Speeches and Transcripts

Transcript - Dr Gannon - SKY - Flu Vaccinations, PHI, Medical Fees

Transcript:   AMA President, Dr Michael Gannon, SKY News, with Ashleigh Gillon, Tuesday 27 March 2018

Subject:  Flu Vaccinations, Private Health Insurance, Medical Fees


ASHLEIGH GILLON:   Joining me live in the Perth Studio is the AMA President, Dr Michael Gannon. Good to see you, Dr Gannon. Thank you for your time.

I want to first ask you about the flu shot. This is something a lot of Australians are thinking about as the weather's starting to turn chilly in some places around the country. I see that you've raised some concerns that people are getting the jab too early. When is the time to get vaccinated?

MICHAEL GANNON:   Our advice to patients is that they should receive the influenza vaccination the same time as the national program rolls out for those people entitled to free influenza vaccination. We saw a real spike in cases in Spring last year, and one explanation for that is that the effectiveness of the vaccine might have started to wear off or that the virus had mutated beyond control. Remember that's the reason why you get vaccinated every year as the virus changes year-on-year. So, about the middle of April, we're expecting groups entitled to free vaccination; Aboriginal and Torres Strait Islanders, some children, pregnant women, people with chronic disease, elderly people, that's when they get their free vaccine. We think that's also the optimal time for so-called healthy Australians to get vaccinated and protect themselves and their loved ones from the flu.

ASHLEIGH GILLON:   So why is there the confusion about when the vaccinations should be happening - are you pointing the finger at pharmacies, for example, which are starting to advertise flu shots now?

MICHAEL GANNON:   We have to take into account that pharmacist vaccinations are a relatively new phenomenon and I understand why private businesses, pharmacies would want to get people in, and to advertise it early. I think rather than criticise pharmacists for doing that I would want to project an overwhelmingly positive message that the most important thing is that people entitled to it do avail themselves of a free vaccine. We encourage those small and big employers that look after their own workforce and, if that means being vaccinated in safe conditions by a nurse or a doctor in the office space, that's good. We would just ask pharmacists to go for the optimum time. So that's not necessarily when you've got someone in your shop, but probably in three or four weeks time when it's likely to have the greatest effectiveness.

ASHLEIGH GILLON:   Okay, good tip. Let's move on to private health insurance. You released the AMA's Report Card and you seem to have singled out Bupa in particular as one of the companies that could be, well, essentially ripping off customers offering junk policies. Why have you singled out Bupa?

MICHAEL GANNON:   Look, it's not so much that we singled out Bupa. They are the largest private health insurer in Australia so we need to pay special attention to them. They're one of the insurers that's perhaps most guilty of having different schedules in every State. That's just one example of the confusion that prevails when people are making a choice about private health insurance. And, of course, Bupa needs to take their share of responsibility. They made announcements in the last month that undermine a lot of the good work that Minister Greg Hunt has done on out-of-pockets. A lot of the work that has been done in cooperation by insurers, by hospitals, by doctors, by patient groups, for people going to day hospitals, for those people who want to use their private insurance in public hospitals, and perhaps most egregiously they've made the situation now where patients need to check on whether or not the hospital their doctor might go to is in or out of contract with Bupa. This is another step down the road of the United States style managed care. Australian doctors will fight any move to a system where insurance clerks on the other side of the country determine what care patients get.

ASHLEIGH GILLON:   I think you've also accused Bupa of leaking the AMA's fee book. We saw the Sunday papers running some pretty horrible headlines targeting doctors. There were things like the health sting takes knife to our savings, doctors bleeding patients dry. Do the fees and the release of AMA's fee book show that the true cost of services are just not really being reflected by Medicare fees? Because we saw on your fees there were two or perhaps three times as much as the Medicare fees?

MICHAEL GANNON:   Yeah, well, I think that's the real message from what was meant to be a dramatic leak of our fees book is that the majority of doctors on a daily basis discount their fees from what their own association says is a reasonable fee. Now the competition regulator makes it very clear doctors can't set fees collectively. But what most of us do day by day is reduce our fees to the bulk billing rates or to the no gap rates, and the no gap rates paid by most of the insurers - as pointed out in detailed fashion in our Report Card available free to consumers and patients out there - is that typically that's about one half to two-thirds of the AMA fee.

Bearing in mind the AMA fee, it's not an overly sophisticated algorithm. Very simply, we indexed that fee list every year according to measures of inflation and have done every year since the mid '80s when successive governments have failed to index patient rebates. That has consequences for private patients through their private health insurance, for veterans through DVA, and of course through Medicare when people go and see GPs and other specialists.

ASHLEIGH GILLON:   There are doctors, though, who are charging well in excess of the AMA fees. If you're calling out, you know, private health insurers, should you also be calling out those among your own mix who are really charging quite exorbitant rates compared to what the AMA is at least suggesting?

MICHAEL GANNON:   Well, it is only a recommended fee, but I think those doctors charging multiples above the AMA fee need to be able to explain to patients why that is the case. I'm very comfortable with an environment where patients talk about fees before they make an appointment. The most important question is, is your surgeon a no gap provider? Is the anaesthetist they use a no gap provider? I think that very simple information should be available to patients before they make an appointment. Doctors are often uncomfortable talking about money, and they often do leave that conversation to their staff at the front desk. But we do not stand behind egregious unreasonable fee setting.

ASHLEIGH GILLON:   Michael Gannon, appreciate you joining us live here in the Perth studio. Thank you for your time.

 


27 March 2018

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                          Maria Hawthorne     02 6270 5478 / 0427 209 753

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