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If only pathology services tested for coal.

Modern medicine and science is an incredible thing. Compared with even a few decades ago, the options available for Australians to manage their health is impressive. A simple blood or urine test can reveal medical issues and potential complications even before symptoms appear or physical health noticeably deteriorates. No longer is a cancer diagnosis a guaranteed death sentence. MRI and PET scans, x-rays and other diagnostic tools have proven crucial to the early detection and management of cancer, disease and infection. Routine blood and urine tests are vital to the health management of millions of Australians.

Up until now, nearly all Australians, young, old, rich and poor, have had access to, and the benefit of a health system where everyone is largely treated equally, and lives are valued. Every person, regardless of gender, socioeconomic status, education, or employment status has had the opportunity of being bulk-billed for pathology services.

But not anymore – at least not if Prime Minister Malcolm Turnbull and Health Minister Sussan Ley have their way.

From the 1 July 2016, the Commonwealth Government intends on cutting the bulk billing incentive for pathology services, putting the final nail in the coffin of affordable and accessible medical diagnostics for Australians.

And it will put the nail in the coffin for millions of Australians. Quite literally for some.

What Ley’s cuts will do is change how Australians seeking crucial testing and diagnosis are charged. Pathology industry representatives have warned that if the cuts go ahead, instead of being bulk-billed, patients will be forced to pay up front for services: Potentially thousands of dollars up front, leaving the most vulnerable and sickest patients hundreds of dollars out of pocket after the rebate has been claimed back from Medicare.

Fiercely defending the cuts, Minister Ley and her office have resorted to the most ludicrous claims to attempt to distract from her attempts to put a real dollar price on the health of Australians. In refuting the claim that pap smears, (a crucial tool to test for early signs of cervical cancer in women) will cost $30 if the incentive is removed, Ley asserted that the Medicare rebate has and will not change.

Of course she is right. The Medicare rebate for pathology services hasn’t changed in over 17 years. However costs to pathologists have continued to rise. Critics warn that the industry simply cannot absorb any more costs or government cuts. And Minister Ley intends to cut a massive $650 million from pathology services over four years.

That is a lot of money and it will affect millions of Australians who may be forced to pay up front for vital services.

According to the Australia Diagnostic Imaging Association patients may have to pay up to $93 upfront for an x-ray, $396 for a CAT scan, a minimum of $85 for a mammogram and up to $186 for an ultrasound. A PET scan could cost up to $1,000.

But patients rarely need just one test.

Each year over a million Australians present to doctors concerned about possible skin cancer. If detected early, skin cancer rarely kills. However early detection requires testing – tests that may now cost patients hundreds of dollars initially. And for the thousands of people diagnosed, upfront costs of around $1500 and out-of-pocket costs of up to $400 after receiving Medicare rebates. Over two years the costs could escalate to over $3000, with out-of-pocket expenses of up to $725.

In 2012, four people died every day from melanoma. This will certainly rise if Ley has her way.

Cervical cancer has no symptoms. The only way to detect it is by testing, and the routine pap smear is crucial for women’s health. In 2009, over 2 million routine tests were conducted, identifying 28,000 cases of high-grade abnormalities or cervical cancer. As a result of early testing, the vast majority of cases were treated successfully, leading to only 152 deaths. However, around the world, every 2 minutes a woman dies from cervical cancer, the vast majority of these in countries who do not offer routine testing.

If Ley’s cuts go ahead, the number of Australian women who die of cervical cancer will almost certainly rise as women on lower incomes forgo the vital test.

Approximately 1.7 million Australians have diabetes; they may now face up to $400 a year in upfront costs just for basic urine and blood tests which are vital to detect early signs of kidney disease or cardiovascular diseases. The cuts may see people forced to choose between medication and ongoing routine tests. Experts warn that some of the patients may go blind where complications have not been detected early enough.

In the indefensible move, Minister Ley’s proposed changes will almost certainly see millions of Australians suffering financially, or even worse, their health deteriorating as a result of declining a test or scan due to the cost. The sickest and most vulnerable patients will bear the brunt of the cuts.

Any Australian who relies on routine testing, who has concerns about their health, any person who panics at the sign of blood coming from somewhere it shouldn’t, any person stricken by lethargy, unexplained pain, or weird symptoms that they cannot quite identify, may have to choose between paying for food to put on the table and accessing tests for diagnosis and treatment.

