Why Your GP Should Remain Your Primary Advocate and Not Bean Counters
?Why Your GP Should Remain Your Primary Advocate and Not Bean Counters
Urge your local senator to pass a bill to protect affordable access to high-quality healthcare, your doctor, and your healthcare provider. Do not allow big business in.
Thank you, Michelle O'Brien, for bringing this alarming Senate recommendation to my attention. You have certainly made my Saturday morning more eventful, and I feel compelled to write a response.
As we navigate the complex healthcare landscape, we must emphasise the importance of maintaining the doctor-patient relationship free from undue influence. In light of the latest healthcare reforms, here’s why your GP must remain your primary independent patient advocate:
The Senate must vote no to a recent recommendation allowing private health insurers or third parties to interfere with the doctor-patient relationship.?
"Role of private health insurance in primary care
2.2? Senator Di Natale's second reading speech indicated that the intention of the Bill is to prevent PHFs from entering the primary care sphere.[1] Three PHFs – Medibank, Bupa Australia and the Hospitals Contribution Fund of Australia Ltd (HCF) – and the Australian Medical Association (AMA) disputed this rationale, contending that there is a role for PHFs in primary care."
Source: Role of private health insurance in primary care
The Risks of US-style? Managed Care
The recommendation to allow private health insurers to enter the primary care sphere is alarming. This could lead to unaffordable and inaccessible healthcare, as insurers may prioritise costs over care to make a profit. This may introduce more disempowering red tape for practitioners and hurt their viability unless you love Big Mac care.?
The Australian Medical Association's (AMA) recent backflip on this issue is alarming. After a three-month US study tour, I presented a paper in 1997 called Managed Care by Stealth; see below. At the time, the AMA nationally supported my concerns.
Remarkably, many of my on-the-record predictions in the article are or are coming true.?
There has been unprecedented overservicing and Medicare fraud, overservicing in the US for decades. Doctors have been subjected to gagging commercial confidentiality clauses. They are not permitted to speak up.
Who can you trust with your healthcare?
The AMA's recent and alarming backflip supporting private health insurers to play a vital role in General Practice is highly concerning. Understandably by increasing a business's for-profit scope of practice into the role of its practitioners should create an enormous amount of anxiety and conflict among the medical and healthcare professional bodies and their members.
The thin edge of the wedge?
Like in the US, The Committee's recommendation that the Senate approve private health insurers' access to GP clinics may ultimately lead to unaffordable and inaccessible healthcare.
In 1980, the High Court clarified that neither Medicare nor Parliament can interfere with the doctor-patient relationship.
“Gibbs J delivered the leading judgment. His Honour reiterated the principle that there is no explicit head of power under which the Federal Parliament can regulate private medical practice, in the sense of the physician–patient relationship.[98] The Commonwealth’s powers are limited to regulation of those financial and administrative incidents of practice that pertain to provision by the Commonwealth of medical and pharmaceutical benefits.”
Source:1980 RACGP v Commonwealth of Australia. Medicare is a public government insurance company that pays for healthcare.
The only legally viable method of influencing healthcare is through financial leverage, either directly or indirectly, such as GP accreditation, Workforce Incentive Programs (WIP), the Medicare Benefits Schedule, and bulk billing incentives. However, implementing these measures directly is politically fraught, making private health insurers a more politically palatable and subtle alternative.
Private health insurers are prohibited from funding general practice, and a bill reinforces this prohibition before the Senate. If private health insurers succeed in this endeavour, it could have significant consequences. Practitioners and patients would lose their ability to complain, as insurers would gain the power to dictate which healthcare providers patients can see and at what cost, similar to the system in the US. This would result in reduced patient choice and force practitioners to accept prices set by the insurers.
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The system would become vulnerable to exploitation since it would operate outside the direct oversight of the Federal Government, allowing them to disengage from any responsibility. This shift would essentially privatise (a public problem) the control over healthcare access and costs, making it a private matter rather than a public concern.
Avoiding Interference from Third-Party Interests
This is a non-negotiable: Third-party businesses, including health insurers, should not be allowed to interfere with the doctor-patient relationship. This interference can lead to financial coercion and compromise the quality of care you receive.
The Threat of Commercial Influence
Big business healthcare operators increasingly influence decisions, often prioritising profits over patient care. It is only sometimes a level playing field. A case in point is the recent payroll tax decisions arising from significant corporate behaviour, creating a systemic risk for the entire industry. Today, patients are forced to pay a GP payroll tax due to a poor business model that many smaller practices have naively copied.?
For decades, there have been many media reports that doctors in the US have been "gagged" by commercial confidentiality clauses, preventing them from speaking out about their concerns about medical and healthcare system errors, fraud, overservicing, or any other concerns they may have. Big companies naturally have undue influence. This is why, for decades, many problems have gone undetected. They are also the slowest to change.
Support Unconflicted Medical Bodies
Unconflicted medical and health professional bodies, rather than health insurers, must be supported in their vital roles. Be wary if they receive significant sponsorship income from vested interests.?
Ethical professional bodies strive to safeguard the public, patients, taxpayers, and practitioners by ensuring that healthcare decisions are made with the patient's best interests at the forefront, in collaboration with a competent practitioner.
The Importance of Patient Advocacy
As an ethical accountant and patient and provider advocate (I had a bad car accident in 1989 and underwent nine operations), I urge you to give your health a fair go. Prevent policies that could compromise healthcare quality by voting out any government or politician that supports such measures.
Let's stand together to protect the integrity of our healthcare system and ensure that your GP remains your primary, independent advocate.
Urgent Call to Action for Australians
This is a critical message for all Australians, medical professionals, and healthcare practitioners: if you want to prevent red tape, rising healthcare costs, and declining quality, you must act now. Share this concern with your local politician and Federal Senator to ensure that the Senate votes against introducing US-style managed care programs to Australia.
Take Action:
1. Contact your local politician and Federal Senator, share this information, and express your concerns.
2. Support unconflicted medical and healthcare professional bodies and their members in their advocacy for patient-centred care.
Share this message to raise awareness about managed care risks in Australia.
It is time to give your health a fair go.
It's crucial to prevent such policies by voting out any government or politician supporting them.
Declaration of interest: I am an ethical accountant and a patient advocate.
Michael Wright Stephen Duckett David Dahm Mark Butler Max Mollenkopf Jeremy Knibbs Holly Payne Dr Nicole Higgins MBBS FRACGP GAICD
#Managedcare by Stealth #IHSEB
Family Physician
1 个月I agree My patient’s frequently ask me after they’ve been to the specialist or hospital where a treatment plan has been advised and say” but you’re my doctor, doctor, what should i do?