Transcript - AMA President, Professor Owler, 2GB with Warren Moore
WARREN MOORE: Now, would you be happy to take your own blood pressure instead of going to a doctor? Well, DIY health checks are being considered as a solution to Australia's booming Medicare cost. Now, in a raft of routine tests that people go to the doctor for, they could be completed by the patient in their own home and the results would then be reported and nurses would contact people who had abnormal results. The idea comes as new figures are released on how much Australians are using Medicare and I have to say the results are pretty alarming. Every day a million claims are made to Medicare. So, a population of 23 million people, every day a million claims are made to Medicare. Now, that's a record amount and it's costing Australia $20 billion a year. So, will DIY medical checks be the answer? Professor Brian Owler, the President of the AMA, joins us now. Thanks for your time.
BRIAN OWLER: Thanks, Warren.
WARREN MOORE: Well, first up, what's your comment about there being one million Medicare claims a day? It sounds a big figure but is that what you would have expected?
BRIAN OWLER: Yeah look, it does sound like a big figure but you've got to remember that these are services that are not actually GP visits. So, you need to remember that one visit can actually result in several services. But, I think, at the end of the day, we have a growing population, an ageing population that is living with more and more chronic disease. And when we see the growth in services, actually they're around things like the chronic disease management items and also the item numbers for practice nurses and that is about managing this burden of chronic disease which we have to do if we're expecting people to live longer, and also expecting to keep them in the community.
WARREN MOORE: Yeah. I heard the Health Minister say today, Sussan Ley, that this shows we need to have some reforms about the sustainability of Medicare. Nothing new on that, we had that very same debate when the co-payment debate was happening and raging but it is an indication that the issue's not going to go away, let's put it that way.
BRIAN OWLER: Well, look, I mean we see these projections all the time. I mean, the projection now is 7.1 per cent growth but actually last year the growth was 5.2 per cent and the year before that was only 3 per cent. So, I'm very disappointed, I have to say, that the Minister has decided to use these figures to again run the narrative when we have an upcoming review of the MBS that the review needs to be shaped at cutting costs. What it should be about is actually providing the right services for patients, about the quality of the care that we provide, and providing our patients with a modern MBS which actually reflects modern practice so that they get the right access to services.
WARREN MOORE: And I suppose you've got to say if we've got a growing population and an ageing population, there's inevitably going to be some extra expense isn't there?
BRIAN OWLER: Well, that's right. It's a first world country, we've got people living longer and longer and are doing so with more and more chronic disease. So, that is our challenge to invest in primary care, to get people going to the doctor so that we can actually make sure that they end up seeing their GP rather than ending up in more expensive hospital care. And I think it should be celebrated in a first world country that we're actually doing a good job and people's life expectancy is now the fourth highest in the world for a relatively modest spend in terms of other OECD countries.
WARREN MOORE: Is there still this residual problem though of people going to the doctor as if it's a social visit and that being a burden on the system?
BRIAN OWLER: Look, that narrative was built up before we had the GP co-payment debacle and that is an absolute falsehood. When you speak to GPs they're very busy in their practices, people aren't coming for social visits. And you've got to say if they're going for social visits then it's usually some other underlying problem there as well. I think this notion that GPs are sort of just seeing people for the sake of it really ignores the fact that what they're actually dealing with in each of their consultations is more and more problems. When we look at the data from the University of Sydney, they're actually often dealing with three or four problems in every consultation, an increase in what they were dealing with - from what they were dealing with years ago.
WARREN MOORE: Well, if you had a look at some reforms, I know we've had the idea of pharmacists picking up some things such as renewable prescriptions in the past, what about this DIY health check idea? Taking your own blood pressure, I guess weight loss is not such an issue but self-monitoring of weight loss programs and those sorts of things?
BRIAN OWLER: Well, monitoring a number is one thing but actually advising and talking to a patient about how they might change that number is the other thing, and that's what the nature of the consultation is. This notion about using telemedicine to record these sorts of numbers has been around for a long time and, yes, it's a novel approach and it may save some money here or there but there's not going to be any replacement for actually having a person sitting next to you and actually having a conversation, not just about the problem that they may have come to you about, but about other problems that you might uncover as well.
WARREN MOORE: What about prescription renewals in particular? And I include the idea of the pharmacist doing it when I include that. I mean, that's - is that something that really a doctor has to do?
BRIAN OWLER: Well, it depends on the medication and it comes back to the issue of safety and making sure that the person actually providing the prescription rather than the dispensing actually knows about the patient's whole medical condition [indistinct] - at I guess the appropriate person to actually provide the information about renewals. Now, where there's a simple renewal, I mean, there might be some scope to change that whether there's a limited effect in terms of safety, but for many medications it's actually about a more detailed consultation than just writing another script.
WARREN MOORE: So, what ideas does the AMA have about making the system economically sustainable or do you just say we have to cop the fact there will be more costs?
BRIAN OWLER: Well, there is an element of that but we've had a number of ideas put forward about where we save money and where we see a lot of money being spent is in later life in terms of patients receiving sometimes what can be described as futile care. But I think that's a conversation that we need to have with the community, it's not something that the politicians can really decide but, you know, we need to, I think, do a better job of using the resources at that higher end, particularly in the later years of life, because we know that many people given the choice would probably not want to have some of those treatments if they had the opportunity.
WARREN MOORE: Okay. Thanks so much for your time. Always appreciated.
BRIAN OWLER: It’s a pleasure.
3 September 2015
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