Motsoaledi lashes out at physician’s NHI criticism
18 edition of the Medical Journal of Australia , Melbourne’s Age reports (Nader, Age, 9/18). The use of mifepristone, which when taken with misoprostol can cause a medical abortion, was prohibited in the country until the Federal Parliament in February voted to pass legislation that removed Health Minister Tony Abbott’s authority to veto the importation of it. The Australian Therapeutic Goods Administration in April announced that it had authorized two Queensland physicians to import and prescribe the drug ( Kaiser Daily Women’s Health Policy Report, 6/15). Mifepristone and misoprostol in combination is considered the best method for a medical abortion, the Age reports. However, Marie Stopes , an abortion provider, is testing methotrexate’s use in medical abortions because of the delays in approval of mifepristone, according to the Age. “There do seem to be more people out there using methotrexate and misoprostol than we were aware of,” Christine Tippet, president-elect of the Royal Australian and New Zealand College of Obstetrics and Gynecologists , said, adding that the application process to supply mifepristone is complex. According to de Costa, “several hundred [physicians] annually” in the country are administering the methotrexate-misoprostol combination or just misoprostol alone “under the radar.” Both drugs are licensed in the country, and physicians are permitted to use the drugs for purposes for which they are not licensed as long as they are effective and safe, the Age reports (Age, 9/18). According to de Costa, physicians are using the drugs to abort fetuses up to 13 weeks’ gestation in cases when severe fetal abnormalities are detected (de Costa, Medical Journal of Australia, 9/18). This article is republished with kind permission from our friends at the The Kaiser Family Foundation . You can view the entire Kaiser Daily Health Policy Report , search the archives , or sign up for email delivery of in-depth coverage of health policy developments, debates and discussions. The Kaiser Daily Health Policy Report is published for Kaisernetwork.org , a free service of The Henry J. Kaiser Family Foundation . Copyright 2006 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
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Archer is accusing me of being disingenuous with my audiences when I inform them about universal healthcare coverage. He claims that I am “painting a picture and creating an aura of hope that simply cannot be unless that is, one ignores and disregards the realities of South Africa’s budgetary and human resource constraints”. In other words, in order not to be accused of being disingenuous, and to be in line with what he calls “the realities of South Africa’s budgetary and human resources constraints”, I must tell my audiences that there is no hope for South Africans. In simple language, he wants me to tell South Africans that the reason that most people’s healthcare needs are not met by our healthcare financing system is an inevitable law of nature and nobody can do anything about it. I beg to differ. To back his spurious argument, Archer then goes on to crunch some numbers to prove that everything we are proposing in the NHI is impossible. This doctor boastfully writes that he is trying to assist me with calculations of health expenditures in various countries. Looking at the numbers and figures quoted by Archer, and the logic he uses to arrive at a conclusion, I personally arrive at two possibilities. The first, is that Archer is the one who is being disingenuous: in his quoting of figures he is deliberately omitting crucial information that would help readers to draw their own conclusions, in order to support his spurious argument. The second possibility is that he is simply ignorant. Either way, he doesn’t qualify to assist me. In fact, hes the one who needs assistance, and I am hereby gladly providing it to him. When comparing countries health expenditures, you first need to establish their gross domestic products (GDPs), their total per capita expenditure and the cost of living in each country. Archer compares the health costs of the United States, the United Kingdom, Australia and South Africa, but what he fails to point out is that the GDP of the US is $16-trillion (21.9% of the global economy), that of the UK is $2-trillion and Australias $961-billion (2.1% of the global economy), whereas South Africa’s GDP is only $576-billion (0.5% of the global economy).
Health Workforce Australia report gives the nod to physician assistants
Firstly, it will stimulate a great deal of discussion, both positive and negative. The report clearly outlines positive impact that the physician assistant will have on the Australian health workforce and the overwhelming support of the rural and remote health sector. To date, most opposition to the Physician Assistant role has been based on a poor understanding of this model of healthcare, which this report confirms. The contents of the report provide a clear and detailed description of the role of Physician Assistant, which should lead to a greater understanding of the position. So, what is the next step? Well the next step is in fact already happening and as can be seen from the recent events in Tasmania, there is a desire in some states to commence the introduction of a Physician Assistant. Whilst the work being conducted in individual Australian states should continue, the Physician Assistant should also be considered at the national level. This report echoes the sentiments of the Australian College of Rural and Remote Medicine (ACRRM) that the profession should be registered nationally under AHPRA, and likely administered by the Australian Medical Board. With much of the professional registration requirements having already been developed and the professional oversight of ACRRM ensuring the validity of Physician Assistant education and continuing professional development programs, national registration can be commenced almost immediately. There are at present over 30 Australian Physician Assistant graduates, with a new cohort of students having commenced this year. As the HWA report identifies, the Physician Assistant will have a positive impact in the health workforce, so now it is time to get started and introduce this new health professional.