Opinion: Time to empower patients in healthcare
Sydney Morning Herald At near double digit rates, health costs are at the heart of government spending rising faster than tax revenues.
While I understand service providers enjoy that growth of spending - I would too if I were a service provider - as a purchaser of services this is simply not sustainable for the federal government.
Health Minister Sussan Ley got it right this week in her address to the National Press Club, reform is certainly needed in funding models.
Is 'fee for service' the appropriate model for patients with chronic disease and ongoing healthcare needs?
One in two patients have some form of chronic disease and will need ongoing expensive care and ongoing interaction with multiple health professionals for the rest of their lives. For these people, is fee for service the appropriate model?
Much of that innovation is being led by the private insurers. The shift to blended funding models is based on understanding the risk associated with each patient, who's a high risk patient, who's a low risk patient. Where we are prepared to pay more and where we are prepared to pay less will be central to the sort of payment systems that are going to succeed in the future.
All of that requires integration across primary care, hospital care, specialists and so on - and that integration is being impeded by our federal model.
There is no doubt there is dysfunction between governments in the way we manage health.
The UK and New Zealand healthcare systems have a big advantage in that you don't have the multiple layers of government that are causing dysfunction. The Federation white paper, if it is to deliver anything useful, must deal with that dysfunction across federal and state governments in health.
We have failed to harness private-sector insurers and other private-sector service providers in the way that I think we need to. We have very serious resistance to that and we're going to have to find a way through it.
Most innovation, in my experience, will come from the private sector. Yes, fundamental R&D can be facilitated by government. However, if you don't have fiercely competing innovators looking for solutions to problems then you're not going to get the solutions.
Perhaps the most important thing of all to drive health reforms is shifting power to customers. In sector after sector people are saying how terrible it is that politicians don't seem to have the courage to drive reform. The fact of the matter is politicians have one incentive above all and that's to win the next election. So if you really want reform then don't give the power to the politicians, give the power to the customer.
That means transparent information.
One of the best innovations of the last government was the My School website, because for the first time ever we could compare the performance of schools. We could do the same in health. While we have a rudimentary hospitals comparison website, why don't we see that with doctors?
The UK National Health Service is leading the world in this area, with NHS Choices. This website and app doesn't just provide details about health services available across the UK, it provides detailed survey results on each service, and allows users to rate the services themselves and to see other people's ratings. The combination of objective fact-based data, survey outputs and customer ratings is a real shift in power to patients.
Empowering patients, paying for outcomes, harnessing our private sector innovators and integrated health services: Now that would be serious reform.