Conditions, such as cervical cancer, bowel and prostate cancers, hepatitis C, and many sexually transmitted infections, have almost no early symptoms. These conditions may go undetected, leading to horrific outcomes for Australians who may otherwise have been able to be treated.

In one of her favourite excuses, Minister Ley erroneously claims that the introduction of the bulk billing incentive in 2009 only saw a rise of 1% in bulk billing rates. Minister Ley additionally claims that bulk billing rates are already so high, no incentive is required. With 98.7% of all out-patients bulk billed for pathology services in 2014-15, it is virtually impossible to imagine much more of an improvement. However it is entirely feasible to see a massive drop in bulk billing if the incentive is cut.

There is little to climb from 98.7% but a very long way to fall.

Each 1% fall in bulk billing rates represents over a million people now having to pay up front for vital services.

Cancer doesn’t discriminate. Neither does serious illness or disease.

Cancer won’t wait for a pensioner to save up thousands of dollars for crucial tests.

Cancer won’t wait for a young child to grow old enough to tell their parents that they are in pain and need urgent medical attention.

Cancer won’t wait for a young man or woman to spontaneously seek a prostate or cervical examination, ‘just on the off-chance’ there’s an abnormality.

There is an enormous and very real risk that many Australians, already struggling to make ends meet, will be dissuaded from undergoing essential tests, or forgo treatment altogether, if they have to pay upfront for pathology services.

If the Coalition has its way, one thing will be certain. Hundreds of thousands of Australians will suffer, and families will be wracked with grief as they watch their loved ones lose the battle against illness, which if detected and managed early enough, could have been successfully treated.

Unable to publicly justify the cuts, Minister Ley’s office has fallen back on the Coalition’s favourite excuse; apportioning the blame on Labor. However stripping funding from pathology services is not the same as arguing who is responsible for a budget deficit. A pathetic whine that “Labor did it first, so why shouldn’t the Coalition rip more money out of a vital industry, thus putting the health of millions of Australians at risk, and potentially resulting in people prematurely dying from treatable cancer and preventable illness?” has a hollow sound when the real life ramifications sink in.

In response to the initial backlash, Treasurer Scott Morrison said, ‘the government could not justify what amounted to “handing out large subsidies” to the pathology industry.’

If only pathology services tested for coal.

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19 comments

  1. diannaart

    Surely Mal (innovation) Turnbull understands the necessity of preventive medical services?

  2. jim

    This is just crazy what this idiot Ley and the LNP are doing why isn’t this Headline news if the ALP was in it would be plastered all over the Telly you bet ur are it would This is not democracy they call it representive democracy this has gotta stop this s…t GRrrr. More human lives lost thanks to this sham of a Liberal National government

  3. Delia Lord

    What is wrong with the underclasses I.e. working poor, disabled, elderly, disabled, indigenous why don’t they just give up and roll over and die from curable diseases like we are telling them too. Because we are the elected Government they voted for. Hang on we didn’t elect Turnbull. He is an unelected Prime Minister. When in opposition the Liberals never let up on Labor or changing Prime Ministers. Why isn’t there an outcry about Turnbull throwing Abbott out on his ear ?????????????

  4. Matters Not

    Can’t pay for ‘heath services’? Take Hockey’s advice and get a good j… . Or maybe not?

    Fact is Ley’s savings have some way to go Can’t see a majority of Senators buying this nonsense.

    Just keep reminding them that 579 of the largest companies in Australia paid no tax. Zero! Zilch! And we don’t have a revenue problem do we? 😎

  5. Roswell

    Are they out of their mind?

  6. Rotha

    Someone has to modernise Australian Pathology. Too much money is being made at taxpayers’ expense.

  7. Matters Not

    Too much money is being made at taxpayers’ expense

    What? What? Are you seriously suggesting that ‘private’ operators are ripping us off? That ‘competition’ between private operators doesn’t give us the best ‘service’ at the ‘lowest’ cost? That government ‘intervention’ in the market place is desirable? (Or necessary).

    Rotha, are you a communist?

    Seriously, Rotha has a point, the advances in technology have been significant. The government could of course enter the market place but is constrained by ‘ideology.

    The government could ask for ‘tenders’, preferred suppliers and the like and solve its problems.

  8. Matters Not

    Health Minister Sussan Ley flagged plans to cut and limit bulk billing incentive payments for pathology and diagnostic imaging services last month, saving the government $650 million over four years.

