BAU budget sets the scene for an aged and health care election

Cost of living pressures may be the name of the game in this year’s Australian federal election, but aged care and healthcare will surely play a big role. The Coalition government has been touting its healthcare cred in the lead up to this year’s budget, citing the billions spent on the COVID response as evidence of healthcare spending, along with the vast sums it can conjure for newly subsidised medicines on the PBS.

It is also touting yet again its “rock-solid commitment to Medicare”, otherwise known as the Medicare guarantee, which outgoing health minister Greg Hunt has used for years as a slogan to push back against Labor accusations of inadequate funding for healthcare and other assorted Mediscares.

Labor this week decided to pitch one of its election tents on the issue of aged care, which its focus groups are obviously saying is a big election issue. The Coalition can splutter all it likes about its billion-dollar response to the Royal Commission on Aged Care Quality and Safety, but with a spokesperson like Richard Colbeck in charge, the government doesn’t look too good. Aged care worker income is also a good link to the ALP’s main election message, that of increasing wages for low and medium-income earners, and the government’s claims that Labor can’t pay for these increases look pretty silly in light of the cash it is splashing at the moment, none of which Labor will oppose.

Electioneering and spin aside, it is clear that this year’s budget is business as usual for healthcare. As the AMA points out, there is no real increase in the budget beyond the usual recurrent spending and planned growth, and whatever extra money has been given to the aged care sector immediately following the Royal Commission’s recommendations has been lost in the news cycle. There is of course no mention of extra money for the primary care sector, which has been crying out for it for three decades, but promises of money for GPs does not get votes. Money for hospitals and new drugs does.

And for digital health? Hmm. Vast sums have been ploughed into the My Health Record system by both sides of government for no discernible benefit, although the current government continues to cling to the idea that it has ushered in a new wave of eHealth through what it grandly describes as “permanent universal telehealth” to the tune of half a billion dollars. It is nothing of the sort. That is money that would otherwise have been spent on face to face GP and psychologist visits, and there is nothing universal about it. Unless you have seen your regular GP face to face in the last year or have a mental health plan, you can’t book a Medicare-funded telehealth appointment. How “universal” is that? As for permanent, it seems the Department of Health keeps changing the rules based on the whims of the president of the RACGP.

The budget contains regular recurrent funding for the Australian Digital Health Agency and a bit extra for Healthdirect, along with expected funding for Service Australia’s work on modernising the Medicare payments platform. There is also a little bit of cash to link the My Health Record to the MyGP voluntary patient enrolment program, and something described as a “meaningful use index” for the MyHR. Goodness knows what that’s all about. We’ll see if we can find out next week but in the meantime, if you know, drop us a line.

And on the topic of ‘goodness knows what’s that all about’, we came across this very curious tender by the Department of Health for prescription delivery service (PDS) and single active script list registry (ASLR) providers. We know of only two of the former that are currently in the market and the latter is serviced by a joint venture between the former, so we have no idea why the department has gone to market. eRx and MediSecure are private companies but they are fully subsidised by the government, so we are a bit at a loss as to why this tender has been issued.

The only reason we can see is in the pricing model. For prescription delivery services, companies can bid at 3c per script dispensed, or on a volume basis. As far as we are aware, the department has in the past been subsidising ETP at a rate of 8c a script dispensed – the exact amount the prescription exchange services charge pharmacies – but that seems to have come down in price over the years. Is that the reason for this tender? Let us know.

The only other big news this week was one of our most popular stories, about the quick roll-out of Vocera’s voice-activated devices at Sydney LHD during the Delta wave. This proved to be a hugely popular story and we’d like to bring you more of the same, but eHealth NSW doesn’t seem to be so keen. This is unfortunate as we hear they are doing great things in digital health, but the lack of transparency is troubling.

That brings us to our poll question for this week:

Was this a useful budget for healthcare and health IT?

Vote here or leave your comments below.

We got a big response to last week’s poll on whether you thought ResApp’s technology for diagnosing COVID-19 had potential. The vast majority agreed: 83 per cent to 17 per cent. We also asked what evidence you used for your conclusion. Here’s what you said.

Comments  

0 # Kate McDonald 2022-04-08 15:57
Last week, we asked: Was this a useful budget for healthcare and health IT? We got a desultory response, at best. Just a handful of respondents said yes: 88 per cent said no.

We also asked that if you thought yes, what measures did you support? If no, what would you have liked to have seen? Here's what you said:

- There is a huge need to increase digital capacity in aged care that remains unfunded. And no funding to connect up our digital health system silos.

- Investment in optimisation and enhancement of a single digital pateint record that is focussed around patient centred approach and value based healthcare

- Better rebates for patients. Many can't afford the gap payments.

- some long term goals ...too focused on short term fixes with no real strategy to address what counts

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