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Reactions to the 2017-18 Budget: rolling coverage

In this post Croakey will provide rolling coverage of reactions to the health related measures of the 2017-18 Budget.

Readers can also follow reactions at #HealthElection17, #Budget2017 and #PeoplesBudget on Twitter.


Statement from the Consumers Health Forum

Medicare thaws, now time to take health reforms off ice

“The staged lifting of the freeze in the Budget does mean that many families on average incomes still face the risk of co-payment increases they can ill afford for at least another year.

The retention of bulk billing incentives for diagnostic imaging and pathology is welcomed.

“A strong and equitable health system that delivers for all Australians is THE top priority for voters.  As the Essential poll showed last week, nearly two thirds of Australians think funding should be increased in health care.

Government also needs to exploit the longer term benefits available to Australians by strengthening and modernising Medicare so it can respond to the rise we have seen in complex chronic disease.

”We welcome the Government’s modest investment for further development of a future patient-focused system through its Health Care Homes initiatives, including a role for community pharmacy. These are developments which could be impeded if GPs faced continued freeze on all of their Medicare payments.

“We must get the right approach to this fundamental development but much more is needed in terms of Government resourcing, local leadership and consumer involvement. A staged implementation of Health Care Homes is prudent.

“While we will always need high quality hospitals, we would like to see future hospital funding arrangements to include deals with the States that shift the focus to integrated care outside hospitals, particularly for those who are at risk of repeated costly visits to hospital.

“The Government in this Budget will generate significant savings by reducing further the price of medicines once they come off patent. A  separate measure to make generic medicines the automatic choice for prescriptions will also contribute to much-needed savings.

“That is very welcome because the savings will enable PBS to subsidise new drugs.  Also welcome is the removal from the budget figuring of the “zombie” $5 increase to prescription co-payments that was first proposed in the 2014 Budget but has been blocked in the Senate.

“Private health insurance will continue to be a source of widespread consumer dissatisfaction prompting possible declines in membership without the consumer-friendly reforms advocated by CHF and others which would oblige health funds to implement or lose eligibility for the health insurance rebate.

“We need a 21st century response to the health hazards of today: obesity, poor diet and sedentary lifestyle.

“The Budget includes a modest down payment in preventive health but we still lack a comprehensive obesity prevention plan. The hiatus in preventive health commitments has failed to recognise the huge dividends available in the future improved health outcomes. And the cost is small relative to the $75 billion the Commonwealth pays out in health costs each year.

“We are disappointed the Government is putting the interests of business before the health of the nation in not pursuing a tax on sugar-sweetened drinks which other countries like the United Kingdom have seen fit to introduce.

“We welcome the national rollout of the opt-out model for MyHealthRecord. This will reinvigorate our health care system which is currently stuck in a pre-internet world.

We welcome the mental health measures including tele mental health and suicide hotspots, and the $350 million to target suicide prevention and mental health of war veterans.

CHF supports the minister’s announcement that he is developing a National Health Plan.

“Overall this health budget is a commendable attempt to rebalance priorities while seeking to establish a platform that provides hope for a future more effective health system that is both responsive to consumer needs but also delivers best bang for the buck,” Ms Wells said.


Statement from National Congress of Australia’s First Peoples

The National Congress of Australia’s First Peoples coordinated a meeting with over 30 representatives from key Aboriginal and Torres Strait Islander organisations in Canberra tonight (Tuesday) to discuss our response to the 2017 budget and the implications it will have for First Peoples.

The urgent needs of our peoples are almost invisible in the budget. We are concerned by the lack of specific measures for Aboriginal and Torres Strait Islander peoples, particularly given
six of the seven Closing the Gap targets are not being met.

We welcome the $52.9 million allocation over four years for research associated with Closing the Gap provided it produces effective and efficient programs that make a tangible difference
to the lives of our peoples.

We support the appointment of a Productivity Commissioner dedicated to Aboriginal and Torres Strait Islander services but believe that the funds for the position should not come
from the Indigenous Advancement Strategy.

Insufficient funds have been allocated for frontline services, which will have a negative effect on health, justice, education and other targets, and increase the burden on these services,
many of which are already over-stretched.

At around $10 000 per participant, the administrative overheads for the cashless welfare card, make the program shockingly inefficient. The outcomes of this program are questionable. In
spite of this, the Government plans to expand the program to include two new sites without having announced the locations.

“This budget continues the trend of punitive measures on welfare recipients,” said Rod Little, Congress co-chair. “This further stigmatises the most vulnerable members of society and is
counterproductive to social cohesion,” added Congress co-chair Jackie Huggins.

We call on the Governments to work collaboratively with us, by implementing Aboriginal and Torres Strait Islander led-solutions, as outlined in the Redfern Statement.

See also the statement from the Close the Gap Campaign.


Statement from Royal Australian College of GPs

Lifting of the Medicare rebate freeze first step towards reinvesting in preventative health

 The peak body for Australia’s GPs The Royal Australian College of General Practitioners (RACGP) has welcomed the lifting of the Medicare rebate freeze as the first step towards a commitment to reinvesting in preventative health.

 RACGP President Dr Bastian Seidel said more than 85% of Australians receive preventative health care services from their GP every year – and that’s not only a great decision by these patients – it’s also a great decision for all taxpayers.

 “If you see your GP early you’ll save the whole community money by staying out of hospital – and receive GP health services that can cost up to ten times less,” Dr Seidel said.

 “The patient rebate had been frozen since 2013 putting pressure on patients and their GPs as out of pocket fees increased.

 “The lifting of the freeze was exactly what the RACGP’s #youvebeentargeted campaign was aiming for.

