Through the provision of health insurance products, members of
participating organisations will be introduced to the concept of enhanced
market purchasing power for consumers of health care, beginning with price
and service arrangements for services not listed in the Medicare benefits
schedule (dental, allied health, optical, non-PBS pharmacy items, some
home-based care services) and services which are listed in the schedule
but priced in excess of the scheduled fee.
Integrated Health Care would package these arrangements in various
formats, develop preferred provider and practitioner arrangements,
introduce billing and payment systems for episodes of care which are
inclusive of various practitioner and service types. It would then develop
information and health record systems which are transferable across
practitioner and service types.
These activities are possible within present public policy settings.
The integration of insurance and service delivery in the form of fully
cost-conscious health care packages is dependent on a series of
far-reaching policy changes. Integrated Health Care aims to create
structural innovations whose enterprise operations and structural
capacities create conditions which are favourable for and facilitate
further public policy change and break the health care reform stalemate.
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Our model and inspiration are drawn from the Group Health Co-operative
in Seattle, the largest consumer-governed non-profit health care system in
the United Sates. http://www.ghc.org/web/about_gh/index.jhtml
For further details, see http://www.sen.org.au/projects/1031058235_17220.html.
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About the Author
Vern Hughes is Secretary of the National Federation of Parents Families and Carers and Director of the Centre for Civil Society and has been Australia's leading advocate for civil society over a 20-year period. He has been a writer, practitioner and networker in social enterprise, church, community, disability and co-operative movements. He is a former Executive Officer of South Kingsville Health Services Co-operative (Australia's only community-owned primary health care centre), a former Director of Hotham Mission in the Uniting Church, the founder of the Social Entrepreneurs Network, and a former Director of the Co-operative Federation of Victoria. He is also a writer and columnist on civil society, social policy and political reform issues.