I personally worry at the waste in healthcare and how we can save on Medicare. Unless we do something we will have to start thinking about how to save Medicare itself. To give an example: prior to the arrival of bulk billing practices in Darwin a few years ago we had one radiology provider and a couple of pathology companies. We now have 4 radiology providers and a few extra pathology providers. These also bulk bill. So I can now order unlimited blood tests and radiology without cost to myself, the practice or the consumer (a more appropriate name in this setting). I can get an MRI in 15 minutes and almost any test apart from an ultrasound within the hour.
I can’t imagine the actual increase in costs – is anyone imagining? I do see the result of confused patients with multiple positive obscure serological tests and a cascade of radiology – each new test suggested by the radiologist to rule out the sinister nature of some incidental finding on the previous view. Further tests require further brief visits while time heals almost all things. Dollars all round – nobody’s money.
This is not ideal and the opportunity cost of unnecessary attendances, laboratory tests and radiology investigations is probably massive in terms of non-health fields such as housing and other basic services. So why don’t we come up with some alternatives for consideration. A $7 co-payment doesn’t seem to do the job at all and seems to have few advocates. Here is an idea of my own which has had as little thought as the co-payment but might help funds go where they do more good.
Any attendance resulting in issuing of a private medical certificate for a period off work of less than 7 days will not be billable to Medicare. This would apply at the time of the visit or at any point in the future (to avoid being able to issue the medical certificate at a later date in order to claim the fee) but would not apply to parent or carer certificates for children.
Would this reduce medicare claims? Would it reduce the time off work for minor illness? Could it work? Would it be open to gaming? Let me know what you think.
Medicine at the Deep End 