Doctors Are Worried That Upcoming Medicare Changes Might Cause Chaos

“Less than one month out from the implementation of these changes, and we still do not have all the information we need to assess and change over our schedules and payment processes to reflect the changes."


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Just weeks before the federal government goes ahead with the biggest ever changes to Medicare, doctors are really concerned about the lack of transparency around the overhaul, and of patients being left out of pocket for upcoming surgeries.

More than 900 health services and procedures that are eligible for government rebates are set to change on July 1, in what will be one of the biggest overhauls to Medicare in its history.

But what actually are the changes, and how much of an impact will they actually have on young Australians?

What We Know So Far About The Medicare Changes

From the start of next moth, what will be eligible for a rebate under the Medicare Benefits Schedule (MBS) is going to change, as is the dollar amount that will be covered.

For context, the MBS is a list of medical services that are subsidised by the Australian Government, and it’s usually accessed through that shiny green card that often makes visits to the doctor — especially for young people — way more affordable.

Since 2015, the MBS Review Taskforce has been looking into the services provided by Medicare; there hadn’t been a comprehensive review of the list for over a decade.

What we know so far is that the biggest changes from the MBS review will be on rebates for private surgeries, including orthopaedic, general, and heart surgery.

A spokesperson for the Minister for Health, Greg Hunt, said patients will see increased rebates across orthopaedics, plastic and reconstructive surgery, and gynaecology.

For the first time, ambulatory blood pressure monitoring will also be added — which is a new kind of service that helps to diagnosis high blood pressure with better accuracy – and a therapy that treats long-term depression, called Repetitive Transcranial Magnetic Stimulation, will also now fall under Medicare.

According to the MBS Review Taskforce, a total of 5,700 items on the list were looked at. The ones that are being removed were deemed “outdated and potentially unsafe.”

The Consumer Health Forum said on Monday that the changes are to ensure that “Medicare payments reflect the latest in cost-effective and evidence-based medicine.”

As experts have explained, when Medicine advances naturally, some procedures become quicker to perform and far less complex, which means the cost of them should theoretically be cheaper.

Dr. Duckett, director of Grattan Institute’s health program, explained to The Feed that he expects the changes won’t actually affect most young people, because the services undergoing an overhaul aren’t generally used by that many young people.

“It’s only relevant if you go into a private hospital. So it basically doesn’t affect many people to start with,” he said.

He among other experts, actually hope the changes will allow for the government to direct additional funding into mental health services, but that might be just wishful thing at this stage.

So Why Are People Upset Over It?

This might sound positive on paper, but the limited details of the 900 changes are pretty much all doctors and consumers have told about them so far.

In a statement released yesterday, The Australian Medical Association (AMA) revealed their concerns about the impact of this lack of information on the private healthcare sector. It hypothesised that health funds, hospitals, doctors, and patients will all likely not be ready for the changes when they happen, due to “poor implementation” by the Government.

Some Australian doctors also believe the timing of the changes could cause “chaos”, especially considering there are already huge delays in surgeries as a result of COVID-19.

“Less than one month out from the implementation of these changes, and we still do not have all the information we need to assess and change over our schedules and payment processes to reflect the changes,” said AMA President, Dr Omar Khorshid.

Referring to MBS review changes that happened back in 2018, Dr Khorshid also said that he felt like history is repeating itself with the upcoming changes.

“Patients were left out of pocket, spinal surgeries were delayed, and doctors couldn’t provide patients with informed financial consent about potential gap fees.”

“More than two years later, we are facing the same problems, but with more than ten-fold the volume and complexity,” Dr Khorshid wrote.

Standing with the AMA, opposition politicians are being pretty vocal in calling out the Liberal Government for cutting rebates.

The July changes involve expected changes to 594 orthopaedic surgery items, 150 general surgery items, and 188 cardiac surgery items.

The AMA has called on the Government to ensure the changes occur without massive disruption to their patient care.