Should I just put a down payment on my coffin now, Scott?
The identity of my Goliath has changed. Right at this moment “Love versus Goliath” can be translated to love for my own health and Goliath, yet again, is the government. Different political persuasion, this government, but essentially the same beast. This isn’t just about the unemployed or low-income earners. ANYONE can suddenly discover they are unwell. ANYONE! It happened to me, it can happen to you too.
I am writing from my personal perspective to illustrate the potential scope of proposed changes to Medicare and the looming doom is a worry. I am gainfully, at the moment anyway, employed. I do earn a reasonable salary. I also have four children at home who strangely are not partial to starving so I can have blood tests. I consider myself “typical”. Not rich by any means, but not on social welfare either. If it is going to be tougher for me, I can only imagine how much tougher for those really struggling financially.
Although it has taken me some time to adjust to the idea I am not well, I’m not. At the moment I am seeing three medical specialists, a general practitioner, a physiotherapist and have just finished a series of support sessions from a psychologist. I’ve had countless blood tests, faeces tests, urine tests, x-rays, a whole body nuclear bone scan, CT scans, ultrasounds, cortisone shots and a nuclear thyroid scan. I’ve also paid a $500 hospital admission co-payment. All since October 2014. I have medications to keep me functioning so I can keep working: these cost money. Not all the blood tests have any rebate available at all, 100% out-of-pocket. If I don’t keep working I become a “burden to the taxpayer”, do I not? Yet make no mistake, if I can’t afford my treatment, I will be unable to work.
The doctors, general practitioners and specialists, impacted by these changes are NOT employed by the government. They run small businesses, like so many Australians. They have the same business expenses to pay has anyone else.
The first change to our Medicare system that was suggested was a $7 co-payment. I thought it a ridiculous proposal and said so in no uncertain terms. The general backlash seemed to have chastened the government somewhat and a slight variation with a $5 figure was bandied about but thankfully the opposition aren’t buying it.
The latest is:
From 19 January 2015, the Government has cut Medicare rebates by $20 for GP consultations that take less than 10 minutes.
Today, the standard GP consultation has a Medicare rebate of $37.05. More than 25% of these consultations last less than 10 minutes. The Government will reduce the rebates for these services to $16.95 by restricting:
- Level A consultations (MBS item 3) to consultations lasting less than 10 minutes; and
- Level B consultations (MBS item 23) to consultations that last between 10 and 20 minutes.\
I’ll admit personally I am not quite as worried about the standard GP consultations as I am about the specialists. THEY COST! BIG TIME! I don’t believe only general practitioner rebates are being slashed, do you? No, I didn’t think so.
Those of us with chronic conditions and multiple medical providers will suffer. I recently joked about my version of M*A*S*H – staying reasonably healthy could send me broke, literally.
I walked into an imaging provider with NO idea how much I would be charged. The medical system is like that, if you don’t have a Health Care Card there is this assumption you have the cash. I was charged $951. Bang, just like that. Now, because as a family we had already hit the Safety Net, I got $885 back, but I had to actually have the $951 in the first place. I stole from the rent money, what else could I do? At least the rebate arrived in my account within twenty-four hours. I actually do not know what would have happened if I had stood at the counter and said, “I can’t pay”.
I have two bills here, as yet unpaid, for three blood tests for which there is no rebate at all. Total $140 but the electricity bill took priority. My last two prescriptions were $26.99 and $36.70 respectively and that is for a month. I spend about $100 a month on prescriptions which I well know is MUCH less that many other people with chronic medial conditions.
My initial consultation with my gastroenterologist was $190: not nearly as steep as the initial consultation for the rheumatologist of $320.00. The endocrinologist was an initial consultant of $304.35.
As just one example, the Scheduled Fee for the rheumatologist item number is $263.90. The rebate of $224.35 falls far short of the actual cost to me, unless the patient/family has hit the Safety Net. You can argue all you like that specialists should charge the scheduled fee, but those scheduled fees won’t be updated again for YEARS (see below).
