Australian Health Care Agreements - Essay Example

Major Policy Critique [Name] [Course] [Lecturer] [Unit Code] [Date of Submission] Introduction Public economics is the study of economic policy. Economic policies can be applied in determining alternative policies and settling on the optimal policy. Developing alternative policies entails theorising the manner in which economic agents select their actions and how these actions are influenced by changes in policy. On the other hand, the evaluation of policy and settling on an optimal policy calls for the design of a purpose for the policy maker that can provide a standard of the performance for every one policy on the basis of applicable description of the balance ensuing from the policy (Myles, 2001). The Allied Health Professions are accredited as important providers of protective as well as curative healthcare in Australia; however consumers’ admittance to their key services is hampered by extremely restricted Medicare along with by stumpy Medicare discounts. In addition, the Australian Healthcare system faces a myriad of challenges such as profound underfunding which has been accepted by the Minister for Health, the Hon Tanya Plibersek MP, while delineating Labour’s pledge to Medicare. The gap stuck between Medicare set charges and health providers charges to patrons is on the rise thereby forming a two level healthcare structure in Australia – those who are able to shell out and access healthcare and those who cannot (AHPA, 2013). The situation above manifests a key challenge for policy makers in the country in trying to ensure affordable and equitable access to healthcare. Healthcare is a vital component of economic growth as it can be directly linked to human resource productivity. In light of this, the following sections expound on the economic challenges of a poor healthcare system and the paper seeks to formulate suitable policies that can be applied to help improve the situation. Economic Issues Health forms the basis of an economy’s welfare and prosperity. Healthy workers engender high participation rates as well as productivity, thereby delivering a strong financial system and value for life. Too it lessens strain on the healthcare system. Healthcare is an incredibly vital policy area that calls for great focus on reforms that will produce sustainability. Australia’s healthcare endowment structure is rather suboptimal where existing policy initiatives entail rationalized access to medical service (Rafferty et al, 2007). Medical progress is likely to propel efficiencies as long as right incentive structures are put in place to support most excellent clinical practice. The government places a key role in guaranteeing good health following a common concurrence that in demanding economic as well as social state of affairs, need for public health services increases since patients shun the private sector to public sector services given a lower cost of care. Quite a lot of research outcome support sturdy link involving unemployment or low income level along with high mortality rates, attempted suicide, madness, low eating appetite and excessive abuse tobacco and alcohol. These effects generally push up the demand for public health care services. Moreover, health expenses cuts directly influence health care practitioners, who are requested to offer high level of care with the token resources. As a result, economic constriction is likely to negatively affect quality assurance in higher education leading to a low quality workforce, and lack of equipment and facilities. A number of research outcomes vindicate that people who lose their employment go through, dejection, nervousness and they are more expected to book appointments with their physicians and take additional medication. Job insecurity has too been linked with drug dependence, very high rates of suicide and heart disease, psychological confusion; the low-income groups suffer more from these effects. In actual fact it has emerged that lasting job insecurity causes unending stress which raises bad health, absence as well as use of health care services. Apparently, health care utilization is correlated with household income. Loss of income does not permit “unnecessary” expenditure. According to Gottret et al (2009), ‘households who suffer income cuts and loss of jobs too cut down the use of health care services. It appears that, the health care use is complex and not easy to be envisaged for the reason that population and income are key features. All the same, efforts should be put in place to ensure most important factors of worth in healthcare such as the equal access to critical health products, population requirements evaluation along with short‐term interventions, can be demonstrated to be extra successful. Quite interestingly, latest research indicate that health worsens once the economy gets better in the short term as it is linked to increased smoking as well as chubbiness, low physical exercise and an unwholesome diet. Gerdtham & Ruhm (2006) state that economies with frail social insurance fortification cultivate variations in mortality rates weighed against economies with all-embracing interventions. As put down on paper by Lionis et al (2009), reinforcing primary healthcare sector is able to produce improved value of healthcare offered, rationalise the healthcare spending, lessen unexpected hospital admittance and boost user’s contentment. Therefore, there is need to develop the primary care sector, owing to health evolution and changing social attitudes, alongside the other two elements of the health system (secondary and tertiary care) in view of the fact that all of them make up the system as one unit. The ever-increasing healthcare expenses may well probably hamper Australia’s universal healthcare system and engender service rationing; a case in point is the longer waiting times for surgery. This will besides be a noteworthy load on upcoming generations