rebate and the fee charged by the doctor, including any fees charged above the Medicare schedule fee.
An extensive range of Medicare services will be covered under the safety net, including those provided by GPs and specialists, pathology and diagnostic imaging services when performed out of hospital.
Senator Patterson said that A Fairer Medicare - Better Access, More Affordable also contains longer-term measures to provide better access to GPs for patients by increasing the size and availability of the medical workforce, particularly in outer-metropolitan and rural areas.
Further information on A Fairer Medicare - Better Access, More Affordable can be obtained from: www.health.gov.au/fairermedicare
Mental Health in AustraliaDepression, Hospital treatment, AIHW
A report, Mental Health Services in Australia 2000-2001, by the Australian Institute of Health and Welfare "AIHW" estimates that there were 10.8 million visits to general practitioners for mental health-related conditions in 2000-2001 and an estimated 2.1 million visits to private psychiatrists in Australia in 2000-2001.
Depression accounted for one in every three mental health problems managed by general practitioners and general practitioners managed a larger number of mental health problems for female patients than for male patients. This applied across all age groups with the exception of people under 15 years of age. The majority of patients with a mental health problem managed were aged 35 to 54 years.
There were also 275,000 mental health-related hospital stays during 2000-2001. Of these, 166,000 were overnight hospital admissions "a stay involving one or more nights", with 131,000 being admissions to public hospitals and 35,000 to private hospitals. Mood disorders, especially depression and bipolar affective disorder "manic depression", accounted for 45,000 of these overnight admissions "26.2 per cent", with 32,000 admissions being to public hospitals and 13,000 to private hospitals.
Apart from mood disorders, public and private hospitals tend to have differing focuses with respect to mental health problems. Public hospital admissions included a comparatively high proportion of schizophrenia disorders "22.6 per cent of public admissions", whereas private hospital admissions included a high proportion of neurotic and stress-related disorders "18.7 per cent of private admissions". For same-day admissions for mental health-related problems, private hospitals had almost 20 per cent growth between 1998-1999 and 2000-2001.
Further information about the report, published by the AIHW can be downloaded in pdf format from: www.aihw.gov.au/publications/hse/mhsa00-01/mhsa00-01.pdf