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Short-term Medicare savings come at hefty cost

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The country will pay a heavy price for policies that have devalued Medicare rebates, forcing up patient out-of-pocket expenses and deterring an increasing number of people from seeking the treatment they need, AMA President Dr Steve Hambleton has warned.

Delivering a key message of AMA Family Doctor Week 2013, Dr Hambleton told the National Press Club on 17 July that increasing barriers to access to primary care would come at a hefty cost in ill health and expensive treatment “down the track”.

In a video launched to mark Family Doctor Week (to view, go to: video/family-doctors-your-medical-home), Dr Hambleton said Medicare rebates had not kept pace with rises in the cost of providing care, leaving doctors and their patients increasingly out-of-pocket.

In the May Budget, the Federal Government froze Medicare rebates, which were due to go up in November, until July 2014 , saving it $664 million but further devaluing the fees paid by the Government to doctors.

When Medicare was introduced in 1984-85, its rebates covered 90.3 per cent of medical fees but, even before the freeze, this had slipped to just 78.5 per cent.

Over the period, Medicare benefits had grown 676 per cent, but patient-funded gaps had soared up 1876 per cent.

Combined with other changes in the Budget, including a sharp rise in the Medicare Safety Net threshold to $2000 and the phasing out of the medical expenses tax offset, the AMA estimates this will add a massive $2.4 billion to patient gaps in the next four years.

“The Government is simply shifting costs to patients,” Dr Hambleton said. “Families will have to pay more each time they visit their family doctor.”

The Federal Government has trumpeted a record-high bulk billing rate of 82.5 per cent as evidence that health care remains affordable, but Dr Hambleton said this figure masked the increase cost burden being shifted onto doctors and patients.

A recent report by the National Health Performance Authority found that around 12 per cent of people avoided or delayed seeing a doctor because of cost, and about 15 per cent in some areas reported they could not afford to have prescriptions filled.

Dr Hambleton warned such affordability concerns would come at a significant future cost.

“If we prevent access, or if access is not freed up at the beginning of the process, it’s going to cost a whole lot more down the track,” he said. “We need to make sure people can afford to see their family doctor.”

The AMA President said Australian patients faced the sixth highest out-of-pocket costs in the developed world, and the patient’s share of health spending had reached close to 20 per cent – far higher than in the United Kingdom (9.9 per cent) and the United States (11.6 per cent).

He said that “proper and realistic” indexation of Medicare rebates was urgently needed.

Adrian Rollins