Doctors must have key role in health financing and funding
On the release of the AMA’s new Position Statement on the Role of Doctors in Stewardship of Healthcare Financing and Funding Arrangements 2016 this week AMA President, Dr Michael Gannon, said doctors must have an active role in the operation of healthcare financing and funding processes, and be involved in decisions on the allocation of resources at the health system level.
Stewardship of health financing and funding means ensuring health funding is directed to achieving health outcomes, does not have adverse impacts or involve wasteful expenditure, and is sustainable and able to meet future needs.
“Without the clinical stewardship perspective, there is a significant risk that health policy decisions will be driven primarily by government financing and political perspectives ahead of positive public health outcomes.”
“When major health decisions are taken without clinical involvement, the results are often sub-optimal and unsustainable, as seen recently with GP co-payments, the Medicare indexation freeze, and cuts to public hospital funding.”
The stewardship role of doctors includes:
- considering and advising on how healthcare proposals will work, or not work, from a clinical perspective;
- identifying what positive and negative impacts a proposal may have on clinical care, including its ‘fit’ with clinical workflow and the practical operation of medical practices;
- impacts of the proposal on the wider health system, including unforeseen and adverse impacts;
- sustainability of the proposal – are patient needs/demand, costs, and performance manageable over time; and
- overall, to what extent does or will the proposal contribute to improved health outcomes, and how will this be measured?
The role of doctors in stewardship of healthcare financing and funding must be explicitly recognised by governments. Doctor representatives must have access to information and data, including:
- access to up-to-date information on the current performance of health care overall, and detailed information about the specific area covered by the proposal under consideration;
- a clear statement on the need for change that the proposal is addressing;
- an analysis of factors currently influencing health care in the area concerned, including trends, pressures, and costs; and
- a clear statement of what is proposed, including expected impacts, forecast costs, and how performance will be assessed.