Private insurance subsidy has increased stress on public health system, report says
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《英国医生杂志》
A discussion paper that challenges government subsidies for private health insurance as a way of supporting the private hospital system has drawn tentative support from Australia抯 leading doctors?group.
The report抯 author, Ian McCauley, a lecturer at the University of Canberra抯 School of Business and Government, argues that subsidising private health insurance has made the public health system worse rather than better. "Because of the subsidies, scarce resources, particularly skilled staff, have been drawn to the private sector. There is no relief of the pressure on public hospitals," Mr McCauley argues.
The report was commissioned by the Australian Consumers Association and the Australian Healthcare Association, the biggest group representing public hospitals.
In July 1999 a 30% rebate on health insurance premiums was introduced by the government but had little impact on the proportion of people with private insurance because of confidence in the public health system. Pressed by the private health insurance companies, in 2000 the government introduced "lifetime cover" policy, which provided for a 2% increase in premiums for private health insurance for every year that people aged over 30 years remained uninsured. The percentage of people with private health insurance jumped by 15% to 45%.
However, as the "lifetime cover" advertising campaign wears off and funds increase their premiums, participation rates have been dropping once more. "Because of leakages to administration, ancillaries and gap payments, support for private insurance has been a high cost way to support private hospitals," the report states.
With almost a third of hospital beds in the private system, Mr McCauley prefers that a subsidy be provided directly to the private hospitals. Only $A700m (￡290m; $540m; �425m) of the $A1.95bn subsidy makes it to the hospitals, he states.
With a federal election scheduled for later this year梩he result of which is expected to be close梡rivate health insurance companies are worried that the opposition Labor Party may get into government and abolish the subsidy.
The leading Australian doctors?group, the Australian Medical Association, has added to the industry抯 anxiety by cautiously embracing Mr McCauley抯 report. In a statement the association抯 president, Bill Glasson, suggested that the option of directly funding private hospitals was "one worth exploring."
A spokeswoman for Tony Abbott, the federal minister for health, dismissed the report. "The government抯 view is that the 30% rebate and lifetime health cover have proven to be good value for money and have been essential in keeping private health insurance memberships rates relatively stable," she said.
The chief executive officer of the Australian Health Insurance Association, Russell Schneider, points to a report by the economic modelling consultancy Econtech, commissioned by a health fund, which states that each dollar of the subsidy saves the government two dollars.
A spokesman for the Australian Consumers Association, Martyn Goddard, disputes the figure. "Only 35% of the rebate makes it to the hospitals. Most of the rest is ancillaries like dentistry and physiotherapy," he said.
Stress on Public Hospitals: Why Private Insurance has Made it Worse is at http://resources.dmt.canberra.edu.au/imcauley/confs/phpi.pdf
The Econtech report, Easing the Pressure: The Intergenerational Report and Private Health Insurance, is at www.medibank.com.au/pdfs/Medibank_Final_Murphy_report.pdf(Canberra Bob Burton)
The report抯 author, Ian McCauley, a lecturer at the University of Canberra抯 School of Business and Government, argues that subsidising private health insurance has made the public health system worse rather than better. "Because of the subsidies, scarce resources, particularly skilled staff, have been drawn to the private sector. There is no relief of the pressure on public hospitals," Mr McCauley argues.
The report was commissioned by the Australian Consumers Association and the Australian Healthcare Association, the biggest group representing public hospitals.
In July 1999 a 30% rebate on health insurance premiums was introduced by the government but had little impact on the proportion of people with private insurance because of confidence in the public health system. Pressed by the private health insurance companies, in 2000 the government introduced "lifetime cover" policy, which provided for a 2% increase in premiums for private health insurance for every year that people aged over 30 years remained uninsured. The percentage of people with private health insurance jumped by 15% to 45%.
However, as the "lifetime cover" advertising campaign wears off and funds increase their premiums, participation rates have been dropping once more. "Because of leakages to administration, ancillaries and gap payments, support for private insurance has been a high cost way to support private hospitals," the report states.
With almost a third of hospital beds in the private system, Mr McCauley prefers that a subsidy be provided directly to the private hospitals. Only $A700m (￡290m; $540m; �425m) of the $A1.95bn subsidy makes it to the hospitals, he states.
With a federal election scheduled for later this year梩he result of which is expected to be close梡rivate health insurance companies are worried that the opposition Labor Party may get into government and abolish the subsidy.
The leading Australian doctors?group, the Australian Medical Association, has added to the industry抯 anxiety by cautiously embracing Mr McCauley抯 report. In a statement the association抯 president, Bill Glasson, suggested that the option of directly funding private hospitals was "one worth exploring."
A spokeswoman for Tony Abbott, the federal minister for health, dismissed the report. "The government抯 view is that the 30% rebate and lifetime health cover have proven to be good value for money and have been essential in keeping private health insurance memberships rates relatively stable," she said.
The chief executive officer of the Australian Health Insurance Association, Russell Schneider, points to a report by the economic modelling consultancy Econtech, commissioned by a health fund, which states that each dollar of the subsidy saves the government two dollars.
A spokesman for the Australian Consumers Association, Martyn Goddard, disputes the figure. "Only 35% of the rebate makes it to the hospitals. Most of the rest is ancillaries like dentistry and physiotherapy," he said.
Stress on Public Hospitals: Why Private Insurance has Made it Worse is at http://resources.dmt.canberra.edu.au/imcauley/confs/phpi.pdf
The Econtech report, Easing the Pressure: The Intergenerational Report and Private Health Insurance, is at www.medibank.com.au/pdfs/Medibank_Final_Murphy_report.pdf(Canberra Bob Burton)