Medicare rebate cut by $20 - from $37.05 to $16.95 for under 10 min consult

[Beanie Girl]

Medicare rebate cut by $20/$25 - $37.05 to $16.95 then $11.95 for < 10 min consult

Information from AMA : -

"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.

This measure alone will take at least $500 million out of general practice in 2015".

https://ama.com.au/article/medicare-funding-cuts-support-materials-practices

The following is a doctor's perspective of the cuts (from Twitter).
She said that "We as the GPs of Australia just wanted to get the ramifications of the changes out there"


Dr Michelle Vollmerhause
January 2 at 5:29pm
I've found that a lot of people haven't really understood the implications of the Australian government's recent Medicare changes, so here's my summary. (GP changes)
There are 3 major changes:
1) From 19th January 2015, the rebate for consultations under 10 minutes will be cut by 55% from $37.05 to $16.95 for all patients, including pensioners. This will affect consultations for things like dressings, prescription renewals, ear infections, and immunisations. This is supposed to cover all practice costs (receptionists' and nurses' wages, rent, electricity, medical supplies, cleaning, insurances etc). For many GP's, the rebate will no longer cover the cost of providing that service, and bulk-billing will become a loss-making exercise.
2) From 1st July 2015, the Abbott government plans to cut the Medicare rebate for all consultations (other than children and pensioners) by a further $5. This $5 cut to Medicare is not a cut to the GP's salary. It's a cut to YOUR rebate. Medicare is YOUR insurance.
If your GP currently charges you $75 for a standard visit, you get $37.05 back from Medicare (you pay the $37.95 difference). From July 1st, 2015, the government will drop this rebate to only $32.05 for 10-19 minute consultations (you will then pay $42.95 difference). The rebate will drop from $37.05 to just $11.95 for <10 minute consultations (you will then pay $63.05). You lose money, not your doctor - ignore the spin.
3) Since 2012, Medicare rebates have not been indexed other than one rise of 2%. It is planned that there will be no further indexation until after 2018. The cost of providing medical care keeps rising faster than inflation. This means your out-of-pocket medical expenses will keep rising.
Not happy with that? Let your local MP know.
If the public/government does not think that this will effect children under 16 and pensioners they are crazy. These two groups will bear the brunt of these changes with much higher out of pocket expenses come 19/01/2015 as more and more GPs will drop bulk billing these two groups Your GPs have been telling the government this They are not listening- may be they will listen to their voting public.

 

[datto]

Don't visit a GP. Go to a hospital or visit a witch doctor.

 

[Beanie Girl]

Here is a doctor's letter to the Sydney Morning Herald 5 Jan 2015

Is this really the kind of health care system we want?

Most people seem unaware that on January 19, the Medicare rebate for a GP consultation lasting 6-10 minutes will fall from $37.05 to $16.95, and then down to $11.95 from July 1.

I am a GP. Sometimes I can resolve a patient's problem in less than 10 minutes. This is usually because of the fact that I know a particular patient or family very well, because our practice provides continuity of care, and because we have years of education, experience, and hard work behind us. Occasional shorter consultations provide a much-needed opportunity to reduce the waiting room back-log while still offering high-quality care.

Forty per cent of my billings go directly to my practice to cover staff wages and their entitlements, rent, accreditation, supplies, etc. None of these costs will drop despite the rebate falling 54 to 67 per cent over the next six months. This is an intolerable insult to the practice of family medicine.

GPs earn considerably less than other medical specialists and yet we are crucial to cost-effective healthcare. It beggars belief that I should use my experience and decision-making capabilities, and expose myself to medico legal risk for $11.95. I cannot do it. And it is unfair to expect families to be able to absorb the huge gap that will be necessary to keep medical practice viable ? especially with further reductions for the 10-20 minute consultation planned for July, and the freezing of all these reduced rebates until 2018. Is this really the kind of health care system we want?

Dr Jennifer Sterrett
Turramurra


Responses on 6 Jan 2015 - letters published in Sydney Morning Herald

Dr Jennifer Sterrett (Letters, January 5) has exposed another example of the Abbott government's willingness to sandbag the electorate by stealth to get its own way.

