The medical association has relaunched its Modernise Medicare campaign, as parliament continues to debate laws which will allow the government to publish specialist fees.
With the federal government seemingly set on passing laws which increase transparency around non-GP specialist fees, the AMA has responded with a patient-facing campaign explaining the bigger picture around Medicare funding.
The Medicare Gap website includes information on how chronic underfunding has led to higher patient costs across general practice, non-GP specialist consults, and surgery.
The AMA’s arguments for general practice will be familiar to those who have followed the association’s advocacy in recent years – its central call is for the standard five-tier GP rebate structure to be replaced by a seven-tier rebate structure.
This would see the current Level B, C and D items split into five different items, with funding more evenly distributed across long and short consults.
What is new in this campaign, though, is the AMA’s argument that non-GP outpatient specialists are potentially even more exposed to Medicare’s failing rebates than GPs are.
“In general practice there’s incentives and WIPs and PIPs and other things that boost funding,” AMA president Dr Danielle McMullen told The Medical Republic.
“In surgery there’s private health insurance.
“But in specialist consult land, there is just Medicare – and that helps doctors to explain to their patients why they might feel like there’s more pain in that sector, and it shows our members that we understand that as well, and that’s why we’re fighting for improvements to Medicare.”
The AMA estimates that Medicare provides around 66% of GP funding via rebates alone, but 89% of GP funding including “top ups” like the WIP and PIP payments.
For specialist procedures, it estimates the split is 45% Medicare rebates, 8% other Medicare funding, and 27% government-support private health insurance, bringing the total to about 80%.
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Specialist consults, the AMA said, receive only the 53% in Medicare rebate funding.
In recent months, Dr McMullen said, public commentary on medical costs has shifted away from general practice bulk billing rates and instead focussed on private specialist fees.
Earlier this year, health minister Mark Butler called non-GP specialist fees a “barbeque stopper” and pledged to test the limits of the constitution when it comes to curbing high out-of-pocket costs.
“This has been a big point of public narrative, and our members in particular have been feeling aggrieved by the constant media conversation about their fees,” Dr McMullen said.
“We as doctors know that we’re doing a lot, doing all we can to minimise out of pockets for patients and smooth their pathway to accessing care.
“As the data in this [new campaign] shows, there are quite high rates of bulk billing for some services in general practice, and no gap or known gap services and procedures.
“Doctors are digging into their pockets to help, so this shines a light on some of the other sources of funding that are letting patients down.”
The AMA put forward three new recommendations.
The first and second go hand in hand – one is to increase the Medicare rebate and the other is to index Medicare to CPI going forward.
The third recommendation is to allow patients to pay gap fees only.
“Letting patients pay only the gap would remove a significant barrier to care, making it easier for Australians to access treatment earlier, supporting better health outcomes and improving equity across the health system,” the AMA wrote.
