Slogans No Substitute For Health Policy
The Age
Monday February 14, 1994
from Russell Schneider, chief executive, Australian Health Insurance Association.
Dr Brendan Nelson's concern (10/2) about my remarks on health financing, conveniently overlooks the fact that it is a section of the medical profession (or its public relations advisers) who have tried to reduce the current health debate to a war of slogans.
It was Dr Nelson (or one of the AMA's PR people) who propagated the claim that health funds were promoting a system that would lead to patients being discharged from hospitals ``quicker and sicker" _ hardly an appropriate term to use when discussing complex issues.
Having embarked on a campaign designed around such crudities (which must inevitably be inaccurate if not downright dishonest), Dr Nelson can hardly complain if anyone else simplifies the issues.
My own comments, which were somewhat robustly reported, should be seen in the context of a situation in which, despite virulent opposition, health funds are genuinely trying to reform the hospital financing system for the better _ for patients, fund contributors, doctors, hospitals and taxpayers. Certainly, one primary concern is to overcome the current problem in which insured patients are faced with large, and often unexpected, uninsurable bills. Overriding that concern, however, is the need to ensure a system is put in place that guarantees, as far as such guarantees are possible, high standards and quality health care.
There is neither desire nor intention on the part of insurers to see quality deteriorate _ quite the reverse. There is no logic in seeing patients discharged ``quicker and sicker". At the same time I am sure most patients would wish to see financial incentives put in place that discouraged unnecessary long stays which occurred, for example, as a result of complications or infections, or even the nature of the financing system itself.
I am glad to see Dr Nelson supports a ``user-friendly" case mix system, with doctor payments built on the existing medical benefits system. This is precisely what AHIA proposed in its own policy paper last year, copies of which can be obtained from my office by anyone interested. Unfortunately, these proposals were not at that time embraced by the AMA.
My own view is that the question of hospital financing arrangements are far too complex to be dealt with by cheap, even puerile slogans and PR gimmicks. The war of the press release _ which in volume terms questions the AMA's commitment to environmental protection _ is no way to deal with these questions. For my part I would welcome a rational debate _ or better, a willingness on all sides to discuss constructively how the administrative details can be worked out. It will be a constructive day when my good friend Brendan tells his PR team to do the same.
Russell Schneider, Deakin, ACT.
© 1994 The Age
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