GPs are the frontline troops in our health system. And, despite a common public perception, they are hardly well-remunerated for their years of training and responsibilities in overseeing the health of our citizens. Additionally they are small businesses with all of the pressures which that involves.

Due to public opinion the Abbott government was forced to back down on the unfair copayment policy. However, Tony Abbott's crass stubbornness would never allow him to truly acquiesce. Instead he is now applying pressure to GPs by reducing their rebates for consultations. This will force doctors to have their patients cover the gap so that their small businesses can survive.

The more obvious consequences that we can now look forward to are disastrously overloaded hospital emergency departments and an increase in long-term health problems. Any attempt at visionary policy has once again become the casualty of Mr Abbott's vulgar ideology.

What deception this man is capable of and may it come back to bite him on that backside he treasures so much.

Bert Candy Lemon Tree Passage

-------------------

The letter from Dr Jennifer Sterrett appalled me. In my view the information should have had front page priority. Our creepy government, having failed to get the $7 Medicare surcharge past the senate, now dishes out this underhand imposition on doctors and patients. The consequences are too dreadful to contemplate.

Richard Waterfield Lane Cove

-------------------

"Back Door Tony" couldn't argue his case for the GP Co-payment so now he is stealth bombing Medicare on January 19 and July 1 with a 54 to 67 per cent cut to the Medicare rebate for a GP consultation to "degrade" it via those dreaded regulations that he says he hates (but they are handy to bypass a pesky Senate). He has no shame. Hypocrisy thy name is Abbott.

Don Smith Ashfield

---------------------

Dr Jennifer Sterrett highlights some of the adverse consequences of the government's change of the Medicare rebate for a GP consultation, designed to remove around $500 million out of general practice each year. This will result in most GPs, who currently bulk bill, having to charge patients at least $35 if the consultation lasts less than 10 minutes. Patients will then receive a Medicare rebate of $16.95 after 19 January or $11.95 after 1 July. Supposing a GP continues to bulk bill for a consultation between 10 and 20 minutes, but not for a consultation less than 10 minutes?

The absurd situation now arises where it is in the patient's financial (and possibly health) interest to make the consultation last for more than 10 minutes, but in the GP's financial (and hopefully professional) interest to keep the consultation under 10 minutes.

When does a consultation finish? When the patient leaves the consulting room or the doctor leaves the patient in the consulting room? Will patients be required to clock on and off? One significant result of this cost saving by the government will be to lower the standard of health care by undermining the doctor-patient relationship, not least by expecting the GP to explain a complex and flawed change to the patient.

John Bradshaw Carlingford

---------------

Dr Jennifer Sterrett informed us that the Medicare rebate for a GP consultation lasting 6-10 minutes will fall from $37.05 to $16.95, and then down to $11.95 from July 1. Where is the money going, or did I miss a Government announcement of a 70 per cent reduction in the Medicare Levy?

How is my GP going to survive?

How will the sick survive if they have to pay the difference?

Christo Curtis Beaconsfield

------------------

Dr Jennifer Sterrett's expose of the new Medicare rebates for short consultations shows the government is effectively 'defunding' Medicare. A two-thirds reduction in the rebate from July 1 means we will all get a "price signal" of at least $25, and quite probably a lot more.

Rob Davies Denistone

 

[D.T.]

 

[Intrinsic_Value]

Information from AMA : -

"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.

This measure alone will take at least $500 million out of general practice in 2015".

https://ama.com.au/article/medicare-funding-cuts-support-materials-practices

The following is a doctor's perspective of the cuts (from Twitter).
She said that "We as the GPs of Australia just wanted to get the ramifications of the changes out there"


