The numbers don’t lie: new ways are needed to continue to provide the best quality healthcare in Australia

Australia has a very good dual public-private healthcare system that delivers timely access to high quality care. However, patient needs and demands are changing, and healthcare costs are approaching unsustainable levels.

One of the greatest challenges we face is Australia’s changing demography. The number of Australians aged 65 and over is set to double within the next 40 years. The ageing population means greater demand on our health system and simultaneously fewer taxpayers to help fund it.

Additionally, one in every two Australians has a chronic disease. This accounts for approximately $45 billion or 36% of the total health budget.

Unless more is done to prevent and manage chronic disease, these costs will swamp the dual public-private healthcare system.

I believe in the adage “what got you here, won’t get you there”, and all sectors of the healthcare system need to adopt a new approach to manage these changing dynamics.

I shared these challenges at the Actuaries Institute’s Future of Health Seminar, because the numbers tell the story here. Over the past decade the cost of healthcare in Australia has risen by 4.5% above inflation, while wage growth has only been 0.4% p.a. above inflation in the same period.

The challenges in healthcare are clear: an ageing population, a growing chronic disease burden, and affordability concerns (including rising out-of-pocket costs), amongst other things.

In response, Medibank is driving a number of transparency initiatives, including providing customers with more information about how often specialists charge an out-of-pocket cost.

Other industries have been able to provide more and better information to their customers, and this expectation should be the same for those of us in the healthcare sector. Medibank is providing more information on our website about specialist out-of-pocket costs (by procedure), how customers found their overnight hospital experience, and the average costs for the most common hospital procedures.

This information is some of the most popular content on our website highlighting our customers’ appetite to access more relevant and timely information.

Medibank has also joined an Australian-first trial with Nexus Hospitals to offer Medibank customers a zero out-of-pocket joint replacement experience with an early-to-home discharge where clinically appropriate.

Early-to-home discharge (also known as short-stay or same day discharge) following joint replacement surgery has been available internationally for years.

Studies have shown that for many patients, outcomes are just as good if not better when they go home soon after their joint replacement surgery. They experience fewer rates of complications and readmissions and report higher patient satisfaction scores.

The clinical team is placing greater emphasis on prehabilitation prior to undergoing surgery, using advancements in surgical techniques and pain management, and rehabilitation and recovery through programs such as Medibank at Home. Doctors continue to have full clinical autonomy and decide, in consultation with patients, what the best care and rehabilitation setting will be.

The objective of this model of care is to provide choice, affordable care and better clinical outcomes. We are excited by the early results with the first patients providing positive feedback on their experience including the reduced financial stress.

The Australian healthcare system has a strong foundation, but what got us here, will not take us into the future.

Hospitals, doctors, health insurers and the government will need to collaborate more than ever in these changing conditions to ensure that the healthcare system continues to deliver the best possible healthcare outcomes and a good patient experience at an affordable cost.