From July 2012 Australian hospitals will move to the ABF system known as Casemix. They will be paid for each service they provide. The Commonwealth will pay 39% of the ‘efficient’ price for each service and the states will pick up the remaining 61% plus any extra amount if the hospital’s costs are higher. The job of deciding efficent prices will fall to a new body – the Independent Hospitals Pricing Authority. Casemix relies on a coding system called diagnostic related groups (DRG). It requires a small army of professional coders to comb through each patient’s medical records and work out which DRG applies to each patient. The coding process also involves grading the patient in terms of severity and complications. Casemix is already operating in Victoria and SA but it will be new to Queensland.
The hospital system costs an absolute fortune. While the country can afford it people love it. But could we manage without it? Are we using it as an absolute last resort after we have taken full responsibility for managing our own health well? Or not? In the Transition movement we think that Peak Oil and climate change will force hard choices even on state and federal governments of rich nations like Australia. There are no absolute guarantees of our nation always being able to afford to provide everyone with access to a high-tech hospital system.
Thinking hard about what an Energy Descent Action Plan would look like for health as we think about building local resilience it looks a lot like losing weight and not smoking or using addictive substances would go a long way to making us healthier. Once you start looking for ways to stay healthy that only rely on locally produced and available resources or things you can do locally without external inputs like pharmaceuticals and hospitals the message is overwhelming that most of our health options are in our own hands available right here where we live. Not having huge expensive hospital systems would not destroy our health. In fact in Cuba when their oil supply got turned off the nation became dramatically healthier!!! They walked worked to grow food ate food they could grow trained a lot of doctors but had little access to health technology. They now export trained doctors.