 “We’re also pleased Minister for Health Greg Hunt, has extended the Medicare Benefits Review.

 “If we are serious about focusing on a preventative GP health care we need to end the inequality of GP Medicare rebates compared to other clinical specialties.

 “It’s also pleasing to see the Federal Government make a genuine commitment to funding practice based research networks.

 “The initial $5 million funding to kick start these networks signals a pivot towards preventative health research that will build a knowledge base for the profession and help us build a healthy Australia.”


Statement from the Public Health Association of Australia

‘Medicine’ budget – not a health budget: Where is the investment on tackling obesity, tobacco and alcohol?

The Prime Minister’s rhetoric on prevention falls way short when looking at the expenditure in the budget. In February the Prime Minister announced a focus on prevention and was followed shortly after by the Health Minister commitment to “tackling obesity”. The three most significant causes of ill health in Australia are tobacco, alcohol and poor nutrition – yet these barely receive a mention in the health budget.

The Public Health Association of Australia (PHAA) expressed disappointment in the lack of investment in prevention. “Expenditure on prevention is likely to remain close to 1.5% of the health budget while the major issues of tobacco, obesity and alcohol remain with minimal increases in funding compared to the investment to remove the freeze on the Medicare rebate,” said Michael Moore, CEO of the PHAA. He added, “Australia is lagging considerably compared to places like Canada and New Zealand where over 5% of the health budget is committed to prevention”.

And now the Minister asks the community to wait another two years for the “third wave of reform”. “Two years is too long” responded Michael Moore.

POSITIVES

Removing freeze on Medicare rebate

The lifting of the four-year freeze on Medicare rebates is a positive step toward establishing universal healthcare for Australians, as it will initially facilitate lower out-of-pocket costs for patients visiting their GPs, as well as specialist medical services, such as pathology and medical imaging, and other procedures.

“The freeze on rebates combined with rising consultation fees has made it more difficult for Australians to visit their doctors and therefore prevented them from receiving the basic level of healthcare which should be their entitlement. A strong public health system means the affordable and efficient provision of healthcare services, which starts with general consultations being accessible and within the means of the Australian public.” Mr Moore added.

Tobacco

There is good news in the decision to equalise the tax treatment of roll your own tobacco and cigarettes. It should help to ensure that smokers worried about price quit rather than switch to equally lethal roll your own products and this budget maintains tobacco tax increases.

Immunisation and Vaccines

A commitment of $19.2m into improving immunisation rates along with stockpiling of essential medicines and vaccines costing around $85million is a strong commitment to protecting the health of all Australians.

Announcement on heart health

The PHAA welcomes the Government’s commitment to heart health with the announcement of $10m over two years to the Heart Foundation for walking interventions and further funding $5 million into material to enable better GP interventions for patients presenting with obesity.

Mental health and suicide prevention

The PHAA welcomes investment into mental health and suicide prevention.

 THE GLARING OMISSIONS

Preventive health 

It is disappointing to see that there will effectively be no increase to the percentage of funding for preventive health in the Budget. This is particularly disappointing considering the announcement by the Prime Minister and the Health Minister in February that there would be a new focus by Government on prevention.

By directing health funding toward the root causes of diseases, particularly those which are largely attributable to environmental factors such as obesity, alcohol and tobacco the general health of the population will increase significantly. This is why the PHAA proposes that preventive health should compare favourably to countries like Canada and New Zealand with prevention at 5% of the Health Budget.

Tobacco

Although there was some good news on tobacco the failure to provide adequate funding for public education on tobacco is deeply disappointing. This is an area where the government has dropped the ball in recent years. They receive around $10bn p.a. from tobacco revenue, but have failed to restore funding for the crucial media campaigns needed to underpin smoking prevention, especially for people in vulnerable and lower socio-economic groups where smokers are concentrated”.

Obesity – a missed opportunity

“Obesity is currently the second highest contributor to the burden of disease in Australia which costs billions to the public and private sectors annually, and it’s time we seek a proactive solution,” according to Michael Moore.

However, PHAA cautions that these are not the types of structural interventions required to fully address the problem, which are necessary if the Government is genuinely committed to tackling obesity as was announced by the Prime Minister in February this year.

“A levy on sugary drinks has proven benefits which we’ve seen in other nations like Mexico which have adopted this approach, therefore it is an essential preliminary step toward controlling the obesity epidemic”, Mr Moore said.

The introduction of a sugar levy would also have delivered additional funds which would have allowed further investment in prevention around obesity and other diet related disease.

The PHAA strongly advocates for a national, coordinated plan to tackle the problem of obesity in Australia, which has become a leading issue due to its high prevalence and severe associated health and social impacts.

Indigenous health

It is disappointing that Indigenous health interventions must also wait for the “third wave” of reform in another two years. However, the Closing the Gap falls within the Prime Minister’s portfolio.

Conclusion

The budget has some positives and negatives. However, the big omission is prevention and it makes no sense to wait another for another two budget cycles to begin on this “third wave” of reform when action taken now will save in the long term.


Statement from the Australian Council of Social Service (ACOSS)

Welcome change of tack in health education and housing, but vilification of people who are unemployed continues

ACOSS welcomes the change of tack to invest in health, education and housing, but the 2014 Budget mindset to demonise and impoverish the most disadvantaged continues.

“The government is trying to put the 2014 horror budget behind it, securing the National Disability Insurance Scheme and putting housing affordability on the agenda but the government still neglects, blames and targets the most disadvantaged in the social security system”, said ACOSS CEO Dr Cassandra Goldie.

“The government’s significant change of tack on Medicare and schools funding is welcome, recognising that people value essential services. The challenge is to properly fund them. The government has begun to strengthen