As a member of the AMA, I would really appreciate more balanced presidential comment on the health policies announced by both parties.
I am yet to see any reference to the significant changes proposed by the Labour party for insurance issues around TAC, Workcover and Medical Indemnity claims. These proposed changes are monumental for all medical practitioners, yet there has been extremely poor reporting of them in the press and by the AMA.
Please, can we not ignore this issue, it has potential to bring our health system to the absolute forefront in the world, and the benefits to all of us, whether as patients (less adversial procedural obstacles in making claims) or medical practitioners (greatly reduced insurance premiums) is enormous.

I have to agree that this sounds like a very unbalanced presidential comment. In contrast to the government's proposal to overhaul basic systems and organisation, including practice nurses, EDs, majority federal funding as well as doctors, nurses and beds, the Coalition policy promises very little. If the opposition leader was not able to bring about this type of change during his long term as health minister, why would we trust him to achieve this now?
I support a cooperative role for the ama in general, but that should not preclude us being critical of deficits in policies of either side.

It appears from the comments above that the real agenda of the ALP, in the long term, is not well recognised. They have always been working towards a UK style NHS to be created by stealth, and this plan continues despite the fact that its failures in the UK have led to calls for its being scrapped there.

Recently, a Labor politician I know said, in an unguarded moment after a few drinks, "Well get you all eventually!"The aim is not to improve health care, but to get control of expenditure.

About 12 months ago a journalistic wrote in The Spectator about his shock at discovering that while his mother's chance of 5 year survival from her bowel CA in the UK was about 30% it would be nearer 70% in the allegedly terrible US system, even as an uninsured patient, sent to the retained "county hospital".

Ray T

There are several suggestions for the AMA that could be made regarding the analysis of the Health Policy from both parties.
1. Does either Health Policy seek to address the short, medium and long-term needs for the Australian Health system?
2. What are the direct and indirect financial costs and benefits of implementing the policies of either party to the day to day operation of Hospitals in the immediate term?
3. Is the policy deliverable with measurable benefits with key performance indicators?

My first reading of the President's Blog was that this was a brief opinion based on the limited Coalition release on the night of the 4th of August. This is fine so long is it was a brief opinion. From my reading, the AMA has met and put forward a case to the Coalition which had in someway influenced their policy structure. For that, the AMA should be proud in its advocacy role.

However, my belief is that it is the responsibility of the AMA to offer a deeper analysis and critique of the policies from both parties.

As such, could the AMA please clarify these statements following on from..."decisions that will deliver real results at the coalface of health"

1) "...We have Coalition commitments for 2800 hospital beds

Whilst this is to be welcome, can the AMA provide comment regarding

a) the proposed retrospective funding arrangements for these hospital beds and how this will impact on provision of hospital services, which need up-front monies (eg. salaries and positions) to continue to run? How will this funding model work in acute care situations such as ICU, coronary care, and high dependency units? How is this funding model different to the current funding model and what is its possible impact of this change to the day to day running of hospitals?
b) The funding for the hospital beds will be at the expense of currently increased funding implemented by the current Government, to reduce hospital elective surgical waiting times. How will the Coalition policy impact on current funding hospital arrangements for elective surgery? What is the potential impact on hospital waiting lists? Has the increased Government funding had its desired impact in reducing hospital elective surgical waiting lists?
c) Will there be additional money to staff the additional beds? This will need to consider the current staff levels both at a nursing level and the level of staffing of doctors. What is the provision for the additional staffing and training requirements to sustain the increased level of activity across the board?
d) What are the planned provisions for the absolutely critical issue of the aging population and the impact on both acute care beds and managed care? This is a key issue which cannot be ignored, since it will have significant ramifications on the delivery of health services not only in Australia, but also world-wide. How will the Coalition seek to fund the increasing Health delivery costs which will be naturally borne out from this demographic inevitability, with a diminishing number of tax payers relative to the aging population not contributing taxes? There is a social and demographic imperative to consider strategies to address this issue TODAY.
e) What oversight of local medical boards be provided regarding fiduciary responsibility and assessment of deliverable services? What are the provisions for Hospitals run by Local boards if they run into operating debt? Who ultimately takes responsibility for these Hospitals should this foreseeable situation occur?

"...and more support and capacity for GPs to meet the increasing demand for medical care in the community.
a) Can the AMA provide an opinion from the member of the College of General Pracitioners whether or not in their opinion, providing greater fiduciary incentive for after hours practices will significantly impact on the number of practices which will be open after hours? Is there any predicted workforce deficit in providing after hours care, and if so, what is the expected number of increased training positions required to provide for this workforce for the short, medium and longer term?
b) What provisions has the Coalition made for preventitive care practice and outpatient based services, including the critical roles for both outpatient medical and nursing based support for GPs and specialists?

These are just a few questions that should be considered and applied to policies from both parties. Again, I congratulate the advocacy that the AMA has undertaken.

Now the hard work of actually assessing the detail should begin.

Kind regards

Dr Ashley Ng

I was astounded then angered when I heard Prime Minister Spinderella announce that she plans to steal $300m from Medibank insurance premiums in the form of a so-called "dividend" to pay for Labor Party election pork barrels. Most of the patients I have who are insured are not wealthy, and are struggling to maintain their Health Insurance because they know they may face massive Public Hospital waiting lists for such things as joint arthroplasties in the future.

The government has no right to spend Health Insurance premiums on anything other than the purpose for which they were paid ie any "dividends should be used to provide cheaper premiums or greater benefits to Fund members.

If Spinderella thinks otherwise, she should be challenged to poll Medibank Private members and ask them all if they wish their premiums to be diverted to pay for Labor election pork barreling.

Surely the AMA should scream to the rafters about this rank Government behaviour, and get the coalition to do likewise.

Yours truly

Dr Clinton Herd

There are few things more predictable than the AMA supporting the Coalition's health policy in an election campaign. It is symptomatic of the abject failure of the Australian Medical Association to provide any leadership on genuine health care reform in this country. It simply reinforces the perception that the AMA is a conservative union, but union nonetheless, of private doctors seeking to advance their own causes rather than that of Australian citizens.
A real leadership might suggest paying for increased general practice rebates through the halving of cataract surgery rebates - amongst other excessive strains on Medicare from the AMA's constituency - who are essentially all private proceduralists. Remember the Relative Value Study guys??? The National Health and Hospitals Reform Process (although, god forbid, instituted by Labor) was the first real attempt at genuine reform in the past two decades - it deserved support, but got none. Now, Tony Abbott produces a half-baked, more of the same, pork barrel of a health policy, failing to address key areas of health reform like e-medicine, federal-state funding and nurse practitioners, and it gets the immediate support of the 'voice' of the profession.
Just keep in mind that predictable support for the Coalition will always help feather the nest, but do nothing to stop the AMA's slide into irrelevance.
I was hoping for more from this leadership, but not more of the same. I see nothing in the AMA's comments radically different from the President's predecessors, who were also unquestioning lapdogs of the Coalition.
Best regards.
Nick Coatsworth

AMA should support control of medical care by doctors and not by bureaucrats.
The proposal by Tony Abbott to provide federal funding but leave management of medical care to doctors and the local community would be consistent with this objective

After earlier headlines about grave concerns for the nation's Mental Health the actual promises aren't materialising. Do we have an AMA comment about solving some issues? There seems to be a large hole in state services for providing for the needs of sufferers with Adult ADD/ADHD among many other areas of need.