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Patients delay care as Medicare rebates frozen

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The Federal Government’s decision to freeze Medicare rebates has been put under the spotlight by findings that many patients are delaying seeing a doctor because of cost concerns.

In some areas up to 13 per cent of adults with a long-term health condition put off seeing a GP because of out-of-pocket costs, according to a National Health Performance Authority (NHPA) report, underlining warnings from the AMA that holding Medicare rebates down until mid-2014 could come at the cost of patient health.

The delay, announced in the Federal Budget, is expected to save the Government $664 million, but AMA President Dr Steve Hambleton said at the time that it was likely to lead to a drop in bulk billing rates as GPs were forced to impose out-of-pocket charges to help cover practice costs.

The bulk billing rate reached a record high of 82.4 per cent in the March quarter, and there is evidence that patients are more likely to seek treatment when they do not face additional costs.

A NHPA breakdown of patient health and access to care by Medicare Local region found a strong association between bulk billing rates and use of GPs.

By contrast, the NHPA found there was no particular correlation between how ill a patient reported themselves to be, and their likelihood of seeking treatment.

AMA President Dr Steve Hambleton said the study indicated a worrying trend among some patients to seek treatment according to ability to pay rather than medical need.

“The report confirms that our GPs and specialists have worked hard to be accessible and to maintain affordability of health care, with no additional assistance from Government,” Dr Hambleton said. “This will become increasingly difficult given the Government’s failure to adequately index Medicare rebates, including its Budget decision to delay indexation until July 2014.”

The AMA President said it seemed perverse, given the findings of the NHPA report, that the Government had pushed ahead with its decision to freeze Medicare rebates, which would only add to pressure on the affordability of medical services.

NHPA Chief Executive Diane Watson said the report showed there was no particular correlation between health and the likelihood of seeing a practitioner.

“The local populations in parts of the country where people have the poorest health were no more likely to have seen a doctor or dentist in the past year,” Dr Watson said.

The study underlined the wide variety and complexity of the health landscape nationwide, with no Medicare Local area performing consistently well or poorly across a range of health measures.

The report was accompanied by the launch of the My Healthy Communities website (www.myhealthycommunities.gov.au), which enables comparisons between the performance of the nation’s 61 Medicare Local regions across a variety of health measures, including visits to GPs, out-of-pocket expenses, hospital admissions, specialist waiting times, bulk billing rates and prescription medicine costs.