Dr Michelle Vollmerhause
January 2 at 5:29pm
I've found that a lot of people haven't really understood the implications of the Australian government's recent Medicare changes, so here's my summary. (GP changes)
There are 3 major changes:
1) From 19th January 2015, the rebate for consultations under 10 minutes will be cut by 55% from $37.05 to $16.95 for all patients, including pensioners. This will affect consultations for things like dressings, prescription renewals, ear infections, and immunisations. This is supposed to cover all practice costs (receptionists' and nurses' wages, rent, electricity, medical supplies, cleaning, insurances etc). For many GP's, the rebate will no longer cover the cost of providing that service, and bulk-billing will become a loss-making exercise.
2) From 1st July 2015, the Abbott government plans to cut the Medicare rebate for all consultations (other than children and pensioners) by a further $5. This $5 cut to Medicare is not a cut to the GP's salary. It's a cut to YOUR rebate. Medicare is YOUR insurance.
If your GP currently charges you $75 for a standard visit, you get $37.05 back from Medicare (you pay the $37.95 difference). From July 1st, 2015, the government will drop this rebate to only $32.05 for 10-19 minute consultations (you will then pay $42.95 difference). The rebate will drop from $37.05 to just $11.95 for <10 minute consultations (you will then pay $63.05). You lose money, not your doctor - ignore the spin.
3) Since 2012, Medicare rebates have not been indexed other than one rise of 2%. It is planned that there will be no further indexation until after 2018. The cost of providing medical care keeps rising faster than inflation. This means your out-of-pocket medical expenses will keep rising.
Not happy with that? Let your local MP know.
If the public/government does not think that this will effect children under 16 and pensioners they are crazy. These two groups will bear the brunt of these changes with much higher out of pocket expenses come 19/01/2015 as more and more GPs will drop bulk billing these two groups Your GPs have been telling the government this They are not listening- may be they will listen to their voting public.

oh my you are not by any chance a James Taggart type of person are you?

 

[chilliblue]

The amount saved by the government should be made to go back into the healthcare system not research where private companies make profits.

 

[greedy2000]

health and welfare are Australia's biggest costs.

if you haven't noticed our economy isn't doing that flash and we have a rapidly aging population that is going to put pressure on both of these costs.

Medical costs and care are rising faster than inflation so these costs are only going to continue to spiral out of control.

Instead of complaining, how would you fund this rising expenditure? What do you propose?

 

[The Fence]

health and welfare are Australia's biggest costs.

if you haven't noticed our economy isn't doing that flash and we have a rapidly aging population that is going to put pressure on both of these costs.

Medical costs and care are rising faster than inflation so these costs are only going to continue to spiral out of control.

Instead of complaining, how would you fund this rising expenditure? What do you propose?

Kudos sent!

 

[Beanie Girl]

By Tim Woodruff
Posted Fir 12 Dec 2014, 10:01am

Doctors are being asked to play God and decide who are the 'deserving poor', and if they choose not to charge the GP copayment, the cost will be coming out of their own pockets, writes Tim Woodruff.

The announcement that the proposed $7 GP co-payment will be replaced by a $5 rebate cut to GPs when they see non-pensioners and non-concession card holders is a kick in the guts to working Australians, and a threat to affordable health care for all but the rich.

The intention of the Government is unchanged. It still regards its budget policy as a good policy, but one that isn't possible to legislate.

It wants doctors to charge co-payments. It wants patients to see doctors less often, claiming that patients see doctors too often despite a complete lack of evidence for such a claim.

The Federal Government completely ignores the fact that patients are not in a position to know whether their apparently minor complaint is an indicator of a life-threatening condition. We doctors want patients to come with apparently trivial complaints like indigestion which is really a heart attack, a tiny foot ulcer which is really the first stage of gangrene leading to amputation, some bleeding from the bowel which isn't piles but instead totally curable bowel cancer. We can save lives. (primary health care is the most effective use of the dollar as it treats a lot illiness before it 1.becomes life-threatening 2. so advanced that it requires hospital treatment and hence more $$$$$/burden on the healthcare system)

This policy is forcing working Australians to pay twice for health care - once through taxes and the Medicare levy, and again through the co-payment.

A parallel is worth considering: there is no co-payment for police care if a person's car is being stolen. Taxes pay the total cost of care. Thus, we provide more support for care of property than for care of our health. This proposal aims to reduce that support for health even more.

