Federal

Jan 17, 2012

Tackling health waste is about more than ‘a few bad apples’

Too often we seem to forget in debates about our mythical "health system" that much healthcare is provided by private interests, whether private practitioners or companies.

Melissa Sweet

Health journalist and Croakey co-ordinator

Dr Tony Webber, a GP who until recently headed the Medicare watchdog, the Professional Services Review, has kick-started a long overdue debate, about waste in health spending.

In an article in The Medical Journal of Australia, Webber estimates that $2-3 billion dollars are wasted annually through misuse of the Medicare Benefits Schedule, Pharmaceutical Benefits Scheme and the Medicare Safety Net. For this he blames poor public policy (for example, he calls the Medicare Safety Net “one of the most poorly thought-through pieces of health legislation”) and the practices of a “minority of unscrupulous and greedy practitioners”.

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45 comments

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45 thoughts on “Tackling health waste is about more than ‘a few bad apples’

  1. Suzanne Blake

    Does the medicare waste exceed the Swan / Gillard waste?

  2. Stiofan

    A few weeks ago my wife had to attend outpatients at our local capital city hospital (Hospital A), with a painful but not life-threatening condition (out of hours).

    She provided samples, was examined, was prescribed antibiotics and was sent on her way.

    Two weeks later, on holiday, the condition recurred. We went to the local hospital (Hospital B). The examining doctor rang Hospital A to find out the results of the tests on the samples she had provided at Hospital A.

    Hospital A had no record of the tests, or even of my wife having attended there.

    Two weeks later, at home the condition flares up again. Back to Hospital A for another examination and more samples. The results are to be sent to the wife’s GP.

    A week or so later, my wife gets to see her GP. The GP claims not to have received the results from the second visit to Hospital A.

    I know it’s just one small anecdote, but it severely dented our faith in basic competence of the health system. On both occasions when we went to Hospital A, outpatients was practically deserted, so it’s not as though the staff there were being run off their feet.

  3. Filth Dimension

    FFS! piss off SB.

  4. Jimmy

    Stiofan – It is one of the big problems, my 2 year old recently got referred down to the RCH for a biopsy, the registrar rang us that night with the results (about 6.30) but when my wife went to the paediatrician who referred us 3 weeks later he had not received the results and relied on my wife to relay the info.

    Hopefully moving to a e health system will fix both our problems.

    As a rural resident I also hope we can move towards morevideo consultation with specialists from a GP’s office which would save hours of driving just to discuss results of previous surgery or tests.

    Also I vote in favour of Filth’s motion.

  5. Jimmy

    Stiofan – It is one of the big problems, my 2 year old recently got referred down to the RCH for a biopsy, the registrar rang us that night with the results (about 6.30) but when my wife went to the paediatrician who referred us 3 weeks later he had not received the results and relied on my wife to relay the info.

    Hopefully moving to a e health system will fix both our problems.

    As a rural resident I also hope we can move towards morevideo consultation with specialists from a GP’s office which would save hours of driving just to discuss results of previous surgery or tests.

  6. Joanna

    I think you have to take care with the ‘over diagnosis’ argument, which is a bit simplistic. It would be better to mount a case for improving diagnostic skills, and encouraging medical staff, especially in emergency, to proceed without prejudice.
    Last May my daughter presented at hospital emergency with what appeared to be (according to the doctor who treated her) symptoms for the onset of schizophrenia. Because we (her family) were adamant that there was no psychiatric history, nor any chance of drug use, the hospital investigated physical causes. Our concern was finally recognised as legitimate when she had a seizure in the emergency room. After days of exhaustive tests (all proving negative), and with her physical condition deteriorating, one of the specialists suggested investigating the possibility of an extremely rare and only recently identified disease – Anti-NMDA Receptor Encephalitis, which is terrible but curable. The test came back positive. She was appropriately treated and is now recovered. Maybe if we had accepted the wisdom of the first diagnosis and had not insisted on every possible test until her disease was identified, they would have eventually made the correct diagnosis. But all the available literature on this (and longitudinal studies are only now being published for the first time) indicates that the best chance of avoiding long term cognitive loss is swift diagnosis and treatment. Patients with this who are misdiagnosed and sent to psychiatric hospitals for some months don’t fare so well: some die, some have permanent brain damage, others have long term cognitive loss.

  7. ggm

    If only we had unified patient records and some kind of smart card…

  8. David Allen

    Yes, I was rather hoping Suzanne would get a new record for Christmas. Alas, the whine continues.

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