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The head of the Australian Medical Association will today call on the federal government to overhaul the medical system, urging an end to the reviews and 'talk-fests' of recent years and action on the known issues. Dr Tony Bartone will urge action in a speech to the National Press Club today, after several years of reviews of the Medicare Benefits Schedule, private health insurance industry and a wide range of other issues. Dr Bartone said the government had spent too many years conducting reviews and talk-fests when the issues were clear across the health system. He said the combined effect of increasing private health insurance premiums and the long-standing freeze on Medicare payments to general practitioners was seeing young and older Australians avoiding getting health treatment for conditions they should be. Dr Bartone also said the increasing premiums were affecting the health insurance industry causing people to forego surgeries because of the cost. The head of the association also hit out at the government for inaction on mental health, indigenous health and the freeze on Medicare rebates, saying there had been enough reviews into these issues, the government knew what to do and needed to get on with it. Despite a high rotation of ministers in and out of the health portfolio in recent years, Dr Bartone said minister Greg Hunt had been in the role for more than two years and he should be acting on the long-standing issues facing the health sector. He said he had raised the issues with Mr Hunt in a meeting a week before making the speech - as have previous AMA presidents - and he now hoped the government would act. "To look at only parts of the system is not working, we need to look across the entire medical system and take action on what we already know needs to be done." Dr Bartone said the situation facing the medical sector was now so desperate if action was not taken, it would be a case of "can the last person leaving turn the lights off". He said if the government did not act on the problems, it would also not be the elite who would suffer amid rising costs, but the average Australian who would be delaying getting healthcare or facing increasing costs. Dr Bartone's calls for action follow the release of a Grattan Institute working paper earlier this year highlighting how health insurance premiums were outpacing wages growth and inflation. The paper, by Stephen Duckett reinforced that people, particularly the young and healthy, were dropping their cover, in turn driving insurance costs up further for older Australians who used health services more. It also questioned the need for taxpayers to subsidise the insurance industry to the tune of about $9 billion a year, arguing successive governments had failed to clearly define the role of private health insurance since Medicare was introduced in the 1980s. "If its purpose is to complement Medicare, offering people choice of specialists and a wider range of services, then the argument for taxpayer subsidies is weak," Mr Duckett said at the time. "But if its purpose is to substitute for public hospital care, then the argument for subsidies is stronger." Dr Bartone also said successive governments had dropped the ball on indigenous healthcare, which along with mental health care needed a complete overhaul that took into account all views, but the government already had the information it needed to act on those failures without another review. Despite the criticisms the association levelled at the government, Dr Bartone and Mr Hunt jointly this week released a new guide to help consumers with their financial health literacy, spelling out in plain English standard medical fees and their implications. The guide will be available from doctors, medical practices and organisations, and the AMA website, giving people an estimate of fees and the costs payable by a patient after government and health insurer rebates. It also includes an "informed consent" form that doctors and patients can complete together, along with advice on fees and medical gaps. Dr Bartone said Australians were often left feeling miffed with health insurers, not because they have had to pay out-of-pocket costs but because they came as a shock. "Complex care can be challenging, it can be daunting. Understanding the cost of your care should be neither of these," he said. It comes as the managing director of insurer NIB, Mark Fitzgibbon suggested in the Australian Financial Review the government should make insurance compulsory, but the government should pay premiums for those who could not afford it. But Mr Hunt said the government would never dump Medicare, and he rejected any such suggestion, but it was also committed to private health insurance.

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