Health crisis. Public is best
by Andrew Jackson "Potential catastrophe", said Australian Medical Association President Kerryn Phelps describing Monday's collapse of Australia's largest medical insurer, UMP. UMP is applying to the court for the appointment of a provisional liquidator next week. Pursuing its crazy "market forces" policies the Federal Government is looking for a way to pass the buck and impose extra costs on doctors and patients. Doctors may be forced to abandon bulk-billing as one consequence. Some doctors may shut down their practices if they are unable to find a new insurer. "Essential health services are now at risk. Services will suffer, it will happen from today unless we get a very rapid and effective response from Federal Government", said Ms Phelps. UMP provides medical indemnity insurance for over 32,000 doctors in Australia, including 90 per cent of those practising in NSW, and 100 per cent of those in rural and regional South Australia. Ms Phelps' statement was backed up by New South Wales Health Minister Craig Knowles, who convened a meeting of Sydney's top neurosurgeons last Monday. "Unless John Howard gives them some sort of ironclad guarantee about their insurance cover by the close of business today, they will be ceasing work in the private sector and will only be able to undertake emergency work in Sydney's public teaching hospitals", he said. Doctors will continue to work in public hospitals because their medical indemnity is covered under each State Government's Treasury-managed funds plan. Stephen Smith, Labor spokesperson for health said, "It's clear that in the aftermath of UMP going into provisional liquidation, the Government has no plan. 32,000 doctors are in crisis because they don't know that their insurance policy is worth the paper that it is written on". Statements by Federal Assistant Treasurer Senator Helen Coonan indicate that the Federal Government has no real plan to meet the situation. She has made one statement after another which, on analysis, is little more than empty words that do not protect doctors or patients from future claims. The Commonwealth Government has said it will work urgently with the provisional liquidator to prevent any disruption of medical services to the community. But what happens in the immediate future and what happens when present insurance policies come up for renewal around the end of June? How are claims that may arise in the years ahead to be guaranteed? None of these questions have received a clear answer from the Federal Government. On Tuesday morning this week, there were media reports of some doctors and dentists restricting which types of cases they would treat. Although the Federal Government announced it would provide a $35 million guarantee to cover claims up to June 30 the medical profession remains highly sceptical and anxious about their position. (Ansett employees were also given "iron clad" guarantees which left many employees high and dry.) The suggestion of a levy arose when Senator Coonan also said, "The government expects medical practitioners to play a prominent role in working through the current difficulties, which may include making a financial contribution as appropriate."It is likely that some doctors will pass on this additional cost should it be imposed, by putting up patient fees. The Royal Australian College of General Practitioners made this clear in a statement which said they were "concerned that this will place an additional burden on practices which will eventually be borne by the patient." Dr Tim Woodruff, President of the Doctors Reform Society, also confirmed this. He said: "Firstly, the decreased availability of some services like obstetrics, especially in rural and remote areas, will mean patients simply won't be treated", said Dr Woodruff "Secondly, the increased premiums doctors have to pay across the board, will mean doctors will be looking to increase their charges. That will mean that doctors who currently bulk bill will feel increasing pressure to stop bulk billing." "The government has watched bulk billing rates slowly decline since it came to office. It doesn't care. The result: further burdens patients as they struggle to be able to afford the many and increasing out-of-pocket expenses of basic medical care." As the Federal Government refuses to increase the Medicare rebates paid for medical services, so the "gap" between what the patient coughs up at the doctor's surgery and the amount they get back from Medicare grows. This will lead to more demands for private health insurers to cover the "gap", and many more patients turning to private insurance, which is what the Coalition has wanted since day one. The Federal Government's lack of action on the issue can only be seen as part of its deliberate campaign to strangle Medicare to a slow and painful death. "Patients will suffer", said Dr Woodruff. "The Government will watch out of pocket expenses rise. And their aim of a two tiered health scheme in Australia where the rich can afford excellent health care and the rest must settle for second best, will move that little closer to reality." In a statement to The Guardian, CPA General Secretary, Peter Symon said that the collapse of UMP, the sixth insurance company to go under in the last few years, shows again that capitalism is incapable of meeting the needs of the people, in this case, the health needs of the community. "There is a stark comparison between the public health system which provides a universal service without feesand meets claims for doctor negligence and the private system so beloved of the Howard Government", Mr Symon said. "The irresponsbile attitude of the Federal Government has been brought out dramatically in a statement just made by John Howard. "He said: 'No we're not playing catch up at all, because we can't act in a way that forces the hand of a company when you've got potential claims of three or four of $500 million, you've got to be very careful, otherwise you'll be accused of meddling in the private business affairs of companies'. "There we have it", said Mr Symon. "Private companies are sacred and the health needs of the community are to be sacrificed to 'the private business affairs of companies'. "Putting the blame on doctors, Peter Costello said: 'The doctors were responsible for setting their own premiums and meeting their own payouts and they've got themselves into financial trouble'. "These statements clearly show the thinking and the callous, don't-care-a- damn attitude of Government leaders", said Peter Symon. "It is the private health system and, in particular, the private insurance companies that are failing and there is a desperate crisis that could bring calamity to many who require medical attention. "The Government is already propping up the private health business system to the tune of billions of dollars a year, through the health insurance rebate and Medicare payments. The long-term solution does not lie in handing over more money to the private system to ensure it can function. "Unless and until the provision of health services is re-established as a public service — as against profit-driven businesses — periodical crises will continue. The present competent public health system shows that public is best. "The aim of the Government, however, is to destroy the public health system and hand the health of everyone over to the incompetent and hugely costly private profiteers, manipulators and speculators in community health", concluded Mr Symon.