Waste of money on useless treatments needs to stop
If you are going to fall sick anywhere in the world, Australia – and Melbourne in particular – would be among the best places to do it.
Our healthcare system is outstanding. But that certainly does not mean it is perfect. Both the Royal Australian College of General Practitioners and health insurer HCF have in recent days issued warnings about the waste of public and private money on useless treatments or unnecessary surgeries.
GPs have issued a warning about waste of money on useless treatments for knee pain.
And many treatments, whether necessary or not, are taking place in hospitals rather than cheaper and more sensible alternatives such as clinics, driving up cost, health insurance premiums and waiting lists.
At a time when Australians, especially older Australians, are under financial pressure, helping them and the government cut unnecessary health costs is especially important.
The Royal Australian College of General Practitioners singled out the waste of public and private money on useless treatments for knee pain. HCF, meanwhile, has provided analysis showing up to 34 per cent of 32,900 admissions in 2016-17 for a range of health procedures including knee arthroscopy were ‘‘low-value’’, unhelpful, and in some cases, potentially harmful.
The health insurer pointed to inpatient intravitreal injections – a shot of medicine into the eye to protect vision – as the main example of a procedure that does not need to be performed in a hospital, adding ‘‘enormous cost for no clinical benefit’’. While one in six of these injections was happening in hospitals in Australia, in other countries this figure was as low as one in 100.
Meanwhile, chemists, supermarkets, big pharma and big health are pushing people who suffer from osteoarthritis, an increasingly common knee condition, to buy pharmaceuticals with dangerous side-effects such as opioids or fad wonder products such as vitamin D or glucosamine.
After exhaustive study, the College of General Practitioners says there is almost no evidence these treatments are effective. The only recommended remedies are cheap ibuprofen from a chemist, weight loss and psychological pain management techniques.
The GPs also warn that several common surgical techniques including knee arthroscopies and meniscectomy do no good. It has been known for 15 years that these expensive, painful interventions bring no benefits but physicians continue to perform about 40,000 each year. As Australia ages and more people suffer bad knees and other chronic pain conditions for which there are few quick, effective treatments, GPs will have to tell their patients not to waste their money.
It is a hard message to sell to patients desperate for a cure, and the GPs’ work is made more difficult by the weight of disingenuous advertising by the wellness industry. The Australian Competition and Consumer Commission should be vigilant about any false claims.
Orthopedic surgeons have recently accepted that arthroscopy is largely ineffective and reduced the number of operations by about two-thirds. Yet that raises the question of why they carried out hundreds of thousands of operations over the past 10 years. It is hard to resist the conclusion that many doctors were just happy to accept the fees.
The broader point is the need to demand value for money from the health dollar. Individuals can buy whatever therapies they like provided they are not dangerous. But taxpayers should not be footing the bill. There should be more scrutiny of how private health funds use the public subsidies they receive via the health insurance rebate. Clearly many funds pay for unnecessary arthroscopies or other quack treatments.
The federal government has from time to time tried to curtail ineffective treatments but the private health lobby has resisted and argued its customers demand them. The government should have a more rigorous process. The Grattan Institute think-tank has warned that surgeons continue to conduct unnecessary operations such as spinal fusions for osteoporotic fractures or removal of healthy ovaries during hysterectomies.
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