The Health Wrap: revamping Medicare; Indigenous policy roadblocks; reforming mental health

By Frances Gilham

Revamping Medicare: a mixed response

News that the Government had stepped back from its $7 GP co-payment proposal and was hoping to replace it with a new, slightly changed package that still aimed for significant Budget savings was met with mixed reactions, with many in the healthcare sector arguing the plan was still inequitable.

This news came after weeks of media speculation about the likelihood of the original proposal passing the Senate, with The Australian reporting on a divided Coalition, mixed messages and “angry cabinet Ministers”.

Prior to the announcement, a Senate report was released that called for a “wholesale rethink of Government policy” and recommended the Government “immediately abandon its plan to implement the $7 co-payments”, according to Croakey.

And Griffith University researchers had written an excellent article for The Conversation examining why price signals are a flawed device when it comes to regulating healthcare markets.

After its release, Michelle Grattan wrote a nice overview of the revised co-payment plan, and provided responses from stakeholders such as the Public Health Association of Australia and the Consumers Health Forum who criticised the plan for shifting the burden onto GPs.

Croakey also provided responses from key players in its coverage, including the Rural Doctors Association of Australia and NACCHO, the National Aboriginal Community Controlled Health Organisation – both of whom worried the co-payment would still be used for those without healthcare cards and would deter both rural and Aboriginal patients from visiting their GPs. In another Croakey piece, Jennifer Doggett looked at the different responses to the plan from peak bodies versus advocates and academics.

Former political adviser and GP Dr Ruth Kearon wrote for Croakey that the proposal may have political, rather than policy, motives, suggesting that this was the Government’s first step in moving private health insurance into the primary healthcare space.

Stephen Duckett wrote an excellent analysis of the plan, saying it was just as inequitable as the old one, and may be solving a problem – “six minute medicine” – that doesn’t exist.

Terry Barnes wrote about the plan for the ABC news website, saying it was a “step in the right direction” but “too generous and risk averse.”

And the Australian Association of Medical Research Institutes (AAMRI) welcomed the Government’s renewed commitment to the medical research future fund.

There was far less fanfare and focus for another federal health policy development, the release of the Health Issues Paper to inform the Federation White Paper: a health policy analyst provided Croakey with this helpful insight.

The Federal Government’s Mid-year Economic and Fiscal Outlook (MYEFO) delivered more bad news on health, including warnings from aid agencies in this MYEFO wrap on Croakey about the lessons we can learn from failure to address poverty and health issues in developing nations from the Ebola crisis.

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Indigenous policy: overcoming roadblocks and driving change

Croakey reported on an open letter written by the National Congress of Australia’s First Peoples to the Prime Minister calling on the Government to protect the future of remote communities by intervening against state action to close them down.

The South Australian Government has also drawn criticism from Indigenous community groups by cutting short the APY Lands’ food security strategy by two years, saying “key priority areas have been met”, despite claims that there is still important work to be done, ABC news reported.

The inequity of levels of Indigenous imprisonment was also in the news. “Indigenous people are one of the most imprisoned groups in the world, yet respective governments are wilfully blind when it comes to seeing prison as part of the cycle of indigenous poverty, ill health and disadvantage,” this Fairfax article said.

But there were also reasons to celebrate successes in Aboriginal and Torres Strait Islander policy, advocates said. In this Croakey article researchers John Gilroy and Nicholas Biddle described how knowing the problem and understanding the research gaps were two early steps in a long process of future change, and they argued we are on the right track.

And BBC News reported on an innovative NSW program run by the George Institute for Global Health, which is helping empower young Aboriginal Australians by mentoring them and supporting them to get a driving license, contributing to better education, employment opportunities and independence.

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Regulating what we eat

Assistant Minister for Health Fiona Nash has officially launched the Government’s new scheme for rating the healthiness of foods via a star rating system, the SMH reported.

The scheme might help sort out dodgy front-of-pack claims, like those exposed by a new Cancer Council analysis that looked at fruit and vegetable claims on packaging; revealing many misleading claims on foods with negligible nutritional value.

This blog post on the Kevin MD website examined whether a carrot or stick approach might be more useful in nudging people to make more healthy choices, using the food stamp program in the US as a case study. It came to the conclusion that a ban on buying soda might be more effective than offering a carrot to eat more vegetables.

In Mexico, the stick approach appears to be working, with preliminary findings suggesting that citizens are drinking less soda after the introduction of a 1-peso-per-litre tax on sugary drinks, this article in the California Report said.

Whether the regulatory approach to nutrition policy will work is still to be determined, but any new initiatives are surely to be welcomed, as new research findings were revealed that showed obesity can reduce life expectancy by up to eight years, The Age reported.

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Reforming mental health

“It’s time to stop saying almost half of all Australians suffer from a mental illness at some time in their lives,” an article published in the Australian Financial Review opened this week.

“Although this is the official view, it depends on floppy definitions and figures,” it said, arguing the pendulum may have swung too far in mental health, trivialising some issues and over-treating and over-medicating others.

But Sebastian Rosenberg said in this Croakey blog post our mental health system is still in crisis, and criticised the Government for withholding the National Mental Health Commission’s Review of Mental Health Services, which will not be publicly released.

And in New York City, a major reform of the criminal justice system is underway, with a focus on providing mental health services for inmates, with the goal of breaking the “revolving door of arrest, incarceration and release that has trapped many troubled individuals in the system for relatively minor, quality-of-life offenses,” The New York Times reported.

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Improving hospital systems: local and global initiatives

An exciting new social media campaign #hellomynameis launched in the US, aiming to transform healthcare by encouraging healthcare staff to focus on the simple things, like introducing themselves to patients. Consumer participation commentator Anne Cahill Lambert AM wrote a piece for Croakey calling for the campaign to be introduced here.

This article described how a new non-profit in the US – the Patient Safety Movement Foundation – is aiming to achieve zero preventable hospital deaths, by holding an annual forum that brings together stakeholders from all areas of the health system to come up with new ideas to promote hospital quality and safety.

As part of a radical transparency drive in the UK, patients will be able to look up the performance of medical teams at two hospitals from early next year when a new program is rolled out to make the system the most transparent in the country, the Eastern Daily Press website said.

Closer to home, public hospitals in Australia are being asked to review their treatment of bowel cancer after a Victorian study found people cared for in private hospitals live longer than those treated in the public system, The Age reported.

And a feature article in Medical Observer examined how expanding traditional health workforce roles can help improve healthcare, with physician assistants used as an example.

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Other Croakey reading you might have missed

• The Open Polar Sea: a creative call for climate action and musical tribute to the late Professor Tony McMichael
• Urgently needed: voices for integrity in public policy making
• Rural health leader condemns ABC cuts
• On the many ways that federal policies are hitting Tasmanians’ health
• Review patient travel schemes and parking costs: Chronic Illness Alliance
• Solving complex problems: adaptation vs attribution