From The West Australian comes rumours that the Federal Government is considering a massive privatisation of the Medicare, pharmaceutical and aged-care benefits payment system in a bid to save potentially billions in operating expenses:
…the $50 billion-plus outsourcing would be the first time the private sector has delivered a national service subsidised by the government…
It would replace back-office operations done by bureaucrats.
They would administer claims and payments while overseeing eligibility criteria, meaning they would require access to people’s sensitive private information…
The savings would rely on the private sector being faster and more efficient, especially in high-tech platforms with which the government’s ageing computer system cannot compete…
My first reaction to this proposal was to push back. The last thing I want is to see is Australia’s health system turned into an inefficient and expensive privatised mess like in the US.
However, upon further consideration, the reform may have merit. Provided there is no change to actual scheduled fees, health funding and the like, and the reform is merely aimed at making the payments/claims system more efficient, then why not?
My wife has battled breast cancer over the past two years and my son has autism, so we have experienced the vagaries of Australia’s health system first hand. And while we have found that actual health care in Australia is excellent, the claims/payments system has been found wanting.
For example, whenever my wife visits her oncologist or surgeon, she pays the bill upfront. The office then sends a claim off to Medicare, who deposits the scheduled fee into our bank account at some later date. Why we don’t just pay the gap, as occurs with most private health insurance claims (via HiCaps) is beyond me. Surely it would be far more efficient?
Another example of this claims/payments inefficiency has been experienced during my wife’s various surgeries. Instead of paying the health insurance premium with Medicare and the private health insurance provider making-up the difference, my wife has instead received cheques in the mail post-op, which she has then had to mail into the hospital. Again, the process is incredibly inefficient and there is much scope for streamlining.
If privatisation of the payments/claims system can deliver a streamlined system, and eliminate these types of inefficiencies, then it deserves a thorough examination.
