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原帖由 小兔子乖乖 于 2008-8-5 23:49 发表
什么政策那么邪乎, 说来听听罢
Health levy plan to 'hurt poorest'
July 11, 2008 The Australian
THE Catholic Church - the nation's biggest operator of hospitals after state governments - has warned Kevin Rudd that his move to lift Medicare surcharge levy thresholds will hammer the battlers he wants to help by choking already stressed public wards and lengthening surgical waiting lists.
In a devastating critique of one of the Prime Minister's main 2008-09 budget initiatives, Catholic Health Australia has used government data to warn the change will lump public hospitals with a $400million burden of providing an extra 200,000 procedures in the next 12 months.
CHA also predicts elderly people seeking hip and knee replacements will be among the hardest hit and that the changes will trigger an unavoidable 10per cent increase in private health insurance premiums next year.
"The CHA review has found specific impact on low- and middle-income earners - the group the proposed threshold changes were in fact designed to assist," says a submission the organisation lodged yesterday with the office of Wayne Swan.
"Patients in both public and private sectors will be adversely impacted by the likely fall in private health insurance membership, but it is low- and middle-income earners who will bear the brunt of the new pressure that will be placed on the public health system."
But the Treasurer last night defended the changes, saying the increase in thresholds was designed to provide relief for families facing the tax, originally introduced by the Howard government to target high-income earners but never indexed.
In the budget handed down in May, Mr Swan announced an increase in the income thresholds at which people without health insurance face an extra surcharge worth 1 per cent of their income.
The income threshold at which single people would be liable to pay the surcharge will rise from $50,000 a year to $100,000. Couples will face the surcharge if their combined income exceeds $150,000 - up from $100,000. Treasury modelling suggests the change will encourage 485,000 people to abandon their health insurance because they will no longer face the penalty of the surcharge.
Legislation enshrining the changes was sent to a Senate committee by the Coalition-controlled Senate last month and will be reconsidered next month.
Yesterday the CHA, calling for a rethink, said the move was at odds with Mr Rudd's stated desire to shorten public hospital waiting lists.
CHA is uniquely placed to comment on the changes because the Catholic Church runs 54 not-for-profit private hospitals around the country as well as 21 public hospitals operated for state governments.
Chief executive Martin Laverty said people in difficult financial circumstances depended on public hospitals to meet their health needs.
"Catholic public hospitals may be impacted by the proposed threshold change as episodes of care that would have been carried out in private settings shift across the public settings," Mr Laverty said. "Our modelling indicated a case load of some 200,000 could be shifted from private to public hospitals around Australia.'
The CHA review document, backed late yesterday by the Opposition and the Australian Private Hospitals Association, said the cost shift would amount to $400million a year.
It said the changes would also rob public hospitals of about $55million a year raised by treating privately insured patients in private wards within public hospitals.
The review predicts the loss in private health fund membership will give insurers the grounds to ask the Government to approve premium increases of up to 10per cent from next March, with the Government obliged to approve fee increases if they will prevent funds from becoming insolvent.
While CHA acknowledges the Rudd Government's support for public hospitals through extra funding to reduce waiting lists, it argues the effects of the surcharge threshold increases run counter to its good intentions.
It says its predictions represent the effects only in the first year of the reform, arguing that because young people will dump their insurance, insurers will be forced to lift their premiums in a self-perpetuating downward spiral that will drive more and more people out of the private health sector.
"There is a strong likelihood that high premium increases will prompt private health insurance ongoing membership drop-out rates in future years, which will increase and become compounding," it says.
Mr Swan said last night the Government was a strong supporter of the private health system and would continue to provide support for both sectors.
"We changed the Medicare levy surcharge thresholds with one aim - to give relief to working families from a tax that was meant for high-income earners," Mr Swan said.
"We've already done a substantial amount to take pressure off public hospitals, including $1billion in extra funding over the next year, $600million for elective surgery, a plan to deliver almost 10,000 extra nurses into health and aged care, as well as investing more in prevention to take pressure off acute services.
"This is not to mention the Rudd Government's $10 billion health and hospitals fund."
But Brendan Nelson last night urged Mr Rudd and Mr Swan to reconsider their plan.
"Mr Rudd's stated intentions of reducing public hospital waiting lists are in conflict with his policy," the Opposition Leader said. "It will shift the financially fit and reasonably healthy from private health insurance into public hospital waiting lists. And it will leave families, pensioners and retirees who really see themselves as needing their insurance in a diminished pool which will turbocharge inflation in their premiums."
A spokeswoman for the Australian Private Health Hospitals Association said late yesterday her organisation had not seen the CHA review.
"But there's no doubt that if the proposal goes through in its current form, it will increase the workload of public hospitals," she said.
Late last month health insurers also attacked the move.
Australian Health Insurance Association chief executive Michael Armitage told The Australian that even if the Treasury figures on the expected loss of fund members was only half-right, large numbers of young people would dump their insurance under the changes, drastically altering fund membership profiles.
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"Premiums will inevitably have to go up to cover the people who leave," he said.
"This is almost an actuarial exercise."
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