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Reform and Development of Health Care Services

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Discuss about the Reform and Development of Health Care Services.

Answer:

Introduction:

The two health interventions that the Australian Medicare does not cover are-

  • Medical surgeries for cosmetic reasons which a
    re not clinically important and some dental services
  • Ambulances services (2)

The two health care services that have larger than “normal” co-pay system are:


  • Medicines which are not in the list of “Pharmaceutical Benefit Scheme”
  • Chronic illness like Chronic Obstructive pulmonary Disease (1)

The exclusion criteria for cosmetic surgeries are justified as these are accessed by public for personal pleasure and are not detrimental to health. Such services do not require skilled nursing care and is an essential care option only for rich members of society. However, it is not justified to exclude ambulances services from Medicare. It is an emergency service especially in remote areas where people cannot access medical services quickly (3). The large co-pays are not justified It only adds to economic burden and higher death rate among socioeconomically disadvantaged members of the society. Eventually it may increase the death and disability as observed in countries like China and India (1).

Lowering the Medicare reimbursement rate for outpatient care is not appropriate. Since outpatient, care largely includes preventive and diagnostic services; rate fall may affect the long run health of uninsured individuals and its associated costs. The effect is significant in communities, which predominantly contains nonprofit hospitals. On the other hand, in profit hospitals, the share increases for outpatient care provided to the uninsured patients (2). Overall, it leads to public anger and vacuum in provision of health care services.

References

Eckermann S, Sheridan L. Supporting Medicare Health, Equity and Efficiency in Australia: Policies Undermining Bulk Billing Need to Be Scrapped. Applied Health Economics and Health Policy. 2016 Jul 20:1-4.

Hussain R, Maple M, Hunter SV, Mapedzahama V, Reddy P, Hunter S. The Fly-in Fly-out and Drive-in Drive-out model of health care service provision for rural and remote Australia: benefits and disadvantages. Rural and remote health. 2015 Jul 19;15(3068).

McCall C. Concerns raised over future of Medicare in Australia. The Lancet. 2016 Jul 23;388(10042):323.

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