22 Comments

You’ve been targeted: supporting the AMA and RACGP supporting us

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.

Source: RACGP

Source: RACGP

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.\

Source: AMA

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.

Source: AMA

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.

AMA Media

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;

Page 3

Sign the RACGP Petition HERE!

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!

EDIT:

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22 comments on “You’ve been targeted: supporting the AMA and RACGP supporting us

  1. […] to looking after my own nails. The health of my nails as noted above and the medical bills for my real health issues were eating into my discretionary spending […]

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  2. […] You’ve been targeted: supporting the AMA and RACGP supporting us (personal illustration of reality) […]

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  3. […] You’ve been targeted: supporting the AMA and RACGP supporting us (personal illustration of reality) […]

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  4. Heavens above, our circumstances are similar! Last year, my family of 4 (3 adults, 1 teen at school) hit the Medicare Safety Net on 7 March! One hospital admission of 3 weeks for me, plus countless tests, scans and expensive medications (all ongoing) meant our family’s medical bills exceeded $28,000. Hopefully no hospital this year, but the GP visits, blood tests to monitor drug levels etc, and expensive medications will continue for the rest of my life. Medicare must be saved.
    Thanks for reading.

    Liked by 1 person

    • Mix, thank you for sharing!!! The more examples the better.

      We need to wake people up out of their apathetic attitude to this situation.

      The doctors can’t fight this battle for us without our support.

      Liked by 1 person

      • I think people are apathetic bc they’re under the misapprehension that the govt will help them. So untrue! It didn’t help me. I have a good employer who has given me extra leave & been very flexible, but the rest I’ve done myself. Try brokering communications between endocrinologist, respiratory physician, immunologist and psychiatrist, not to mention GP and path labs. I’ve awarded myself honorary degrees in medicine and pharmacy lol. Seriously, it’s very hard to navigate our health system and I work in it!!!

        Keep well. Enjoy your blog.

        M

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      • You are so right! I commented one day it was harder work being sick than being in my office. As you say, co-ordinating to ensure all the Docs have all the results, that I see them in the right order, get the tests done at the right time……

        I need a medical secretary!

        My employer also very supportive, but of course there are limits.

        Luckily the thyroid meds have made improvements, so I should now be OK work-wise, but what of others who are not so lucky?

        Everyone thinks it will never happen to them…… it does!

        Liked by 1 person

  5. […] there was a system called HECS and university fees were regulated. There was also a system called Medicare, where Australians paid a levy with their tax to fund a universal health insurance system and […]

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  6. Thank you very much. Fantastic article

    Liked by 1 person

  7. […] I looked at the financial aspects of the proposed cuts to the Medicare Rebate. This article assumes knowledge of the previous article. There are non-financial impacts we […]

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  8. […] tests and medication. I’m lucky in that respect. But, what if you are sick? My Twitter Pal @TeamOyeniyi has blogged comprehensively about her personal medical situation. When I read her blog, it was an eye-opener to the stark future for the ill when Abbott destroys […]

    Liked by 1 person

  9. You are so right the she will be jake mate approach to the poor is wrong they dont have a voice we must fight

    Liked by 1 person

  10. Excellent article, Robyn. It’s a scary path we seem to be on, when the basic right to necessary medical services is threatened.

    I wonder how often medical conditions worsen because patients delay accessing treatment because of the costs. I’ve read statistics that say that early intervention is actually cost effective, so where is the logic? Just as worrying, when will a parent hesitate too long over that rash or high temperature for the same reason?

    My best wishes to you on your personal health journey and thanks for fighting this inane legislation on behalf of us all. I’m going to forward the article to my local Liberal MP. Hope it will be a wake up call.

    Liked by 2 people

    • Share as far and wide as possible Jan. This is for the public good, copyright is suspended for appropriate use.

      YES re early intervention. Rheumatoid arthritis is one classic example. This was long enough, I might write a follow-up covering that aspect.

      Thank you for supporting this fight!

      Like

      • Thx Robyn, realised after posting I’d left out the ‘if that’s okay with you’ about forwarding but hoped you’d know I wouldn’t without your okay. Think your example would make a great, much needed, ‘wake up to yourself Australia ad’, btw.

        Cheers, Jan

        Like

      • It was published on the Australian Independent Media Network today. ☺

        Have you read my follow-up? You might like that too.

        There are some medical people spreading it around too.

        Like

    • Thank you also for your kind thoughts re myself. 😊

      Like

  11. This is scary for all of us. Even those of us on the “safety net” we worked for and paid taxes for over the years. These neo-nazis are changing the rules openly and blatantly!

    Liked by 2 people

  12. Wow…and I thought we had it bad over here. Goodness the medical system is terrible there. It is becoming like America where only the rich can afford to get sick.

    Liked by 1 person

    • Yes, Jo, it isn’t a good situation. Not through parliament yet, so we have time to DO something.

      My concern is the”average” person thinks only the poor/unemployed are impacted and they don’t have the political clout to fight.

      By using myself as an example I am hoping people will see ANYONE can be impacted at any time.

      Liked by 1 person

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