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Opinion_

Time for smart choices on Medicare reform: Who is acting in the public interest?

Professor Ian Hickie of the Brain and Mind Centre has blasted the Medicare review's mental health reference group
Professor Hickie says that a report calling for rebates to be extended to people "at risk" of being mentally ill will not be a smart choice for long term reform.

We have this problem in Australia of thinking if everyone gets a little bit that's better than, actually, people getting better. Why has our national policy failed for 30 years? The simple answer; we focus on access rather than quality outcomes. The mental health reference group's report, which is out for consultation and will inform expected reforms, this week called for up to 10 Medicare-funded therapy sessions a year for people who have not been diagnosed with a mental illness.

The Productivity Commission review would be crucial to determining what structural changes might be needed to ensure the system was geared towards effective treatment outcomes, and that the health minister of the day must think carefully before making changes. The idea that access to mental healthcare will fix the problem [means] the more severe and complex problems will not be fixed. We need to take care of those who actually have complex cases and who actually result in the most healthcare, but also the most lost productivity - because they don't go to school and they don't go to work.

A bundled care model, under which a larger sum could be allocated to put together a team of specialists - such as a GP, psychologist, mental health nurse and dietician - to provide a tailored "package of care" to the patient would be more beneficial. People need combined interventions - medical, psychological but also social, occupational and educational - to get an outcome.

This will not be a smart choice for long term reform
Professor Ian Hickie