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Medicare rebate for specialist consultations drop to all time low
ABC NEWS (Australia)
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9/25/2024
Medicare is now covering little more than half of the cost of seeing a specialist leaving patients to pay the gap. An Australian Institute of Health and Welfare study shows Medicare funding for specialists has dropped to an all-time low.
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00:00
If you've noticed that you're handing over more money when you see the specialists, you're
00:05
not alone.
00:06
This official data from the AIHW tells us that Medicare is picking up just 52% of specialist
00:13
fees between January and March.
00:16
That's the lowest rate on record and it's quite a significant drop when we look at figures
00:20
from 2004, where Medicare was picking up 72% of specialist fees.
00:26
Now these fees include things like consultations and visits, they don't look at surgery.
00:32
But when we look at figures from July, we can see Medicare picked up 55%, so there was
00:37
a slight uptick, but overall the trend is down, which many people would already be feeling.
00:44
Expectant parents are particularly hard hit.
00:46
Medicare covered just 39% of obstetric fees in July, compared to 60% in 2009.
00:52
Dr Gino Pecoraro, who's the National Association of Specialist Obstetricians and Gynaecologists
00:58
President, says Medicare rebates are out of touch with reality.
01:02
Over time, the Medicare rebates fall further and further behind, so that we see now where
01:09
they're almost meaningless when it comes to accessing care in the federally funded Medicare
01:15
sphere.
01:17
So as you heard, specialists want and have long called for Medicare rebates to be increased.
01:22
I also spoke to the Granite Institute's Health Program Director, Peter Braden, who said historically
01:28
when rebates have been increased, it hasn't necessarily translated to lower out-of-pocket
01:33
costs for patients.
01:35
Instead, he says that governments should be looking at things like shoring up the supply
01:38
of specialists, there's well-documented specialist shortages, and also looking at expanding public
01:44
care for people who can't afford to see a private specialist.
01:48
At the moment, people are languishing on waitlists to see public specialists for years.
01:53
He also said that governments could look at improving transparency around specialist costs.
01:59
In some cases, they could potentially even penalise specialists who are consistently
02:04
charging very high out-of-pocket costs, saying that governments could potentially even threaten
02:10
to take away the Medicare rebate in that instance.
02:14
Let's take a listen.
02:16
Bulk billing of specialist care is falling fast and fees are rising fast.
02:21
And nearly a million Australians say they are delaying or skipping specialist care altogether
02:26
because of the cost.
02:28
And that has big effects on people's health and wellbeing.
02:31
It's definitely a problem that governments have to tackle.
02:35
Now the federal government says it has delivered the largest investments in Medicare in decades.
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