Fiona Armstrong, a health policy advisor and longstanding advocate of health reform, is deeply disappointed by the National Health and Hospitals Reform Commission report. She writes:
“The NHHRC report is not only a missed opportunity to create a system that will address equity and efficiency in the current system – instead its proposals threaten both.
Of course no one would argue that primary health should not be strengthened, and that dental and mental health, Indigenous health, rural and remote health and aged care are not being failed by the current system. But identifying the changes needed is quite different from creating a system that will address them.
After years of debate, the commission has chosen to proceed largely in the same incremental direction we already find ourselves. Instead of finding in favour of structural reform that will ensure we have a sustainable and efficient system that will assist us to provide high quality care to the whole population, the commission has opted for an approach that will see the blame game continue and inequities entrenched.
Not content with the current status quo of a two tier system in hospital care, the commission has recommend we extend this to all health care and, in a highly risky first step towards managed care system, proposes a greatly increased role for the private sector and private health insurers.
This is the system from which the Obama administration are trying desperately to escape. The commissioners have chosen to mistake choice for equity, and thus have proposed greater choices for those who already have it, and less for those who don’t.
The proposal for Medicare Select threatens to take us in a direction where the sickest members of the community will have their health care limited to a basic package of care, while those who can afford it will be able to have as much as they like. A bit like now, only much, much worse.
This report should make the poor, the disadvantaged, the truly sick, and anyone with an sense of fairness very afraid for what lies ahead.
It is deeply disappointing and the health care sector and the community have every right to feel betrayed by this report as it does not reflect the feedback and ideas they so generously provided during the commission’s 16 month consultation.”