MUCH-NEEDED PRIVATE HEALTH INSURANCE REFORM ABANDONED ONCE AGAIN BY BUDGET
Catholic Health Australia has expressed disappointment that the Federal Budget was not used to advance much-needed innovation and reform in Australia's struggling private health insurance system.
With Australians showing dwindling enthusiasm to take out private health insurance coverage, CHA, representing the largest grouping of private not-for-profit hospitals in the country, has been advancing a range of policy reform ideas to make the industry more sustainable. Ideas include:
• improving and expanding the coverage provided by private health insurers for out-of-hospital care;
• mandating better private health insurance coverage for mental health services, which would likely help attract more young people into the system; and
• removing low value private health insurance products from the system and making 'bronze' products the minimum level necessary for individuals to avoid paying the Medicare Levy Surcharge (MLS)
"If it's not in crisis right now, the private health system is certainly headed that way in a hurry," said CHA Health Policy Director, Caitlin O’Dea.
"Giving the private health insurance lobby what they ask for in the short term is not the same as actually reforming the system so it works better for patients, clinicians, and the national interest.
"We have been urging the federal government to bite the bullet on private health insurance reform before it's too late. If we don't start funding innovations in out-of-hospital care and attracting younger people back into private health insurance, the whole system just won't work.
"Selling low value insurance that doesn't cover anything useful, purely so people can avoid paying the MLS, is great if you're a private health insurer keen to boost immediate profits. But it's terrible for the Australian health system.
PALLIATIVE CARE LEFT WANTING
While the Budget delivered some money over the next few years to trial improved coordination of palliative care, it failed to deliver additional funding for actual service provision, for the development of a national workforce plan to identify the gaps in services, nor more money to fund a trial of palliative care nurses in residential aged-care homes.
With an ageing population the need to improve the end-of-life care for hundreds of thousands of Australians is greater than ever, says peak advisory body Catholic Health Australia.
Catholic Health Australia’s Health Policy Director, Caitlin O’Dea says palliative care should be available to everyone who needs it.
“Palliative care should be a universal right to anyone who is suffering towards the end of their life. Our ageing population is set to double, demand for palliative care is expected to increase by 50% between now and 2035 and double by 2050, and yet, the number of palliative care specialists and nurses is on the decline.
“We need to know how many people are receiving palliative care today so that we can plan for the future. When it comes to palliative care data there is a black hole.”
“It is disappointing that, as more states introduce voluntary-assisted dying laws, people are not given a real choice between ending their life prematurely and receiving proper palliative care that would relieve suffering for them and their families, and allow them to live well until their death.”
FAILURE TO ADDRESS WORKFORCE CRISIS IN AGED CARE
There is nothing of substance in tonight’s Budget to address the workforce crisis that is gripping current and future age- care services.
Catholic Health Australia says the failure to address workforce remuneration is a bitter blow to the sector and its workforce, which is struggling with fatigue, spiralling living costs, low morale, and a growing shortage of carers and nurses.
The $49.5 million aged-care training places and clinical placements for nurses in tonight’s Budget is, at best, a band aid, and underscores a tin ear to the risk that workforce pressures pose for the quality and safety of aged-care services.
CHA CEO Pat Garcia said: “Additional training places are all very well, but the sector is struggling to attract and retain aged-care workers because they are simply not paid enough for the essential and demanding caring role they perform for the Australian community.
“When unemployment has the figure three in front of it then it makes the job of attracting people to the industry and to training places that much harder.
“Tonight’s Budget should have been an opportunity to deliver real reform to ensure a sufficient and qualified workforce to care for the increasing number of older Australians needing care and support but, disappointingly, it didn’t do that.
“The Government has previously announced that minimum staffing levels will be mandatory in residential aged care, but it is far from certain whether there will be the workforce available to meet these standards, let alone the additional workforce required for the significant increase in the number of home-care packages and the needs of the ageing cohort of baby boomers.
“The Government could not even bring itself to support the Royal Commission’s recommendation for a change to the indexation formula for personal and nursing care funding that could have prevented further wage erosion. Sadly, that is not in tonight’s Budget.”
“It is vital therefore that once the Fair Work Commission hands down its decision on the current minimum award rates claim for aged-care workers, whoever is in government commits to fully fund the wage increases. Failure to fully fund a wage rise will mean that Australia will be unable to attract, retain and grow the skilled aged-care workforce that is so desperately needed.”
"This budget was one of the last opportunities we have for meaningful reform. Regardless of who wins the election this year, we need the federal government to grasp the nettle on private health insurance reform."
DESPITE IMMEDIATE RELIEF, SYSTEMIC PROBLEMS WILL CONTINUE
Social services
The $420 cost of living tax offset, as well as a $250 payment for welfare recipients, is a welcome immediate relief for marginalised individuals and families facing the rising cost of living, inflation, and fuel costs.
However Catholic Health Australia’s Director of Strategy and Mission, Brigid Meney said: “Recognising these experiences as temporary hardships with one-off payments does not adequately address the social inequity that drives systemic barriers to financial stability and health.
“Our report into COVID’s impact on society showed exactly how the pandemic has exposed pre-existing social inequalities already prevalent in the country.
“COVID exacerbated the hardships of those who are marginalised, such as people with a disability, women, culturally and linguistically diverse communities and those of a low social economic status.
“Budget measures could have done more to address some of the gaping holes that have existed long before COVID, beyond temporary relief.”
Disability
Ms Meney said CHA members welcomed the $33.9 billion allocated to the National Disability Insurance Scheme, including a $249.1 million investment into growing and supporting the workforce, a core component of maintaining safety and quality of care for vulnerable Australians.
“For the duration of the pandemic, those with a disability have been some of the most isolated demographics, and bolstering a workforce that supports their participation, health and wellbeing is imperative,” she said.
“Making sure vulnerable Australians get quality care and the assistance they need is paramount and should be a priority.”
Mental Health
Catholic Health Australia welcomes the attention mental health is receiving in the 2022 Budget, $648.6 million with a doubling of mental health funding since the 2021-23 budget.
However, given the rise in mental health challenges since COVID, CHA maintains that large-scale reform of the system would improve outcomes for the most vulnerable in society.
Ms Meney said: “A core mission of CHA is to take the healing mission of Jesus to all who need support but, when it comes to mental health, funding and system flaws mean that timely access is still limited primarily, to those who can afford it.
“A comprehensive plan to better incorporate private providers into mental health services and reduce the burden on the public system would go a long way to addressing the current challenges that many face in accessing appropriate and timely community and acute care.
“Consideration by the Government of mandatory inclusion of community (out-of-hospital/non-admitted) and online mental health service delivery for all private hospital insurance tiers, as well as abolishing all waiting periods for mental health services, would include challenges but may yield significant benefits.”
Palliative Care
As the most significant providers of palliative care in the private health system CHA members are disappointed by the extremely modest $7.5 million funding allocated towards key initiatives in the 2022 budget.
Ms Meney said: “It is disappointing that, as more states push through the legalisation and implementation of voluntary assisted dying laws, people are not given a real choice between ending their life prematurely and receiving proper palliative care that would relieve suffering for them and their families, and allow them to live well, experiencing care and compassion until their death.
“One of the key findings from recent Catholic advocacy is the profound lack of understanding among legislators of the benefits of palliative care, and advances in effective pain mitigation techniques.
“The Commonwealth Government can play a leading role in ensuring consistent high-quality palliative care is available across Australian jurisdictions, to ensure no Australian is left to choose assisted suicide because high-quality palliative care was not made available to them.”
