The AMA has long campaigned for better indexation of Medicare schedule fees. Since 1999, we have included a fee gaps chart in the AMA Fees List to show the ever-widening gap between the indexation of Medicare schedule fees and the indices for CPI, average weekly earnings and AMA fees.

The AMA Gaps poster illustrates how successive Governments have failed to index the Medicare schedule fees in line with the CPI and average weekly earnings.

With year upon year of indexation that has been well below par, today there is now quite a disconnect between Medicare schedule fees and the realistic cost of providing the services.

Poor or no Medicare Benefits Schedule (MBS) indexation, cuts to existing rebates, withdrawal of MBS funding and caps on the Extended Medicare Safety Net benefits by the Government simply shift costs to patients and make medical services less accessible.  The AMA Gaps poster shows that medical practitioners and patients are shouldering the Government’s failure to keep pace with the cost of delivering care.  Basically, the Government is letting patients down.

Access to private out-of-hospital medical services in the community must remain affordable so that patients can seek early medical attention.  As well as being detrimental to patients’ health, delayed diagnosis and treatment will simply add to the cost of other parts of the health system.

Though nearly 80 per cent of GP services are bulk billed, there is cross-subsidising of these services by patients who incur a gap, and their gap is increasing.  For referred attendances, only 26.7 per cent of consultations are bulk billed.  The average out-of-pocket cost for these consultations is now $46.

Patient out-of-pocket costs for other non-referred attendances, diagnostic imaging and pathology services are also rising.  Medicare fees for other non-referred attendances have not been indexed at all since 1991, and diagnostic imaging and pathology services since 1998.

In order to maintain a high rate of bulk billing and remain financially viable, many medical practices have had no option but to increase their charges for patient billed services.

I hope that you will explain this to your patients and that the poster is an easy way to show them why they may have to pay a gap.

The AMA has also developed a template letter on Medicare rebates to assist medical practitioners to explain to their patients why they need to charge higher fees and a checklist for those doctors who have decided to move to patient billing.  Please click on the links to download your copy of the template letter and checklist.

Dr Andrew Pesce
President

Click for PDF version

Click for PDF version