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Orthopaedic Surgeons Reject Health Fund Intervention In Clinical Care (US Managed Care)Fri, 29 Jan 1999

"Private Health Funds seeking to influence clinical care in Australia will find themselves in conflict with the great majority of practising doctors" Chairman of the Australian Society of Orthopaedic Surgeons, Dr John Harrison, said in Sydney today.

A programme known as Measures of Appropriate Clinical Care (MACC) financed by Australia’s major health funds, is due to be launched next week by Mr Russell Schneider, Chief Executive of the Australian Health Insurance Association.

The project aims to "demonstrate the responsibility of the medical profession with regard to delivering cost-effective health care".

Dr Harrison said "This project had never been discussed with practising Orthopaedic surgeons and we believe that it is nothing more than a Trojan Horse for US style managed health care in Australia".

"This system of managed care is now the subject of a massive patient backlash in the United States and we don’t want it here" Dr Harrison said.

Dr Harrison rejected claims that the MACC project had the endorsement of the Royal Australasian College of Surgeons.  "Our College knows very little about this project and it has never informed the Fellows of the College of its involvement."  Dr Harrison said that "The Australian Council on Health Care Standards was a self appointed body who do not speak for the medical profession.  The ACHS is a monopoly regulator that regulates hospitals, not clinical procedures".

Some of the procedures to be rationalised include childbirth procedures, heart surgery, lens procedures, and a number of Gynaecological operations.

"We have been warning since November 1995 that the ultimate intention of health fund contracts was to facilitate third party involvement in the way we treat our patients.  This is exactly what has happened in the US and it is an absolute disaster."

"We cannot allow third parties to intervene and ration quality patient care", Dr Harrison said.

"Orthopaedic surgeons spend a lot of time ensuring that our work meets the highest possible standards.  This includes many hours at quality assurance meetings, examining the latest techniques in patient treatment and care.  This MACC project has never been discussed at any of these meetings.".

"The MACC project is not backdoor managed care, it’s front door managed care", Dr Harrison said.

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