HCF is a not for profit competing with other large, for profit private health funds. What differences, if any, come about due to your NFP status?
SJ: Having no shareholders enables us to have an undivided commitment to our members’ health. We believe, that the private health system is a very important, a really vital part of Australia’s health care system as a whole. Being a NFP inevitably has a positive Influence on our decision making. We take a member first mindset in all our decisions and we can take a long term view on investment, well beyond the next market reporting cycle. This sets us apart from our for profit competitors.
How does the Australian Health system stand internationally?
SJ: Extremely well. According to a number of metrics we would be number one globally.
Such as?
SJ: There are various ways to measure this. Specific studies and measures which analyse patient outcomes show Australia rates toward or at the top. Health care cost as a percentage of GDP is also competitive.
That pushes the question toward a look at the high costs in, say the U.S. which are widely commented upon, often in the negative.
SJ: It is very complex to easily compare one system with another. A better way to look at this is through the Australian example. We have the benefit of a mixed system, public and private, which is reasonably well balanced. The US is significantly private and the UK predominately public.
Can you be more specific, please?
SJ: Yes, both the predominantly private and predominately public systems of the US and the UK have well published issues, arguably much greater issues than Australia. Our balance of public and private really encourages the system as a whole to leverage the best of both worlds and the outcomes demonstrate this.
Take elective surgery as one case. Two thirds of elective surgery is performed in the private system. Elective surgery procedures are really important to improve quality of life. Ready access to elective procedures is a good measure of universal health.
And therefore, HCF is an enabler of access to desirable but not critically needed surgery?
SJ: Yes, but “elective” can be a bit of a misnomer. These procedures – joint replacements, cataracts - can really impact a person’s quality of life. How critical is being able to mobilise without pain or see clearly? Access to these procedures, as well as really great mental health facilities and preventative diagnostic procedures through the private system ultimately improves the health and access to health services for the whole nation by taking this demand pressure off the public systems.
What role, if any do you have in influencing government policy?
SJ: Maintaining the sustainability of the private health care system and it’s role in symbiosis with the public system is critical. A big part of this is ensuring costs are at their most efficient and health outcomes are at their best. Our health system is large and complex. The private system plays a critical role in taking pressure off the public system. Government policy is central to the way the whole system functions and hence working with Government to help support and inform the best outcomes is very important.
How active are you in research in things like patient care and outcomes?
SJ: We are particularly proud of a research partnership with the University of Sydney led by Professor Elshaug, on studying what is known as “low value care". This is defined as any intervention where clinical evidence suggests there is very little benefit to patients, or the risk of harm exceeds the benefit. This kind of research is valuable for both the private and public health sector and we’re very proud of the impact this research has had. In particular this research was an important input into the recent Medicare Benefits Schedule review.
This sounds like a form of ongoing research which must lead to improvements, or innovation. And we understand you have a more direct form of spurring innovation in the med tech field.
SJ: Yes we started HCF Catalyst, the first corporate backed health tech accelerator 5 years ago.
And how does this work?
SJ: We have an application process which is rigorous and it attracts some brilliant people. Successful participants take part in a 12 week program that really helps these entrepreneurs acquire the skills needed to build their ideas into real businesses that solve real problems in the health system.
So essentially you are doing first stage, pre-funding incubation?
SJ: Yes, that would be a reasonable summation –but it goes further as we can provide broader support. When the products eventually commercialize we are able to recommend or publicize them to our loyal customer base of 1.6 million, and we believe that is an important boost for many young companies that are looking to disrupt the health system to drive better outcomes.
In some cases at least that might be more beneficial than just giving cash.
SJ: Yes that’s right
Another activity of HCF which is of interest is your Research foundation.
SJ: This was founded in 2000, and it is devoted to health services research. Each year we attract hundreds of applicants and narrow these down to a handful of the highest quality to whom we issue $1-2M in funding in total. Topics vary from year to year but we’re really interested in research that is translatable and can be used practically in the health care setting. Treatment for back pain, for example has received a lot of attention recently and we have funded research in this area. We want to apply the learnings to broad settings and ensure the findings are disseminated to the health care professionals where it will make the most difference, regardless of public or private, member or non-member. We’re interested in working towards better health outcomes for all Australians.
This article is taken from the recently published digital book
Australia's Nobel Laureates Vol III State of our Innovation Nation: 2021 and Beyond