“The Budget decision was based on poor advice that does not reflect the reality of performing quality cataract surgery and providing professional follow-up care for patients,” Dr Pesce said.

“The Government believes that most cataract surgery is performed in 15 to 20 minutes – wrong.

“The Government claims that ophthalmologists are overcharging their patients – wrong.

“The Government believes that halving the Medicare patient rebate for cataract surgery is good health policy – wrong and unfair.

“The Government has put a modest saving to the Budget bottom line ahead of the health and welfare of some of the most vulnerable people in the community,” Dr Pesce said.

“It is time for the Government to do the right thing by these people, many of whom who may be denied the vital operation that could save or improve their sight because they can no longer afford it.

“The rebate must be restored to its proper level.”

Dr Pesce said that the AMA survey showed that more than two-thirds of private ophthalmologists would cut back their public patients if State Governments followed the Federal Government and cut the contract rate for cataract surgery.

“MBS fees no longer reflect the true cost of delivering medical care,” Dr Pesce said.

“The Medicare patient rebate for cataract surgery has been significantly cut twice since 1987.

“On this occasion, the Government has failed to acknowledge that the Medicare rebate must cover at least two postoperative visits to the doctor, with most doctors providing three visits, and some doctors providing four or more.

“On top of this, the income that doctors generate from providing professional medical services must cover their practice costs, which include their staff and equipment.

“These costs are met entirely from the fee charged by the doctor.

“The fees that ophthalmologists are actually charging has increased by just 1.8 per cent a year between 1993 and 2008, which is less than the CPI increase of 2.5 per cent or the increase in average earnings of 3.7 per cent over the same period.”

During August and September, 334 ophthalmologists responded to the AMA survey.

Key findings of the survey include:

· 72 per cent of cataract operations take more than 20 minutes;

· 62 per cent of ophthalmologists provide three postoperative follow-up visits as part of the cataract surgery.  Ten per cent provide four or more visits; and

· 81 per cent of private ophthalmologists contracted to provide cataract services to public patients will not be able to continue to provide these services if the contract payment is reduced as a result of the cuts to the Medicare rebate.

Medicare data shows that:

· 79 per cent of Medicare rebates for cataract surgery are paid to men and women over the age of 65; and

· more than 105,000 older Australians had private cataract surgery in 2008-09.

A Fact Sheet on the survey appears below.

22 September 2009

CONTACT:

John Flannery 02 6270 5477 / 0419 494 761
Peter Jean 02 6270 54 64 / 0427 209 753

AMA OPHTHALMOLOGY SURVEY

August-September 2009

FACT (AND MYTH) SHEET

Fact

79% of Medicare rebates for cataract surgery are paid to men and women over the age of 65.

Fact

Over 105,000 older Australians had private cataract surgery in 2008-09, for which the Government contributed just over $67 million.

That’s around $634 per person for surgery that prevents people from losing their sight, allows them to continue to live independently, and enjoy a high quality of life – to cook, to read, to drive, to see.

Fact

The Government now wants to contribute only about $308 per person for cataract surgery.

Myth

The Government believes that cataract surgery can now often be performed safely in 15 to 20 minutes.

Fact

An AMA survey of ophthalmologists revealed that only 27% of cataract operations take 20 minutes or less (and only 6% take 15 minutes or less).

72% of cataract operations take more than 20 minutes.

Fact

62% of ophthalmologists provide 3 postoperative follow up visits.  These visits are included in the Medicare rebate for cataract surgery.

A further 27% of ophthalmologists provide 2 postoperative visits, and a further 10% provide 4 or more.

Myth

The Government believes the current MBS rebate reflects an era when cataract surgery took two to three times longer to perform.

Fact

MBS fees for cataract surgery were reduced to reflect efficiency gains by 32% in 1987 and reduced again by 10% in 1996.

The Government is not reducing the fee for cataract surgery provided to veterans.

Myth

The Government believes cataract patients are being slugged with unreasonable fees.

Fact

The actual fees charged by ophthalmologists have increased on average by only 1.8% p.a. between 1992-93 and 2007-08.  This is a much lower annual increase than the average increase in CPI of 2.5% p.a. or average earnings of 3.7% p.a. over this same period.  
Growth in MBS expenditure on cataract surgery is because there is more surgery being done - demand has increased by 7.3% since 1992-93.

In contrast, ophthalmologists’ fees have increased by 1.8% p.a. since 1992?93.

Myth

Slashing the Medicare rebate will force doctors to reduce their fees.  Only 3% of ophthalmologists have said they will reduce their fees.

Fact

Ophthalmologists estimate that 20% to 50% of their patients will seek treatment in the public sector if their out-of-pocket costs increase because the MBS rebate is reduced.

Fact

More than half of Australia’s private ophthalmologists provide cataract services to public patients under contract.  In almost half of these contracts, the payment is tied to the Medicare rebate. Eighty one per cent (81%) of private ophthalmologists contracted to provide services to public patients will not be able to continue to provide these services if the contract payment is reduced.

Fact

The proposed fee cut (50%) from November 2009 taken together with the real 32% MBS fee cut in 1987, the 10% MBS fee cut in 1996 and the low level of MBS indexation over the entire period, will effectively result in an 80% total real cut in the government's MBS fee for cataract surgery since 1992-93.