Indexation freeze hits veterans’ health care
A recent survey of some AMA members has highlighted the impact of the Government’s ongoing indexation freeze on access to Department of Veterans’ Affairs (DVA) funded specialist services for veterans.
The DVA Repatriation Medical Fee Schedule (RMFS) has been frozen since 2012.
The AMA conducted the survey following anecdotal feedback from GP and other specialist members that veterans were facing increasing barriers to accessing specialist medical care.
Running between March 3 and 10, the survey was sent to AMA specialist members (excluding general practice) across the country.
It attracted interest from most specialties, although surgery, medicine, anaesthesia, psychiatry and ophthalmology dominated the responses.
More than 98 per cent of the 557 participants said they treat or have treated veterans under DVA funded health care arrangements.
For the small number of members who said they did not, inadequate fees under the RMFS was nominated as the primary reason for refusing to accept DVA cards.
When asked, 79 per cent of respondents said they considered veteran patients generally had a higher level of co-morbidity or, for other reasons, required more time, attention and effort than other private patients.
According to the survey results, the indexation freeze is clearly having an impact on access to care for veterans and this will only get worse over time.
Table 1 highlights that only 71.3 per cent of specialists are currently continuing to treat all veterans under the DVA RMFS, with the remainder adopting a range of approaches including closing their books to new DVA funded patients or treating some as fully private or public patients.
If the indexation freeze continues, the survey confirmed that the access to care for veterans with a DVA card will become even more difficult.
Table 2 shows that less than 45 per cent of specialists will continue to treat all veterans under the DVA RMFS while the remainder will reconsider their participation, either dropping out altogether or limiting the services provided to veterans under the RMFS.
In 2006, a similar AMA survey found that 59 per cent of specialists would continue to treat all veteran patients under the RMFS.
There was significant pressure on DVA funded health care at the time, with many examples of veterans being forced interstate to seek treatment or being put on to public hospital waiting lists.
The Government was forced to respond in late 2006 with a $600m funding package to increase fees paid under the RMFS and, while the AMA welcomed the package at the time, it warned that inadequate fee indexation would quickly erode its value and undermine access to care.
In this latest survey, this figure appears likely to fall to 43.8 per cent – underlining the AMA’s earlier warnings. The continuation of the indexation freeze puts a significant question mark over the future viability of the DVA funding arrangements and the continued access to quality specialist care for veterans.
The AMA continues to lobby strongly for the lifting of the indexation freeze across the Medicare Benefits Schedule and the RMFS, with these survey results provided to both DVA and the Health Minister’s offices. The Government promotes the DVA health care arrangements as providing eligible veterans with access to free high quality health care and, if it is to keep this promise to the veterans’ community, the AMA’s latest survey shows that it clearly needs to address this issue with some urgency.
Which of the following statements best describes your response to the Government’s freeze on fees for specialists providing medical services to veterans under the Repatriation Medical Fee Schedule (RMFS):
I am continuing to treat all veterans under the RMFS
I am continuing to treat existing patients under the RMFS, but refuse to accept any more patients under the RMFS
I am treating some veterans under the RMFS and the remainder either as fully private patients or public patients depending on an assessment of their circumstances
I am providing some services to veterans under the RMFS (e.g. consultations) but not others (e.g. procedures)
I no longer treat any veterans under the RMFS
Which of the following statements best describes your likely response if the Government continues its freeze on fees for specialists providing medical services to veterans under the RMFS:
I will continue to treat all veterans under the RMFS
I will continue to treat existing patients under the RMFS, but refuse to accept any more patients under the RMFS
I will treat some veterans under the RMFS and the remainder either as fully private patients or public patients depending on an assessment of their circumstances
I will provide some services to veterans under the RMFS (e.g. consultations) but not others (e.g. procedures)
I will no longer treat any veterans under the RMFS
Published: 18 Apr 2017