There is something decidedly unwise about pushing ahead with the Medicare Rebate changes supposedly still scheduled to start on Monday, January 19th when those changes are still subject to a Senate vote.
What changes have already been made to the Medicare computer systems to implement the change? We, the taxpayer have paid for those. How much did that cost? If the Senate disallows the changes, how much will the taxpayer have to pay to roll back the changes?
Then there is the question of the reduced rebates paid in the meantime. Most patients will have paid up front. Some patients will have been bulk-billed and any roll-back will require payments to either the medical provider or the patient. Or is it that the period from January 19 to the date the Senate disallows the changes will just be a period of disallowed reduced rebates? Does that mean people should wait until March to go to the doctor?
I am not against well planned and justified changes to Medicare. The Superannuation Guarantee Levy was a MAJOR change for Australia, but there were transition provisions enabling adequate planning for the future. Structural changes to a system as important as Medicare need very careful analysis and planning, taking into account all considerations.
There is also the question of who is penalised for what. If the government suspects certain doctors of over-billing, deal with that issue, don’t penalise the people needing health care! Address the root cause, do not penalise the innocent.
A friend of mine and I strongly disagree on the topic of Medicare changes. He says too many people go to the doctor and waste the doctors’ time and a price point may prevent that. My friend may have a point: we have perhaps lost the ability to take care of relatively minor ailments ourselves. We perhaps don’t drink enough water, we eat bad foods and we get a stomach ache: the doctor tells us to go home and drink more water. Did we really need a medical consultation? No, we needed to be more aware of our own bodies.
Short consultations seem to be the government’s biggest concern. Let’s consider the costs around a consultation of any length. There is the patient change over time at the start and end of the consultation, the recording of the consultation details, any stationery costs, processing the payment and/or Medicare claim. Those costs are direct costs for each and every consultation irrespective of the direct labour cost of the doctor.
One impost on the health system is the requirement for medical certificates for work when sick. Now, as a manager, yes, I like to have a certificate to confirm an employee was unwell. However, as a doctor in Canada has pointed out, this is a waste of the time and resources of the health system. Even if this letter isn’t genuine, the concerns are valid.
As a business operator in Nova Scotia, I am asking for your support in helping to alleviate an unnecessary pressure on the health-care system. I am hoping you will consider revisiting your current absenteeism policy and remove the requirement for your employees to obtain a medical note for missed time from work.
This policy creates an unnecessary burden on the health-care system and also exposes seriously ill patients in my office to viruses that could cause detrimental consequences to their health. In most cases, the best remedy for a patient with an isolated illness (i.e., gastrointestinal virus or common cold) is to stay home, rest and drink fluids. Coming to a doctor’s office or an emergency room for a medical note does not complement their recovery.
If, for whatever reason, your business decides to continue to require a physician to authorize their employee’s absenteeism, I will require your employee to bring with them a written request from the organization for the medical note. Upon providing this service I will invoice your company $30.00 per medical note. This is standard practice when providing non-medical necessary services for third-party organizations.
These are normally short consultations. Clearly we have two parties with conflicting needs here and the patient/employee stuck in the middle. If you have influenza, do you REALLY feel like dragging yourself to the doctor to prove it? No. Does the doctor really need to see you? No. Is the employer justified in requiring proof you were sick? Yes. How do we solve this problem?
My friend worries that some doctors own four houses and many of us are lucky to own one. I’m not sure that is justification for messing with Medicare, which is the peoples’ insurance, not the doctors’ insurance. Many of our politicians own more than one house too: should we scrap the House of Representatives?
I have digressed, as is often my wont. I’d really like to know how much this exercise, implemented in great haste and which looks likely to be thrown out, has cost the taxpayer. How much will it cost to roll back?
Related articles in this series:
- You’ve been targeted: supporting the AMA and RACGP supporting us (personal illustration of reality)
- How Medicare Rebate cuts may impact the patient, other than cost (more general considerations)
- In the Australia of the future, you will fly out to see a doctor (just check it out)
- Medicare is YOUR insurance cover