The co-payment is a price signal, but at $5 it signals nothing to a rich politician on $200,000 a year, even with 50 visits for the family over the year. For a low-income-earning family on $50,000, paying off a mortgage, it is a kick in the guts.

As a price signal it will work, and lives will be lost.

This is also an attack on doctors. It is putting them in the invidious position of deciding whether to maintain their own income by charging patients the $5 that they will lose from the rebate, or accepting an income cut of more than 15 per cent for every patient they continue to bulk bill. It is asking doctors to play God and decide who are the 'deserving poor'.

Many doctors prefer not to do this but will be forced to do so or accept an income cut, something which is not being asked of any politician or public servant.

The further effect of these changes will be to see co-payments rise well above the $5 suggested. Many doctors will charge more to cover the costs of collecting the payment or to cross-subsidise the bulk billing of other patients. Freezing the rebate for another four years (i.e. not rising with inflation) and changed rules for short consultations will also add pressure to increase copayments and abandon bulk billing, even for pensioners and card holders. Once co-payments become standard, they just keep on rising.

Whilst many might see this proposal as a change for the better because pensioners and card holders are now partially exempt, the truth is otherwise. The backdown is political. The ideologically driven policy remains unchanged i.e. to destroy Medicare as a system of universal public health insurance, with premiums through taxes according to capacity, and benefits available to everyone according to need.

This proposal progresses that destructive agenda as it will further entrench the idea of co-payments as justified and reasonable policy despite the evidence of the grossly inequitable effects of such extra charges.

With the current 80 per cent bulk billing rates, most working Australians have been able to access GPs. It is about to change. Combine this proposal with the Federal Government's encouragement of private health insurance to cover the rising GP copayments, and the stage is set for the rich to get better GP services while the rest must accept second rate or unaffordable access. A two-tiered health system. That's what Americans have.

We should have a debate about our health system. Inefficiencies exist, but money can be saved without affecting the fair go which ordinary Australians deserve.

Instead the Federal Government has chosen to withdraw money from the most efficient part of the health system i.e. primary care and general practice, while ignoring many areas of potential savings which might make our health system more efficient and more equitable.

Tim Woodruff is currently the vice-president of the Doctors Reform Society and a specialist physician working in private rheumatology practice in Melbourne. View his full profile here.

 

[Ausprop]

overhaul the entire stupid system. the health industry is deliberately set up to be inefficient and protected to maintain the significant 6 figure incomes of the participants and billion dollar profits of the corporates.

Lives will be lost? they already are amongst the hopeless inefficiencies.

 

[kathryn d]

The government could save the money, instead of making the patient pay
by
reducing the amount a doctor is permitted to charge for a consultation. etc.


It would be up to the doctors office to reduce expenses then.


If a government needs to reduce expenses, cuts need to be made.
or
find cheaper alternatives

Not everyone is going to be happy.

$5 is a cup of coffee...what''s the big deal

 

[Ausprop]

exactly.

or nationalise all GPs - bring in a few thousand GPs from overseas and put them all on a salary of $75k with a white camry like everyone else

 

[Beanie Girl]

It's not just $5......
the Medicare rebate for a GP consultation lasting 6-10 minutes will fall from $37.05 to $16.95, and then down to $11.95 from July 1.

People will be out of pocket $20/$25/$35 or more for each visit if it's less than 10 minutes depending on what your GP chooses to charge. This includes children who have to go for immunisations, it also includes pensioners who go to the doctor for a simple prescription renewal.

 

[perthguy]

The Government is sending a message to the senate.

 

[kathryn d]

It's not just $5......
the Medicare rebate for a GP consultation lasting 6-10 minutes will fall from $37.05 to $16.95, and then down to $11.95 from July 1.

People will be out of pocket $20/$25/$35 or more for each visit if it's less than 10 minutes depending on what your GP chooses to charge. This includes children who have to go for immunisations, it also includes pensioners who go to the doctor for a simple prescription renewal.

Like I said, if you are really concerned about the cost to the patient,reduce your expenses.