You don’t have to be a maths major to work out the patient needs to juggle the finances to ensure they can see the doctors required to keep the patient in good enough health to keep working. What choice do I have? Forego treatment and end up on the DSP? If I “went public” how long would I wait before I was diagnosed and treated, too unwell to perform my job?
From July 1, 2015 the Medicare rebate for standard consultations will be cut by a further $5 for non-concessional patients. The doctor will receive a rebate of $11.95 for a non-concessional patient for a consultation of less than ten minutes. You will pay the difference. I don’t know what your doctor charges, but $70 perhaps? $75 or $80? Don’t get too many viruses.
“What it will mean is that GPs are forced to pass these changes on to their patients in terms of costs,” he said.
A/Professor Owler said experienced GPs were often able to conduct an examination, take a history, prescribe and management plan and counsel a patient within eight or nine minutes, but such efficiency would be punished under the Government’s changes.
“Why that consultation should be worth on $11 now, compared to the $37 that it was worth last week, is certainly not something the AMA supports,” he said. “That is an enormous burden on practices which, at the end of the day, are small businesses.”
In addition to the reclassification of consultations, the Government also plans a $5 cut to the Medicare rebate, which A/Professor Owler said practices would have no choice but to pass on to their patients.
How much will be cut from other item numbers, such as those claimed when I see my specialists? No-one is talking about that yet and despite diligent research, I’d uncovered nothing and asked the AMA directly.
There is another kicker in all this. From the same AMA link as above:
The Government has extended its freeze on indexation of Medicare rebates until July 2018.
As with all small businesses, the costs of providing medical care go up each year. Costs to run medical practice include wages for receptionists and nurses, rent, medical equipment, cleaning, electricity, computers and insurance. All these costs must be met by the single fee the doctor charges the patient for their care.
Medicare rebates have been frozen since 1 November 2012 for GP* and specialist consultations and operations and will not be increased until 1 July 2018.
Medicare rebates for pathology and diagnostic imaging services have not increased for more than 15 years.
If you are a business person, can you honestly say you haven’t increased any of your selling prices since November 2012? I didn’t think so. So the doctors still have to face the cost of living increases the rest of us face in their lives.
If you work for a medical practice and you want to buy a car, for example, can you go to the bank and ask for a cheaper interest rate because the medical practice can’t afford to pay you an increase like the rest of the population got? Unlikely. The discretionary spending power of the workers in the health industry will be reduced with the resultant negative impact on the economy.
Before you dismiss the cuts in rebates as “not something you have to worry about”, think very carefully. Next week, even tomorrow, you might feel a little off-colour. Then a bit worse. Then you have some blood tests: then …… welcome to my world, my friend.
Heaven help your finances if anyone else in your family gets sick as well, short-term or long-term.
Save Medicare. Support our brilliant medical profession. Download or share the RACGP poster: Targeted
It is worth reminding the government the objectives of the Liberal Party state:
(j) in which social provision is made for the aged, the invalid, the widowed,
the sick, the unemployed and their children;
(k) in which adequate medical services are within the reach of all;
The aim of this article is to enable the “average Australian” to consider what these changes may mean to them. The poorest don’t have the political clout – the rest of us do. If using myself as an illustration achieves this objective, I’m happy to be the guinea-pig! For a medical practitioner’s perspective, you might like to visit New year, same approach: implications of the Fed Govt’s confidence trick on Medicare.
I also care about our environment, so while you are here, may I tempt you to kindly click on Today’s Neros fiddle while our planet burns. We might need our health system even more!
- The above article has been published on The Australian Independent Media Network, titled Changes to Medicare – you’ve been targeted.
- How Medicare Rebate cuts may impact the patient, other than cost is a follow-on article on this site that may interest you.
- Abbott destroys Medicare refers to this article, but paints an even scarier picture than I do!