Here’s a skilful pitch for government dollars. Why shouldn’t online appointments with medical health people be funded under Medicare. Why indeed? It’s all slickly done as you’d expect from Change.org. These guys have optimised social campaigns to a high art.
Anyway, it got me thinking along the lines of my recent essay on human services and evidence-based policy that this is all pretty crude. Right now we have a ‘market’ in primary medical services and that market is very heavily subsidised by Medicare. And that subsidy then leads to a situation in which lines are drawn as to what will and won’t be subsidised. Yet the subsidy should be a subsidy with a brain. That is the funding creates a lever by which one should be setting up an evidence base around what works and what doesn’t.
It would be a bad idea to imagine that this could be rolled out in any large way any time very soon. Because the skills don’t exist to convert a market into something richer in generating evidence of efficacy. If you pushed it, you’d get role play. The bureaucrats would try to implement something, but it would all be pretend and would be unlikely to be of much help.
My understanding is that some counselling services work and some don’t. My understanding is also that this is irrelevant to existing funding of counselling through Medicare. So rather than upset the apple cart and change any of this, wouldn’t it be good to identify how much money would fund what the campaign is seeking and then make some similar amount of money available for primary health care services predicated on the idea that a ‘brain’ would be part of the program which would help the system discover what worked, what could be improved and what should not be continued.
Well no-one else has commented on this – which is entirely fair enough. But if it will get the ball rolling, I’d just like to say that this is a grand idea and the author – whoever he is – should be nominated for the Nobel Prize.
I can see potential for many GP visits to be replaced by online interactions, and it’s frustrating how little impact communications technology has had on the system so far. Taking time off work, waiting around to see the doctor to get what in some instances is more or less admin work such as getting a prescription renewed or finding out test results is ridiculous when we can easily free up everyones time.
I did a presentation on this earlier this year. What is in the way of mass adoption of distance medicine via the internet in general is not really the rebate system, but the problem that it is very hard to fleece people for unnecessary procedures if you give them advice remote. Then some other doctor gets the benefits whilst you still get all the liability and hassle of electronic meetings. Nothing to do with empathy.