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17 Dec 2015

AMA President Professor Brian Owler has accused the Federal Government of ‘having it in’ for the ill over its plan to scrap bulk billing incentives for pathology services and downgrade them for diagnostic imaging.

As Health Minister Sussan Ley admitted some patients “may be worse off” as a result of the changes announced in the Mid Year Economic and Fiscal Outlook, Professor Owler warned they would increase expenses for patients and amounted to a “co-payment by stealth”.

“I really don’t understand why this Government has it in for sick people,” he told Channel Nine.

The AMA President said the Government’s decision to save around $300 million by axing bulk billing incentives for pathology services would force many providers, who haven’t had their Medicare rebate indexed for 17 years, to introduce a charge for patients.

“That is why it is a co-payment by stealth,” Professor Owler told ABC radio. “It’s about forcing providers to actually pass on those costs to their patients.

“So, while Tony Abbott might have said that the co-payments plans was dead, buried and cremated, it seems to have made a miraculous recovery and it’s reaching out from beyond the grave – or, at least, components of it are.”

Treasurer Scott Morrison has denied the claim, and Health Minister Sussan Ley said competition in the pathology industry would ensure increased costs were absorbed by providers rather than being passed on to patients.

In an interview on ABC radio she initially claimed there were 5000 providers operating in a “highly corporatised and highly competitive” environment.

She later clarified her comments, admitting that there were 5000 collection centres rather than individual operators, and most were owned by “two very large corporate entities and they're doing very nicely.”

Ms Ley said the charging practices of providers was a commercial decision and “we can’t dictate what they charge patients”.

But Professor Owler said it was “completely ridiculous” for the Government to pretend its cuts would not result in charges for patients.

“You can't take out what is essentially over $300 million from pathology and not expect that there's going to be some sort of effect on patients,” he said. “Without that money being supplied to those providers, of course they're going to have to charge the patients and so you're going to see more patients with more out of pocket expenditure.

“And that is the plan of this Government - to pass more expense on to the pockets of the patients, and that is going to affect the sick and the most vulnerable in our community.”

In addition to axing and downgrading bulk billing for pathology and diagnostic imaging services, the Government expects a further $595 million will be saved by “streamlining” health workforce funding, including dumping several programs including the Clinical Training Fund (which was originally intended to fund up to 12,000 clinical training places across a range of disciplines), the Rural Health Continuing Education Program, the Aged Care Education and Training Initiative and the Aged Care Vocational Education and Training professional development program.

The Federal Government is also tapping the aged care sector for significant savings. It plans to cut more than $480 million by improving the compliance of aged care providers and making revisions to the Aged Care Funding Instrument Complex Health Care Domain.

The Government also expects to realise $146 million in savings from improving the efficiency of health programs, and plans to extract $78 million from the Independent Hospital Pricing Authority and $104 million from the National Health Performance Authority.

A further $31 million will be withdrawn from public hospital funding over the next four years.

Professor Owler said the health sector needed more detail and explanation from the Government regarding the MYEFO cuts.

“All up, MYEFO has delivered another significant hit to the health budget with services and programs cut, and more costs being shifted on to patients,” he said.

The health savings have been announced as part of measures to help improve the Budget, which has been rocked by a plunge in revenues caused by soft economic activity and falling commodity prices.

Since May, the Budget deficit has swelled by more than $2 billion to $37.4 billion, and is expected to be $26 billion bigger than anticipated over the next four years. Mr Morrison has targeted social services and health to deliver the bulk of spending cuts needed to put the Budget on the path to a surplus, which has been pushed back to 2020-21.

But the tenuous nature of this goal has been underlined by the fact that the Government is relying on savings measures that have little prospect of being implemented to help achieve the surplus.

In particular, proposed changes to the Medicare Safety Net worth $267 million were withdrawn by Ms Ley earlier this month after failing to garner sufficient support in the Senate, but still included in the Budget.

While the Government targeted health for major cuts, it did announce some initiatives welcomed by the AMA, including $131 million to expand the Rural Health Multidisciplinary Training Program and establish grants for private healthcare providers to support undergraduate medical places, and a further $93.8 million to develop an integrated prevocational medical training pathway in rural and regional areas – a measure the AMA has long been advocating for.

The Government has also introduced new MBS items for sexual health and addiction medicine services.

Adrian Rollins


Published: 17 Dec 2015