AMA President, Dr Mukesh Haikerwal, With Jon Faine on ABC 774 Re Gap Payments

Tony Abbott, as you heard on AM, told the story of all the bills he got when he himself recently was in hospital. Many of those bills were from doctors that he felt he'd never met, and he had no idea who they were.

But it turned out they were people like assistant surgeons and anaesthetists.

Well, he's now saying that something has to be done to get rid of The Gap.

Dr Mukesh Haikerwal is now the Federal President of the AMA. Mukesh, good morning.

DR HAIKERWAL: Jon, good morning.

FAINE: How can we get rid of the gap? 44% of patients faced gap payments after treatment of an average of more than $700 each.

DR HAIKERWAL: Yeah Jon, the majority, 80% of all medical gaps are covered by the health funds. So 80% of all services actually have no medical gap.

The 44% includes health fund incurred gaps, because they don't have a decent contract with the hospitals in which you're going to, and sometimes they have a flagfall for consultations or for services like chemotherapy.

So, for instance, if somebody's going for chemotherapy, each time they go in, they're being slugged with 50 bucks.

FAINE: So, are you, are you blaming the health insurers?

DR HAIKERWAL: I blame the health insurers quite strongly for this. They're getting a $2.6 billion subsidy from the government to provide excellence in health care and health funding services.

If they're not doing that, then there's something wrong and they've got to look at their own house and get their own house in order.

80% of medical consultation fees are completely covered, and that's something that's, you know, that is there. And the other thing is the government has a responsibility too. The government provides the Medicare Benefit Schedule on which all medical rebates are based. They have been completely out of whack with the true cost of providing services…

FAINE: Yeah.

DR HAIKERWAL: …so obviously doctors who want to stay in business and provide a service, which is an excellent service, have to provide a gap.

FAINE: Well far be it for me to speak on behalf of Russel Schneider and his members in the Australian Health Insurance industry, but I suspect that if they were asked to get rid of the gap they'd say, yeah, sure, it's easy, just let us put up our fees.

DR HAIKERWAL: Yeah, well look, health funds are being subsidised quite dramatically, and the doctors are providing services which are charged at the rate that they're aware of. If the health funds want to get rid of the gaps, they can simply do it with the stroke of a pen, by increasing the rebate that they provide.

FAINE: And they will say, if you want us to do that, just let us have greater income. If you want us to put out more by way of outlays, you need to give us more by way of income.

HAIKERWAL: I mean, they have a significant income currently, and there's some excellent funds out there that provide excellent products.

What we have to do is make sure that those excellent products keep going, and if funds provide a product and are asking for increases in their premiums, and are not providing the product where people can get cover for the surgeon, cover for the anaesthetist, cover for the x-ray, and cover for the pathology; they shouldn't be allowed to get that increase, until they can provide the product that does that.

FAINE: Well that's also overwhelmingly confusing for consumers, and that's where we turn to doctors for advice. Thank you. Dr Mukesh Haikerwal, now the Federal President of the AMA.