    The evidence suggests that pathology and diagnostic imaging services are lucrative for the private providers. And such services are both desirable and necessary for the average ‘punter’.

    Seems to me that Ley should (perhaps) not only cut and limit incentive payments for private providers but abolish same entirely. Instead put such services (necessary as they are for all citizens) up for tender.

    Seems to me that the private providers will cut each others’ collective throats to be the preferred supplier and (perhaps) save even more over the forward estimates.

    Or is it not about savings at all, but about establishing a ‘user payment’ ideology?

    Has Ley ever been asked these questions? If not, then why not?

    Why are her ‘claims’ just accepted at ‘face value’? Why does she ‘hate’ competition? And so on.

  9. Bacchus

    Go wash your mouth out Matters Not! – you’re not allowed to make “common sense” suggestions – they’re just not that … “common” 😉

  10. Greg

    I have commented on similar articles and still stunned by the shear stupidity of some of the responses , I am one of those people these cuts will effect directly .. I have up to five MRI’s , xrays a year with blood an other test every few months and doctors every few weeks and I’m in and out of hospital every few months , I have also given the comment exactly like in this article stating that when these cuts come i’ll have to make the decision of weather or not to get the needed test done or get the medication that keeps me alive or help put food on the table for my family , In addition to these cuts people like me are being taken off DSP and told they can work for up to 15 hours a week by a paid social worker at centrelink who disregards and rejects doctors certificates and reports , luckily that hasnt happened to me yet but it’s only a matter of time , I mean what the hell , not trying to get sympathy here or argue about reform or so called expenditure necessities , whats just another person to the LNP … nothing … people like me according to all the current governments polices and cuts are acceptable collateral damage for the greater good , well come July the 1st this year If these cuts continue .. well i’ll have about two years tops and I’ll just be another statistic the LNP can proudly put in their book , only wish I could have started saving up for a funeral but cant afford that either hahaha ….well bring it on LNP .. i’m just not going to roll over an die for you buggers , if the government wants a fight …. they have it

  11. Keith

    When does “good government” begin?
    The notion that Turnbull is being held over a barrel by the extreme Tea Party right is quickly being shown to be wrong.

  12. John Kelly

    The alternative is to cancel private health insurance, which is a waste of money anyway and present yourself at a public hospital. You are diagnosed with the best equipment by the best doctors and it’s free.

  13. Roswell

    Good luck with everything, Greg. The government has let you down. You deserve better.

  14. Mercurial

    Eva, you forget: Australia doesn’t need people on low incomes. It needs people of calibre; people who are prepared to fork out the hundreds of dollars in pathology charges.

    Don’t they call this eugenics? Oh, sorry, it’s just competition.

  15. Anon E Mouse

    The prices stated above, on what these tests will cost, are what has been charged in regional centres for those without private health insurance.
    It goes like this. A person finally gets into a gp (if there is a hospital nearby it is almost impossible to see a dr for an outpatient visit because they are swamped) after a sometimes 6-8 week wait. The dr says you need these tests urgently, so you have to go private (if a hospital in the 100km radius can offer those tests you can’t even get patient travel costs). Very kind drs might try to convince the pathology that you should be bulk billed but if not the above charges, or more, apply.

    I fear what the new changes will mean – ct scans will go up from $400- 600.

  16. Glenn K

    I love the photo heading this article. ……preparing to stick it up to the Aussie public, with a smile on her face….

  17. diannaart

    A friendly Nurse Ratched? All set to lobotomise Australia.

  18. Roswell

    She has evil intent.

  19. Rotha

    Having many tests is not a sign that a patient is well cared for. Tests are often unnecessarily invasive. For example, Presence of Helicobacter can be established with a bacteria count of the patient’s breath, collected in a plastic bag. Yet, many years after this was possible, doctors were still subjecting patients to cameras inserted in to both ends of the Alimentary canal. Invasive, expensive, but the only tests funded by the public ‘Health ‘ system. ‘Normal’ guide lines for Thyroid tests and Sugar tests change with each lab, and since patients’ input and experience is heavily undervalued, over or under medication causes more problems.
    Doctors ask patients to ‘take responsibility’ but will not be open to anything the drug reps don’t like.
    ‘Health’ departments heavily punish Doctors for thinking outside the square proscribed by drug companies.
    Corruption is piled on corruption and no one dares to challenge the crazy state of things.

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