Harney's warning on free healthcare for all

Health Minister Mary Harney has said she is not convinced that the goal of best health outcomes and developing high quality, efficient health services for all requires services to be free at the point of use to everyone regardless of income.

She was commenting on the Adelaide Hospital Society's proposal for a social health insurance system providing GP, hospital services and drug costs free the point of access and available equally to everyone regardless of income.

The system, however, would be likely to require additional taxtion

Speaking yesterday at a conference on health funding organised by the Society, Ms Harney said it was not just a question of how the State would pay for such a system, "there is the question of people understanding the value and use of a resource - be it a busy GP, the A&E, a prescription drug or a diagnostic test."

The Minister said in a system that is free at the point of access, if we want to guard against overuse of resources, someone other than the patient has to carry a "gatekeeper" role, for example , the GP regarding access to consultant services.

However, she questioned whether there was not a role for the patient themselves in guarding against overuse of free healthcare.

"Is some small element of personal responsibility not appropriate in any circumstances? Are some signals of the value of the resource being used not possible, without offending against equity of access?"

The Minister claimed the new 50 cent per item prescription charge for medical card patients was a protection against potential over-use of health resources, and A&E charges were another.

She pointed out that the Fair Deal nursing home scheme has achieved considerable public support from users, notwithstanding that co-payments towards the cost of care under the scheme vary according to people's means.

She warned against presuming that financing of healthcare through social or private health insurance would ease the complexity of designing benefits clearly in law for the public. This task, she said, would still not be any less complex, less political and any less subject to resource limits under an insurance-based system.

The Minister also warned that the Adelaide Society's social insurance proposal could still result in asking the public to contribute substantial additional sums to the health system.

For example, one of the funding models proposed under the system would add €2.8 billion in funding to health.

She pointed out that this is more than double the current funds collected under the Health Levy.

See also: 'Do we need to reinvent the wheel?'

[Posted: Thu 15/04/2010]