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Changes to Medicare – you’ve been targeted

Should I just put a down payment on my coffin now, Scott Morrison?

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.\

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 MAS*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 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 (on page 3) 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!

This was an edited version of You’ve been targeted: supporting the AMA and RACGP from Robyn’s website Love versus Goliath : A Partner Visa Journey.

18 comments

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  1. la_lasciata

    I only ‘like’ it because it’s so utterly relevant to the times. Because it’s yet another warning about TROWC. But come to think of it, I also like it genuinely because it indicates that these swine mean to continue as before – and that seals their fate in 21 months’ (approx.) time.

  2. Kerri

    I’ve never done a full assessment of our medical costs as a family of four. Between the four of us we require help for; fibromyalgia, coeliac disease, alopecia, epilepsy, high blood pressure, cholesterol, regular antibiotics for prosthetics, psoriasis x 3, asthma and possibly chronic fatigue or rheumatoid arthritis (yet to be diagnosed). We can afford this and if you can, you just pay and try to stay healthy and comfortable. For those who cannot afford to “just pay” I guess the LNP have a lot of friends in the funeral industry?

  3. townsvilleblog

    Try having two chronic illnesses and trying to survive of the DSP its not easy, and after July it will be bloody near impossible.

  4. Loz

    It is absolutely disgraceful what these politicians (who have no problem with paying bills) are doing to those less financially fortunate.

  5. diannaart

    Maybe I should do ‘Team Australia’ a big favour and take permanent leave – clearly I am not wanted either well or ill.

  6. John Fraser

    <

    Here's another example of how it could happen to you :

    A couple of years ago my wife got sick, really sick … if she had been a horse I would have put her down …. she went to 3 doctors with the last one sending her along for a "Stress Test".

    Finally she got a reference to an Eye, ears and nose specialist and within 1 minute … yes 1 minute the diagnosis was in, it turns out that not too many G.P.s see adults with Whooping cough.

    Whooping cough !

    Bloody frightening to see an adult with it let alone a baby.

    And over the 2-3 week period that she had it we had visited people with young children.

    My wife had had the shots when she was young.

    Whooping cough !

    Yes Adults can get it …. and yes they can get a booster shot against it.

    Further investigation shows that Whooping cough numbers in Queensland have been steadily rising, in spite of the vaccination being free for pregnant woman.

    So don't … for 1 minute think bad health cannot happen to you or your loved ones.

    And figure out how much help you will get if you can't afford medical assistance.

    Fight for Medicare by talking about it positively, with everyone.

    FTR : we have full private medical insurance.

  7. Keitha Granville

    Welcome to a club no-one wants to join, Robyn. I am “unwell” like you, I made the mistake of falling victim to breast cancer a few years ago. I am fortunate, I have been treated, hopefully will remain healthy now with the drugs I am on and the treatment and surgery I have had. I provide as much as possible with health insurance for my own care which covered the hospital stuff, BUT every month I spend between $40 and $70 dollars on medication, I see my GP and my specialists more than several times a year, I have scans and blood tests regularly. My husband is a pensioner and I work casually and am classified as a Low Income Earner by the ATO, and yet Centrelink in its infinite wisdom does not deem that good enough for a Low Income Health Care Card. So I too am watching with fear the gradual increases in costs, and wondering how long it will be before I have to decide what not to pay for because I NEED my medicine, and I NEED to see my doctors to stay alive. Who are these people who are systematically destroying our universal health system without a moment’s thought ? They are not Australians, they are not on any team I want to be on, they are not representing me or the millions of others in my position – or yours.

  8. DonG

    Both my wife and I suffer multiple chronic illnesses, I myself have been placed on a disability pension, my wife gets a carer allowance, GP visits are scheduled every 3 weeks, but that is only advanced appointments for 3 weekly injections, it doesn’t count the emergency appointments in between. Medication is a big burden on our finances, even with a health card, some of our medications are not covered by the PBS, even so we hit the safety net is within 4 months, such is the amount of medication we both require, but those not on the PBS still have to be paid for, currently we get get bulked billed, these changes put this into jeopardy.
    I fear those with chronic illnesses will soon have to make big decisions, do they keep seeing GP’s to keep up with staying out of hospital, do they go without medication, to pay for rent, utilities and basic food, or do chronic ill patients just give up, stop seeing GP’s, stop taking medication. Hospital ED departments are the only course left open for this group, and yet there lies a bigger problem, current waiting times can be up to 6 hrs, before these measures come in, what will they be once they are passed, how many will die before this Government sees the error of their ways or will they, the sick, elderly, disabled and unemployed are all seen as leaners, always being bashed by them and the MSM.

  9. RichardU

    Not really @John Fraser. One tweeter “under fire” hardly makes. Don’t you think the story was just another Silly Season beat up? James Maskell was clearly on a mission and was not introduced as any sort of peer reviewable “expert”

  10. John Fraser

    <

    @RichardU

    Talking to a "concerned parent" while not telling the audience he is an anti-vaxxer ?

    Currently 15,000 children in Queensland are not vaccinated.

    Every time the anti-vaxxers hit the media people should be told.

  11. Team Oyeniyi

    Anti-vaxers are a menace. That is all.

    Thank you all for your contributions. Much appreciated.

  12. ' george hanson '

    Hey peeps ! Vaccines don’t always work .Educate yourselves before you go on-line . Signed : polio victim , vaccinated by medical doctor father THEN came down with the disease at the age of 3 . You are never safe .

  13. jagman48

    Hey George Hanson peeps. How many children got polio before the vaccine was discovered. How many children have been saved. What do you mean “educate yoursely before you go on line”or do you mean you have a degree from the google university like so many others.

  14. Taz Caz

    George Hanson – I literally despise people like you – your ignorance coupled with your selfishness threatens not only any poor children you may have or might have in the future, but all of us. Three of my mother’s five siblings contracted polio during the 1940s, in Melbourne. Once upon a time, people were fined in Australia, for failing to have their children innoculated – personally I think a prison sentence is warranted.

  15. jagman48

    Hi Taz Caz at the age of 18 months I contracted polio. This was 1949 in Frankston Victoria. To say my life has been chequered would be an understatement. Like you I despise people like George Harrison.

  16. Taz Caz

    jagman48 – you poor thing – you are a year younger than me, and luckily for us none of my generation contracted that awful disease in our family. You can bet all of my siblings and cousins were innoculated as soon as the Salk vaccine was available! I realise I’ve wandered off topic – I was lucky enough to be treated successfully for bowel cancer in 2000, thanks to our wonderful doctors and other medical staff – then it cost me literally nothing, though I also had nothing, and was immediately placed on a disability pension. I really understand the trials everyone with a chronic illness is going through – I managed to save my tiny little old house, just, but haven’t been able to work since. We must save Medicare as it is.

  17. Anomander

    As a nurse once said to me – “Id love to grab all these anti-vaxers and take them for a stroll through a turn of the century cemetery and show them the thousands of graves of children who died from totally preventable diseases”.

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