Some people run to the doctor for a cold.
Nothing a doctor can do

Our doctor (in Canada) charges $5 for a prescription renewal over the phone, nothing if you make an appointment (yet)

 

[2FAST4U]

It's poor idealogically driven policy.
Now every man and his dog is going to flock to the ED, which will at best waste staff's time with them having to turn them away. At worst it will result in serious clogging and a decline in patient care.

 

[perthguy]

It's poor idealogically driven policy.
Now every man and his dog is going to flock to the ED, which will at best waste staff's time with them having to turn them away. At worst it will result in serious clogging and a decline in patient care.

In WA, the Government is talking about implementing (or has implemented) an ED charge for non-emergency treatments. So basically, if you turn up to the ED with the sniffles or a headache, you are treated as if you visisted a GP. For genuine emergencies, you vistited your ED. I have no idea how that is going to work out but it is a reaction to the whole GP co-payment debacle and ongoing misuse of EDs for non-emergency treatment.

 

[Perp]

There's no point introducing a higher payment for people who are already paying; what's really needed is a price signal for all users, i.e. nobody bulk-billed. Make the price signal smaller for pensioners, if necessary, but there has to be some price signal.

When prescriptions changed from free to a small payment for pensioners - I think it was $1 or $2 way back when that was introduced in the late '80s? - the rate at which those people got prescriptions dropped dramatically.

 

[MRO]

Government needs to raise money somehow. There is no pain free way to do this.

What are the alternatives?:
- higher income tax rates
- Higher GST rate
- wider GST tax base
- reduced assistance to HECS
- less spending on pensions
- reduced medicare rebate

All would receive a poor response. It is a shame that when a government makes a decision to reduce spending it is always a negative response.

 

[Beanie Girl]

To reduce spending on primary healthcare in the name of saving money is the most counterproductive and stupid move you can ever make - penny wise, pound foolish
Ever heard the saying 'a stitch in time saves nine?'
Primary health care (GPs) address health problems before it becomes so advanced, so serious that an individual needs hospitalisation and becomes more of a burden on the healthcare system, increasing the cost to the healthcare system

---------------------------------------

Let's improve, not discourage, access to primary care

The most important thing that Australia can do to make sure we get the most
from the health care dollar is to protect Medicare. Medicare is one of the great Australian public policy success stories. It may not be perfect but for 30 years it has delivered health care fairly and efficiently. It keeps costs down because as a single universal insurer Medicare has the power to set prices which keep a lid on the cost of a visit to a doctor. The result is that everyone gets access to high quality health care, no matter what the size of their wallet or whether they are unlucky enough to be born with a chronic disease.

Tony Abbot claims to be Medicare's best friend but his government appears
determined to dismantle it The Health Minister believes there should be a bigger role for private health insurance in primary care but allowing insurers
to cover general practice services will take the lid off the price of a doctor's visit and everyone will end up paying more. While health insurers providing
GP cover has superficial appeal, this change will mark the end of Medicare
as we know it. Private health insurance would become a necessity to see a GP yet insurance premiums will skyrocket. It would take us further towards a two tiered American-style health system.

Mandatory co-payments or means testing bulk-billing won't work either.
Putting a price barrier between a patient and their doctor would
disproportionately impact on low income Australians who also tend to
be less knowledgeable about health and have poorer health. Some of
these people will present to expensive emergency departments impacting
on people who need urgent care. Others will stay away from the doctor
completely until their simple treatable illness becomes a more serious and potentially life threatening condition requiring intensive and costly hospital
treatment. The South Australian Health Department modelled the impact of a GP co-payment and it demonstrated that any potential savings in primary care would be greatly outweighed by an increase in hospital costs. Most importantly, the cost of a consultation shouldn't be a factor when someone is considering whether their chest pain is just indigestion or something more serious.

The proposal for a co-payment undermines the direction of public
policy in health care over recent decades. We must improve access to
primary care rather than discourage it. We want people visiting their doctor
for screening and early intervention; we want people getting medical advice
when they have a concern. Catching problems early and treating them is not only good for the patient, it is a good investment.

https://www.chf.org.au/pdfs/chf/HV_APRIL14_DiNatale.pdf