Veterans’ rebate not enough to keep practices viable

4 minute read

Even 115% of the Medicare rebate isn’t enough to cover the cost of caring for veterans, so what chance do GPs have of staying open?

Veterans may become the latest group of vulnerable patients to lose access to health care, as fears mount after one practice group in Canberra announced it would refuse to accept Veteran White Cards.

Now, the AMA worries it could become a trend.

Doctors receive 115% of the MBS rebate for treating white card holders, and if they accept that rebate they cannot charge the patient a gap fee. But even 115% of the rebate is not enough to make providing the care veterans need a viable financial option for general practices.

Owners of the YourGP three-practice group in Canberra sent a letter to their patients recently letting them know that they will be charging full fees to DVA White Card holders from now on.

AMA President Professor Steve Robson told The Medical Republic that it was yet another example of how divorced from reality the Medicare rebates system is currently.

“I’m an ex-serviceman myself, so I know how important this is,” Professor Robson said. “We are all very keen to support veterans and their health.

“The white card gives 115% of the MBS rebate and that has not kept pace with the reality of what it costs to provide the care needed by our veterans.

“I suspect that this will be the start of a number of other medical practices saying that it’s not possible to provide the care that’s needed under the current funding arrangements.”

The Veteran White Card provides eligible veterans with free treatment for accepted service-related injuries or conditions and all mental health conditions (for veterans with continuous full-time service or certain reserve service). It also provides medical treatment for cancer (malignant neoplasm) covered under non-liability health care, and pulmonary tuberculosis covered under non-liability health care, as well as a range of services and support.

The financial stress on GPs has been top of mind in the profession since the covid pandemic ramped up the pressure, with bulk-billing rates plummeting as practices fight to stay open.

“You’d have to have your head in the sand not to see that the combination of the [Medicare rebates] freeze and the hopeless indexation that we’ve had since it was lifted doesn’t bear any relation to the realities of running a viable practice,” Professor Robson said.

“We are putting vulnerable people in a position where they can’t afford care. It doesn’t make sense.”

Dr Mel Deery, co-owner of the three-practice YourGP group in Canberra, told TMR that since making the decision to refuse to accept Veteran White Cards, the practice had received a lot of feedback.

“There has been a lot of discussion around this,” she said.

“A lot of the comments from veterans have shown some disappointment but any anger seems mainly directed towards the Department of Veteran Affairs rather than the practice itself.

“There is an understanding of our position. This decision was not about how do we make more money. This decision was about how do we stop ourselves from losing money.

“Things have to change, absolutely [with the rebates system]. But as long as we accept the fees as they are, they have no reason to change them.”

Professor Robson said he hoped the message was getting through to health funding policymakers.

“I don’t think the practice was trying to send a message — they’re just trying to stay open,” he said.

“[White Card] holders are feeling at risk from this. Veterans are a very close-knit community and I suspect they are the ones who will be sending a message to the DVA.

“I don’t think any animosity they are feeling about this is directed to the practice. I think they will want to know how this will be fixed. My sense is they get it.”

A spokesperson for the Department of Veterans Affairs told TMR that the department was aware some health care providers were no longer willing to accept DVA payment rates. “This is a business decision for the providers concerned,” they said.

“Veterans and their families can contact DVA for assistance in locating health care providers that accept DVA Veteran Cards on free call 1800 VETERAN (1800 838 372).

“DVA can help by assisting the client to find a local provider who accepts the Veteran Card; arranging transport to alternate health care providers; or, where there is a valid clinical need, funding services above the DVA rate.”

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