‘Best before’ dates advise consumers of the optimum time to use a product. Consuming particular food products after the stated date won’t necessarily make you sick, but some of these products will lose their freshness or nutritional value beyond the designated date.
Manufacturers provide ‘best-before’ dates to advise consumers on when the product is at its best quality. Use-by dates are different; they indicate a produce is unsafe or may pose a health risk if consumed after the specified date.
Medicare, Australia’s universal health system, was created in the mid-1980s. It is still safe for consumers to use, although if it has a ‘best-before’ date, it would be close to expiring by now.
The advent of digital health technologies, AI in healthcare, interoperable data sharing and myriad advances have rendered aspects of Medicare past their ‘best-before’ timeframe.
Medicare works, and by all international comparisons, those living in Australia enjoy an excellent health system. Yet, we are using a model that is diminishing in effectiveness because it isn’t sufficiently agile to adopt and adapt to technological advancements.
So often we hear stories – or experience them ourselves – of inefficient, outdated, and costly health practices that can (and should) be reformed because there are digital health solutions that can make them more efficient, effective and cost/time-saving.
Referrals, for example
The simple referral to a specialist is just one example. Recently, a colleague was contacted by their specialist, who said they needed to see them based on a review of their remote monitoring (digital health) data.
Problem was, the patient didn’t have a referral, although it was the specialist who requested the appointment. So, they had to book an appointment with their non bulk billing GP to obtain a printed referral, then book in with their specialist. This process took almost six weeks.
This scenario is not uncommon, in fact, we hear examples of this daily – repeat visits to obtain referrals when we know this can be undertaken through cheap, safe digital means.
Patients are instructed to book appointments to receive pathology test results when technological solutions, including the appropriate use of AI, could allow a nurse (or AI generated text) to contact the patient and provide routine results that have been approved by a treating physician.
Adaptation ‘difficult’
A problem with Medicare is that its payment structure is out of date, and this makes adaptation to digital health incredibly difficult.
A system that remunerates private practice medical and allied health practitioners on a fee-for-service basis perversely encourages the continuation of routine processes that are inefficient and wasteful. As long as funding mechanisms are not adjusted to support the adoption of more efficient processes, the discontinuation of the legacy ones would lead to significant incomes losses for healthcare providers.
We have a shortage (and mal-distribution) of General Practitioners in part because GPs are not well remunerated when you factor in their qualifications and the demands placed on modern primary care physicians.
In rural, regional and remote areas, the pressure on GPs is significant, and burn-out a major issue. Reducing doctors’ incomes by removing Medicare rebates for services that can be provided digitally creates a plethora of additional problems.
All this is obvious and has been outlined numerous times by leading health economists. And yet, here we are in another election cycle where a most fundamental aspect of Medicare has not been discussed in-depth.
It is likely we will be back again at the next election watching political parties argue over access to Primary Care, out-of-pocket costs, hospital waiting lists, crowded EDs and the poor state of regional and rural health services.
What will it take?
What will it take to reform Medicare to be fit for purpose in the digital health age?
Substantial reforms in healthcare are typically driven by either crisis, or the election of a reformist government with sufficient capital to initiate changes without fear of being removed at the next election.
In the UK, the Blair Labour government was swept into office in 1997 after 18 years in opposition, promising to reform the National Health System (N H S). Depending on what you read, it has, in varying ways, been successful, party successful, problematic or a failure.
Without getting into debates about the merits of UK’s health system, what we know is the UK public wanted substantial reforms and better funded, managed and accountable health services.
Digital health and the complexities around governance and regulation of AI in healthcare appear to be not ‘sexy’ enough or easily digestible for mainstream news services to cover.
We asked the media
AIDH contacted the major media outlets and health journalists asking them to ask about the digital health policies of Labor and the Coalition. They didn’t respond.
Instead, we were served up tepid, shallow ‘debates’ about bulk-billing numbers and Urgent Care Clinic presentations, when the pressing issue is how do we remake an outdated, stale Medicare system into a model that can adapt to the technological changes already capable of delivering the health system we need.
These two aspects of Medicare reform must be undertaken together – removing inefficiencies, duplication and unnecessary overservicing through the strategic adoption of digital health and AI; while ensuring this doesn’t reduce doctor’s income and the sustainability of General Practices.
Over to you: Share your view by Commenting below or going to our Poll:
Can Medicare be reformed to be fit for purpose in the digital age?
