Sunday, October 02, 2005

AH! THE PAIN! WITH A PUBLIC MEDICINE SYSTEM NO MONEY IS EVER ENOUGH

Those bureaucrats are expensive! But there are SOME sensible suggestions for change to the Queensland system in the latest report on it

The Beattie Government must find almost $400 from each person in Queensland each year to fix the ailing health system in line with Peter Forster's blueprint for reform. In his 429-page final report on the health system, Mr Forster said he was shocked at what he had found and recommended sweeping changes to the staffing, structure and service delivery of Queensland Health. He said the State Government had significantly under-funded health care. It should now consider raising taxes, introducing means tests, reviewing increased patient fees and encouraging people to take better care of themselves.

Mr Forster also said Queensland Health should ration or withdraw from some services. The report recommended that hundreds of Queensland Health head office staff be sacked or transferred to regional centres. And it called for an additional 280 doctors and 1500 nurses.

Mr Forster said the Government should be honest about the cost of health care delivery and the performance of Queensland Health. He recommended six-monthly reports on the true state of waiting lists, which had been under-estimated by almost 50 per cent. Accepting the report yesterday, Premier Peter Beattie and Health Minister Stephen Robertson estimated the cost of reforms would be $1.5 billion a year. Spread across Queensland's population, which is tipped to reach four million late this year, this equates to $375 a person in new taxes or charges, or a reduction in existing services.

Mr Beattie previously had promised money from last year's $3 billion Budget surplus for health reforms. But with large amounts of that money needed for public servants' superannuation, and with the surplus projected to decline to $220 million in 2008-09, Mr Beattie yesterday admitted there would be pain in paying to fix health. He had not yet decided to raise taxes or introduce new charges, but said the cost of the reforms meant the Government would have to find new ways of funding hospitals. "The current surplus is not sufficient to deal with all the $1.5 billion additional expenses," Mr Beattie said.

He pledged to maintain the essence of the free hospital system but to also consider the Forster recommendations for co-payments and means testing at public hospitals. Mr Beattie admitted the report was "a serious indictment on a range of governments, including mine". He said the poor funding of hospitals had come about through a combination of Queensland's traditionally low taxes and its high population growth.

Mr Forster said that Queenslanders needed to realise they could not continue to have low taxes if they wanted leading-edge health services, adding: "We've now got to make decisions as a society." He said a better funding agreement was needed between the state and commonwealth governments. As well, the state could consider buying private health insurance for Queenslanders who could not afford it. .....

Mr Springborg said Mr Forster had missed the opportunity to implement serious reform of the health bureaucracy. He predicted that the system eventually would settle back to exactly what it had been before. "All they've done is rearrange the bureaucracy and you've still got the same problems – four times as many bureaucrats and administrators as doctors and nurses."

More here

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For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?

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