and shrink government financial support set aside for other important areas such as education and infrastructure. Numerous studies have documented a link stuck between poorer nurse recruitment levels and high rates of several unfavourable patient outcomes tackling protection and quality of health care offered. The studies too indicate that healthcare staff deficiency will make health experts sparse and duties extra demanding. Being exhausted and job frustration are more expected to occur in hospitals with soaring patient‐to‐nurse ratios as illustrated by the research outcomes of Rafferty et al (2007) portraying that the small the patient‐to‐nurse ratio the enhanced outcomes. The nurses in the high patient‐to‐nurse ratios health centres were just about twice as probable to be frustrated with their duties, to suffer high exhaustion levels, and to indicate failing quality of care on their health centres. According to the WHO Report (2010), income is the topmost crucial incentive for health workers’ movement followed by job frustration, job openings plus political shakiness. Suggested Policies and their Review Presently, there exist numerous divisions of health-related funds that may well play a superior role to population health. The most prevalent sources of Commonwealth health care endowment are the Medicare Benefits Schedule along with the Health Care Grants. Medicare Benefits Schedule Medicare Benefits Schedule has not been fully utilized, limited merely by the level to which citizens access suitable services. One key attribute of this model is that the scope of qualified services is limited to a large extent such that the population has been barred from health involvements. It is limited to clinically pertinent services commonly acknowledged in the medical profession as basic for proper treatment to the sick. Even as its focal point in the past has been on the medical treatment of diseases, the Medicare Benefits Schedule is an authentic and possible channel of population health financial support. With the exception of clear preventative services supported under the programme, including some forms of screening, standard discussions ought to be considered for various one-to-one population health actions, such as detecting as well as reporting infectious diseases, offering advice on the standards of living, and immunisation (Towler, 1999). Public Health Purchasing Regardless of resource availability for optimal population health, it is crucial to agree on the most excellent way to deal them out. The choice of purchasing systems will rely heavily on the policy initiative the endowment is projected to help realize. Health financing systems have got to serve health policy since systems by their own can put in to or else hold back realization of government objectives as well as communities hope in the health care scheme (Cichon, 1999). Population health can be bought via various mechanisms in Australia. These systems engross a wide assortment of actions or products such that it is dodgy for any single purchasing mechanism to be relied on in all situations, taking in all the diverse works. For that reason, a collection of purchasing mechanisms may well be combined to engender the most excellent net outcome. Below is a description of quite identical divisions of population health products along with a collection of latent pooling and purchasing models. Active mechanisms are employed as examples principally where they have been applied in population health funding. Each method is appraised alongside a set of criteria prior to making a conclusion regarding the fitting matches involving purchasing mechanisms and population health products. The effectiveness of any one of the numerous models of health purchasing in realizing a definite health policy initiative will be based on the character of the item being bought. The groupings for sorting purchasing mechanisms are modified from (Eagar, 1997). Quite a few strictly do not entail systems for leading dealings among purchasers and providers, but to a certain extent involve the switch of finances between agencies that collect finances, and those that variously procure or offer health services, for example, the Australian Health Care Agreements. 1) Historic funding (Cost-based approach) This model simply applies preceding year’s level of endowment to recompense a provider, regardless of neither a client’s measure of wants nor the value of the product that is formed. In general, payments are prospective. This system is favoured in long-term programs of past forms of financial support with no detailed intent, end-results as well as output happen to be embedded, and/or where the array and blend of productivity shows a considerable discrepancy from one service to the next, or is not easy to put a figure on. Although this method has not attracted much support, it is incredibly rife and tricky to abandon. This approach is economical to run, even though it may well absorb a rigorous analysis of inputs in the lack of answerability based on outputs. The approach is able to permit providers to utilize finances flexibly to outfit domestic desires and situation. On balance though, it does not caught the attention of funders of whichever kind of population health. 