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Healthcare may be about to get (even more) expensive for patients

Patients who already have high out of pocket costs for X-rays, CT scans and other imaging services are facing even higher costs as a result of little-understood Federal Budget changes.

Representatives of the Australian Diagnostic Imaging Association gave evidence to the Senate Select Committee on health last week about how patients will face significant upfront costs as a result of federal budget changes.

The transcript also shines a spotlight on the complexity and lack of transparency in the system. A number of Senators – including even system insiders like Senator Richard Di Natale – struggled to grasp how the system works and the implications of the proposed changes.

Whether this complexity is a help or a hindrance for the Government is perhaps debatable.

In the article below, Shadow Minister for Health Catherine King argues that the implications for patients could be “disastrous”. 

****

Catherine King writes:

The Abbott Government is not telling the truth to patients about the full impact of its GP tax: that those who require an X-ray, mammogram, or ultrasound will be up for a lot more than $7.

That’s because the GP tax is compounded by a 10-15 per cent cut in the rebate paid to radiologists, and the abolition of a safety net for high cost diagnostic imaging services such as PET scans and Nuclear Medicine.

The combined impact could see patients forced to pay hundreds, even thousands of dollars in up-front costs.

As the Australian Diagnostic Imaging Association (ADIA) told the Senate Inquiry into out of pocket expenses: “In the face of significant cuts to rebates, it is not realistic to expect that diagnostic imaging practices will be able to charge just the $7 co-payment and no more.”

Most will now be forced to charge their patient a lot more than $7 but here’s the catch. Under Medicare rules, any patient charged these higher fees must pay the entire amount up-front.

And these costs are not inconsiderable.

According to the ADIA, general patients would have to pay a minimum of $90 upfront for an x-ray, $380 for a CAT scan, $160 for a mammogram and $190 for an ultrasound. For those unfortunate enough to need a PET scan, the up-front cost could hit $1,000.

For a typical patient with thyroid cancer, for example, a confirmed diagnosis comes after an ultrasound and thyroid function test, a follow up ultrasound and pathology, and finally head or body scans.

All up, that comes to around $1,000 in up front charges. Patients will eventually get much of this back from Medicare, but they will still be left with hundreds of dollars in out of pocket expenses.

And that’s just one scenario. According to the Association of Nuclear Medicine Specialists, a woman with a breast lump who was previously bulk billed would need to spend at least $280 up-front to have her cancer diagnosed.

A person with lung cancer will have a minimum up-front payment of $320 and someone with lymphoma $350.

For many of the 66% of patients who are now bulk-billed, those sorts of costs will be unaffordable. We already know that up-front costs are a huge barrier to people on limited incomes. Indeed, doctors are reporting that even talk of a GP Tax is turning patients away from surgeries.

Many patients will delay, or even skip crucial scans, or, as is common in the US, take out a loan to pay for their treatment.

People who do skip appointments may get lucky, and find their condition has not deteriorated. But the odds are those who do miss important scans will get sicker, require even more extensive treatment, and end up costing the health system much, much more.

And the costs of such delayed diagnosis go well beyond mere financial pain. A recent study by Cancer Research UK found almost half of English cancer patients are not diagnosed before their disease was already at an advanced stage, reducing their chances of survival.

In Britain, those findings have prompted calls for heavier investment in ways to improve earlier diagnosis.

Yet in Australia we have a government whose principal public health policy is introduce a barrier to primary health care. The aim of the GP Tax is to prevent people seeing a doctor by imposing a tax on the sick, a tax on cancer patients, a tax on chronic disease that impacts at every stage of illness and treatment.

A $7 GP Tax may not seem much for some, but its interaction with the MBS cuts for X-rays, ultrasounds and MRI and PET scans could have disastrous consequences.

As Australian Medical Association President Dr Brian Owler warns, for a woman who delays a scan because of the cost, only to have the lump on her breast diagnosed as malignant “that could be the difference between life and death”.

• On Twitter: @CatherineKingMP 

Comments 1

  1. Delia says:

    Conservative governments rarely tell the truth about the out of pocket costs of privatised healthcare. One appointment with a private specialist could be $600. One night in a private hospital could cost $1,000. One minor surgery could set you back $10,000. The insurance rebates may return nothing, to 80% of the total cost. Insurance rebates are kept secret. Very few private doctors and hospitals discuss their out of pocket costs. Private bills are completely fragmented with one surgery triggering six bills alone from different providers.

    I am not aware of any ‘bundled quotes’ for whole of treatment care in any Australian private hospital. Patients are frequently left to find out at the last minute, on the hop, what their bills actually are. Unlike all other commercial products, there is no public debate about cost and quality of health care.

    We have the USA style privatisation in 1/3 of our hospital beds. Healthcare lobby groups simply have too much power over politicians. The community/consumer voice is underfunded and under resourced. The result? Many bankrupt patients and an excess of sub standard medical care.

    Please consider supporting my crowd funding campaign to create an app, giving Australians information on the cost and quality of health care. http://www.pozible.com/project/187069

    And before you think the NHS is Britain is safe, have a look at this video. http://youtu.be/0Nyht8oNBM0?list=LL8ISbIvRR5yhBTyyuIC5wLg

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Australian Centre for Health Services Innovation Forum 2013
Australian Health Promotion Association Conference 2013
Closing the Credibility Gap 2013
CRANAplus Conference 2013
FASD Conference 2013
Health Workforce Australia 2013
International Health Literacy Network Conference 2013
NACCHO Summit 2013
National Rural Health Conference 2013
Oceania EcoHealth Symposium 2013
PHAA conference 2013
2014 conferences
#IPCHIV14
AIDA Conference 2014
Congress Lowitja 2014
CRANAplus conference 2014
Cultural Solutions - Healing Foundation forum 2014
Lowitja Institute Continuous Quality Improvement conference 2014
National Suicide Prevention Conference 2014
Racism and children/youth health symposium 2014
Rural & Remote Health Scientific Symposium 2014
2015 conferences
#CPHCEforum
#CRANAplus15
#HSR15
#NRHC15
#OTCC15
Population Health Congress 2015
2016 conferences
#AHHAsim16
#AHMRC16
#ANROWS2016
#ATSISPEP
#AusCanIndigenousWellness
#cphce2016
#CPHCEforum16
#CRANAplus2016
#IAMRA2016
#LowitjaConf2016
#PreventObesity16
#TowardsRecovery
#VMIAC16
#WearablesCEH
#WICC2016
2017 conferences
#17APCC
#ACEM17
#AIDAconf2017
#BTH20
#CATSINaM17
#ClimateHealthStrategy
#IAHAConf17
#IDS17