The News – 8 August 2014

Overview

  • Cancer patients requiring reconstructive plastic surgery have been denied or delayed hospital cover by Medibank because the nation’s largest health insurance provider claims it is a “cosmetic” procedure.
  • Mining magnate Andrew Forrest’s “baby box” idea should replace the “perverse incentive” that is the baby bonus, a child health expert in the NT says.
  • West Australian Health Minister Kim Hames has confirmed health employees are being offered a package if they resign from the public sector and find work with private operator Serco.


Stories Discussed
News on Health Professional Radio. Today is the 8th August 2014. Read by Rebecca Foster.

http://www.abc.net.au/news/2014-08-07/reconstruction-treatment-delayed-by-medicare-cosmetic-clause/5655346

Cancer patients requiring reconstructive plastic surgery have been denied or delayed hospital cover by Medibank because the nation’s largest health insurance provider claims it is a “cosmetic” procedure.

Breast cancer survivors requiring nipple reconstructions and treated skin cancer patients and burns victims requiring skin grafts have all had their insurance claims queried by Medibank.

Australian Society of Plastic Surgeons vice president Tony Kane says the insurance provider implemented a new policy in June.

He says dozens of patients have since come forward, saying the insurance provider may not be able to fund their procedure.

Medibank says it made the decision to challenge proposed plastic surgery procedures after auditing 1,000 hospital procedures it had paid for and discovering 25 per cent were cosmetic.

The insurer is also under fire for confusion over so-called exclusion clauses, where patients elect not be covered for plastic surgery in their insurance policy because they thought it referred to cosmetic surgery.

Geoff Drewell has skin cancer and required a skin graft following his treatment but was told his Medibank Private policy excluded plastic surgery.

Australian Society of Plastic Surgeons vice president Tony Kane said insurance policies lacked transparency.

But Mr Boyd said there “was only so much information” Medibank could provide in a website or a product brochure but made an effort to point members to its fund rules.

The insurer’s fund rules do not, however, have a definition for plastic surgery.

Dr Tony Kane says Medibank’s policy change is an attempt to change the doctor-patient relationship.

Australian Medical Association president Brian Owler warned of an Americanisation of the healthcare system by stealth – moving towards a “managed care” style system where insurers have a say in what procedures doctors do.

But Dr Boyd said Medicare was simply making sure it only paid for genuine medical procedures.

http://www.abc.net.au/news/2014-08-05/cleaners-and-orderlies-offered-transition-payment/5650200?section=wa

Mining magnate Andrew Forrest’s “baby box” idea should replace the “perverse incentive” that is the baby bonus, a child health expert in the NT says.

Professor Sven Silburn, the director at Menzies Centre for Child Development and Education, said Mr Forrest’s “baby box” idea – a kit containing clothes, nappies, bath products and other supplies – would be a practical solution to the problem of Indigenous women not accessing antenatal clinics in the early stages of their pregnancy.

“I think it’s a terrific idea and particularly if it could replace the baby bonus, which at the moment provides a perverse incentive that isn’t actually producing the outcomes that could be there and could be offered by what the baby box project offers,” Professor Silburn said.

Similar boxes are offered to women by Aboriginal health services in Cape York and Alice Springs and for a long time have been available in Scandinavia.

Mr Forrest’s Creating Parity report – commissioned by the Abbott Government and released a week ago – recommended the boxes be offered as an incentive to encourage women on income support to access antenatal services in the earliest stages of their pregnancy.

“A local community nurse or health organisation can then monitor and support the pregnancy,” the report suggested.

Prof Silburn said he was in favour of the introduction of the boxes.

“It’s the kind of practical intervention that makes good sense and it actually delivers what Indigenous young women particularly need.

He said the boxes were already used by Aboriginal communities in Cape York and should replace the Federal Government’s baby bonus.

Professor Silburn said the incentive could go a step further and replace the Federal Government’s baby bonus payment of $5,000.

He said the baby bonus did not always go towards expectant mothers and their babies.

http://www.abc.net.au/news/2014-08-05/cleaners-and-orderlies-offered-transition-payment/5650200?section=wa

West Australian Health Minister Kim Hames has confirmed health employees are being offered a package if they resign from the public sector and find work with private operator Serco.

Serco has been contracted to provide non-clinical services at the new Fiona Stanley Hospital, when it opens in October.

It is expected the company will recruit 240 workers to meet the needs of their contract, and some of those may come from existing public hospitals.

The one-off transition payment for health workers to leave the public sector has been described by Dr Hames as an incentive.

Southern Metropolitan Health Service chief executive Frank Daly explained the package on offer.

“We’re happy to make a one-off transition payment to those staff which will compensate them partly for the fact they’re moving,” he said.

“That payment will be two weeks for each year of complete service, up to a maximum of 12 weeks.

“We’ll also be paying out long service leave pro rata, and they can obviously cash out their other leave entitlements.

Cleaners, caterers and orderlies took industrial action last week, saying they had been kept in the dark about the future of their jobs.

One cleaner said she was worried because she has children, bills, and a mortgage, but no job security.

About 197 non-clinical staff are expected to be surplus to requirements at Royal Perth Hospital but Dr Hames believes vacancies will arise.

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