2) Needs-based Approach Needs-based backing entails giving out a predetermined share of funds to providers catering to a definite group of people proportionate to their qualified needs. Issue indicative of qualified needs take account of population size, the expenditure of offering services (this may fluctuate with inaccessibility along with population spread), plus population attributes deemed to point to relative need. Ascertaining a quantitative correlation involving any exact measures of need such as, health status, as well as the virtual constraint for health care funds can be quite demanding (Deeble, 1998). Although grant stipulations might indicate that the beneficiary has to provide information aligned with performance indicators, there is no precise rapport between what is reported and the amount of grant offered. Needs-based approach was developed to trounce the limitations of historical funding especially the imbalance in the distribution of funding in programs. Impartiality as a minimum in the distribution of funds from funder to provider is the focal point of this approach. This approach has the capacity to support proficient use of funds as well as accountability of the provider to the funder or the end user. The needs-based too can augment value by supporting better equity of financial support delivery, save for it will no more than discharge efficiency and accountability objectives when pooled with output-based models of purchasing. 3) Output-based Output-based funding entails the provision of funds proportionate to the magnitude of output created. Hence, it depends on the ability to put a figure on and price tag a standard measure of productivity. This approach has attracted widespread application in sensitive health care than in population health so far. Payments can be backward-looking, based on past accounts, or prospective with conservative alteration. In a restricted comprehensive financial plan, providers are financed impartially based on their split of the entire amount and density of outputs produced in an earlier phase. Providers bear the possibility of demand surpassing their competence to meet it. The out-based approach served up allocations in some sections of hospital budgets in nearly all States. Duckett (1998) proposes two versions of this system. First, he proposes that payments be honoured independent of fixed overheads (hospital overheads) and for the variable/marginal expenses connected to each one patient taken care of. The second proposition entails an integrated disbursement for every one patient cared for that takes in the variable expenses associated with the handling of that patient plus a guesstimate of the hospital’s standard per capita expenses. The output-based model has two key advantages weighed against the earlier approaches. The approach attracts additional motivation for cost suppression as well as procedural good organization by the funder. Under a fixed price for each unit of output, the provider is expected to fabricate that output at a bare minimum outlay. However, there is danger for quality being compromised. Secondly, output-based approach spawns data on the amount of output created which can support accountability and prop up planning and strategy improvement. The usefulness this information depends on exact specification of outputs and the extent to which the outputs are legitimate proxies for the outcomes the program is intended to pull off. The Medicare Benefits Schedule, for instance, breeds huge quantities of data on the subject of who consults doctors, where, how regular. However, the deficiency of better-quality levels of information regarding the character of the relations involving the patient and the doctor has engendered the need for test surveys of doctors (Sheill, 1998). On the contrary, the output-based approach forms the basis for funding to tag along utilisation, other than a people’s need. However, with a specified volume and price, the funder enjoys some degree of influencing the allotment of supply (the .purchasing: price and volume. model). Another drawback is that, just the once finances are attached to strictly described outputs, the provider has a reduced amount of flexibility to equate funds with domestic needs. A case in point is where by means of a Medical Benefits Scheme, funds can be obtained just for GPs services together with various referred services (Towler, 1999). However, the most fitting and gainful approach might take in a broader blend of key health care services on offer by not just GPs but various related health professionals too. These limitations engendered the preamble of the Coordinated Care Trials as well as conducting tests with other ways of funding GPs. On the whole, the ability of output-based technique to support competence and accountability relies on the level to which an individual is able to expressively put a figure on and forecast the most select quantity of outputs. The approach’s aptitude to encourage impartiality depends on its ability to be combined with needs-based pooling or purchasing means. Economic Evaluations Given the high rate of healthcare spending over past few years, health economic evaluation could be attracting wide attention from decision-makers. Health economic evaluations are intended to guide efficient use of healthcare funds. On the contrary, health policy decisions analysis has time and again shown that information from health economic evaluations is moderately used, in particular at the local level of management. Modest attention has been at the centre stage to the issue of why economic evaluations are not widely used and why they possibly will produce dissimilar results in varying circumstances whereas they are a good policy initiative. There exist scores of obstacles hindering the application of health economic evaluations in complex and uncertain situations (NPHP, 1996). These challenges need ground-breaking as well as original answers to economic evaluation of healthcare activities, for instance, health economic evaluations ought to be viewed in the perspective of complex adaptive systems theory. The theory makes available a conceptual framework that considers appropriate factors, several input and output, various perspectives along with the hesitation implicated in healthcare activities. Conclusion Considering its size along with the rate of growth there is a dire need to develop a suitable policy framework that will enable Australia to manage population healthcare effectively. Items covering population health involvement call for comprehensible proof that it would predispose to particular savings to either the Medicare