Ley prescribes more talks on reform for 'sluggish' and 'bloated' Medicare

After an extensive round of consultations with health professionals and patients, Health Minister Sussan Ley has announced that yet more work needs to be done to find solutions to Medicare’s problems.

Rather than immediate changes or budget savings, the minister said there would be a taskforce to examine the Medicare Benefits Schedule, an advisory group on primary health care, and an initiative to develop clearer rules for Medicare compliance.

The government’s proposed reforms would be “an ongoing process”, she said, with taskforces expected to report back “with key priority areas for action in late 2015”.

The focus on developing a more efficient system “meant no overall savings target had been attached to the consultation process”.

Meanwhile the pause on indexation of GP and specialist Medicare rebates will remain while the government worked to reform the system. But “as an article of good faith, I am open to a future review of the current indexation pause as work progresses to identify waste and inefficiencies”.

Ley said the government’s consultations did not include a co-payment or a proposal to examine one. The co-payment was scrapped after it was clear it would not pass the Senate and the Coalition suffered damage from a sustained doctors' campaign.

The government has appointed Professor Bruce Robinson, Dean of Sydney University’s Medical School, to head a Medical Benefits Schedule Review Taskforce. Ley said the MBS had more than 5500 services listed and not all “reflect contemporary best clinical practice”.

Former Australian Medical Association president Steve Hambleton will lead a Primary Health Care Advisory Group. It will look at how to provide better care for those with complex and chronic illnesses, innovative care and funding models, improved mental health care, and greater connection between primary health care and hospital care,

Ley said the government would work with clinical leaders, medical organisations and patient representatives on compliance rules and benchmarks. “The vast majority of medical practitioners provide quality health care, but a small number do not do the right thing in their use of Medicare.”

She said doctors and patients had raised problems from over-testing and outdated or unproven treatments to unnecessary refusals and duplication.

The overwhelming feedback she’d had during her consultations was that Medicare’s structure “no longer efficiently supported patients and practitioners to manage chronic conditions or the complex interactions between primary and acute care”.

“Basically, there’s wide agreement the Medicare system in its current form is sluggish, bloated and at high risk of long term chronic problems, and continuing to patch it up with bandaids won’t fix it,” she said.

Michelle Grattan does not work for, consult to, own shares in or receive funding from any company or organisation that would benefit from this article, and has no relevant affiliations.