Benefits Schedule or some other component of the Commonwealth Health portfolio. Even if the Australian Health Care Agreements ought to have a say in optimising individual as well as community health, and balancing investment between individuals and communities, they are supposed to mainly hold up access to public hospital services. The National Health Development Fund (NHDF) can too be brought into play in streamlining the health system in a manner that will uphold good organization and helpfulness as demand for hospital services is reduced and endorse improved cooperation linking hospitals plus the rest of the health sector (AHCA, 2003). Principally, either of these means may well be used to support population health involvement, so long as they could are able to trim down demand for public hospital services. Apparently utilising either or both the Medical Benefits Scheme and the Australian Health Care Agreements as ways of opening up population health financing, population health involvement must be evaluated alongside similar criteria as for other supplementary expenditure in the Medical Benefits Scheme or the Australian Health Care Agreements. A needs-based system of resource distribution usually come about just at the margin as added financing is accessed if not any redistribution will evidently end in a worse situation. An output-based approach to can aggravate opposition for the reason that they bring in the likelihood of a funder controlling outputs (Deeble, 1998). The historical approach fails to intrinsically uphold equity, effectiveness or accountability. Nonetheless, needs-based distribution can enhance output-based financing to unite its ability to uphold equity of distribution with the potency of the output based move. Obviously if there is no government intervention, public goods provision will be left to the private sector. Fundamentally, private provision is based on the Nash behaviour assumption which has been proved to lead to an inefficient allocation. In addition, the equilibrium level of provision is invariant to changes in the income distribution and exogenous changes in public good supply. These properties, and the limiting behaviour of the equilibrium, are at variance with empirical observations. Alternative conjectures have been analysed but these are entirely arbitrary and do not provide a better explanation of reality. Altering the structure of preferences and the social rules do provide improved predictions but no alternative has yet received convincing arguments in its favour (Myles, 2001). Social and public health policies that can cover the most important health determinants by reducing unemployment, minimizing income and wealth inequality, show proof for better population health according to relative study of policies on health variation form eight different European countries. It has been widely agreed that health reforms have to give emphasis to deterrence plus early involvement. Bendable systems, dissimilar guidelines of distribution, working methods as well as custom-made health care services to the society, may well be followed (Cichon, 1999). On the other hand, these difficulties can be well thought-out as an opening and an inspiration to develop good organization by applying health care policies that improve the performance of health care systems. The ultimate objective of such a move is to do away with ineffective policies that have been proved to be costly, unproductive, risky and disproportionate. References AHCA. (2013). Equitable access to affordable health services. Journal of the Consumers Health Forum of Australia, 31. Australia, C. O. (2000). Federal Financial Relations 2000-01, Budget Paper No.3. Canberra: Commonwealth of Australia. Cichon, M. N. (1999). Modelling in Health Care Finance: A compendium of qualitative techniques for health care financing. Geneva: International Labour Office. Deeble, J. M. (1998). Expenditures on Health Services for Aboriginal and Torres Strait Islander People. Canberra: Australian Institute of Health and Welfare and the National Centre for Epidemiology and Population Health. DHAC, C. D. (2000). Medicare Benefits Schedule, 1 November 1999 including 1 February 2000 and 1 May 2000 Supplements. Canberra: DHAC. Duckett, S. J. (1998). Casemix Funding for Acute Hospital Inpatient Services in Australia. Medical Journal of Australia, 169: 17-19. Eagar, K. H. (1997). Funding Levers for Public Health. Centre for Health Service Development, University of Wollongong. Gerdtham UG, Ruhm CJ (2006). Deaths rise in good economic times: evidence from the OECD. Economic Human Biology, 4 (3):298‐316. Gottret P, Gupta V, Sparkes S, Tandon A, Moran V, Berman P (2009). Protecting pro‐poor health services during financial crises: lessons from experience. Adv Health Econ Health Serv. Res, (21):23‐53. JCPA, J. C. (1995). Report 342 – The Administration of Specific Purpose Payments: A Focus on Outcomes. Canberra: Parliament of the Commonwealth of Australia. Lionis C, Symvoulakis EK, Markaki A, Vardavas C, Papadakaki M, Daniilidou N, et al (2009). Integrated primary health care in Greece, a missing issue in the current health policy agenda: a systematic review. International Journal of Integrated Care, 9: 88. Myles, G. D. (2001). Public Economics. NPHP, N. P. (1996). Discussion Paper on the National Public Health Partnership. Retrieved from http://hna.ffh.vic.gov.au/nphp/discus.htm. Rafferty AM, Clarke SP, Coles J, Ball J, James P, McKee M, Aiken LH (2007). Outcomes of variation in hospital nurse staffing in English hospitals: cross‐sectional analysis of survey data and discharge records. International Journal of Nursing Studies, 44 (2):175‐82. Sheill, A. (1998). Public Health: Some Economic Perspectives. Mooney: Gavin & Scotton, Richard (eds). Towler, B. (1999). Enhancing the Population Health Role of General Practitioners’. May: unpublished paper. WHO Report (2010). Migration on health workers. Fact sheet No 301. Read More