Cuts will force diabetes patients to 'pay hundreds more for blood, urine tests', say pathologists   

Date
    January 13, 2016
    Canberra Times

Diabetics could be out of pocket hundreds of dollars each year for their treatment if cuts to pathology go ahead, raising the risk of complications including kidney disease, doctors warn.   

Health Minister Sussan Ley flagged plans to cut and limit bulk billing incentive payments for pathology and diagnostic imaging services last month, saving the government $650 million over four years.

Dr Nick Musgrave, president of Pathology Australia, said that without the payment, most pathology services would no longer be bulk-billed. Major pathology providers have already indicated they will pass losses from the cuts on to patients.   

About 1.7 million Australians with diabetes, he said, could have to pay more than $400 upfront for a year of standard blood and urine tests to monitor their kidneys and risk of heart disease. Higher costs could deter some patients from doing the tests "making management of their diabetes more difficult for their doctors, and will result in an increase in complications of diabetes including kidney disease and blindness," Dr Musgrave said.

This follows reports that the Royal College of Pathologists of Australasia said pap smears could cost women at least $30 upfront if the cuts go ahead. Ms Ley's spokesman last week said that the government was not changing the Medicare rebate for pap smears but removing an "inefficient payment" to pathology firms. Patients would be "rightly suspicious" of providers claiming they will charge patients $30 to make up the losses from incentive payments worth up to $3.40, he said.

Dr Musgrave said that even with the rebate, patients with diabetes will still be left about $270 out of pocket a year, as the Medicare rebate for pathology services had been frozen for the past 20 years: "It doesn't matter how the government would like to construct the funding of the tests, [the bulk-billing incentive is] part of the overall funding for them."

Diabetes educator and nurse Cheryl Steele said that Type 2 diabetes patients over 50 years, including pensioners, were most likely to forego pathology tests, risking kidney and cardiovascular diseases, because they are often already paying for multiple medications. Those from non-English and lower socioeconomic backgrounds were particularly vulnerable because they had a lower understanding of how to manage their diabetes.

"We have patients who will take medication for blood pressure this month and cholesterol next month because they can't afford it all," Ms Steele, a director of the Australian Diabetes Educators Association, said. "Anything that puts extra burden on them to maintain good health will ultimately end up costing more hospital beds."

Dr Musgrave said that higher pathology fees could also deter patients from getting tested for conditions that do not display obvious initial symptoms, including cervical, bowel and prostate cancers and Hepatitis C: "If there's a delay in diagnosis ... because of the co-payment they will have a far worse clinical outcome and it's possible that by the time of diagnosis, the disease is incurable."

Health Minister Sussan Ley's spokesman said the Medicare rebate for pathology tests remained the same, and the tests were still covered by the Medicare Safety Net.

He called pathologists' warnings "opportunistic", saying it "shows this debate is really about protecting profits, not patients".

The incentive payments to pathology firms were worth "just $1.40 to $3.40" but had only raised bulk billing rates one per cent since 2009, the spokesman said. He would not say whether Ms Ley was concerned about pathologists' claims the removal of the payments would reduce bulk billing rates.

aquascoot wrote on Jan 14^th, 2016 at 6:45am:


Scare-mongering by pathology companies.

Services required by patients will not be covered and will cost a lot more.

Waffle all you like but the fact is that everyone who needs these services will be paying a lot more.

Quote:


Every business is about profits, of course any cuts will be passed on to the customer. Where do the Liberal find these num nums?

That would work if the market was competitive but not if it is a cartel.

aquascoot wrote on Jan 14^th, 2016 at 7:32am:



In my region all the services are fully booked out all the time, they do not compete for business they can not service more, they often send business to their competitors. They will all choose to recoup their costs.

As today they all use the same cost structure the trend will continue in the future just at a different level.

These guys currently all bulk bill in my area, this may not be true in the future, it is very likely they will move to a model similar to doctors.

aquascoot wrote on Jan 14^th, 2016 at 7:32am:


surely lefties must HATE corporate health companies

The theory sounds good but the fact is that these guys in my region seem to provide excellent service at a good rate. It is hard to complain about them.

Dnarever wrote on Jan 14^th, 2016 at 7:45am:


It is a good rate to the consumer as its bulk billed.
But , in all seriousness, if patients start getting charged, they wont be wanting their tests done,
volume will fall, profit will fall , and the bulk billing will start again.

This is exactly how an efficient market works.

Gillard putting in incentives of 500 million when bulk billing was already at 89 % seems foolish.

A lot of the medicare schedule needs to be overhauled.

a cataract operation used to take an hour and a half,
now with laser and cryo ablation, it can be done in 15 minutes.

the medicare rebate is 600 dollars.

on ophthalmologist did 18 in one day.

thats 10,000 in medicare funding IN ONE DAY TO ONE GUY and he had the hide to charge double the rebate in gap fees.

now , if the government try to slash the rebate, the eye surgeons will be crying poor and we will have cry baby stories about grandma being stuck at home, blind, thanks to the minister for health cutting back on what is obviously a rort.

lefties need to get on the right side of this.
stop supporting a guy who makes 10 grand a day from medicare, as much again from greedy gap fees and seeks to pretend to be "the patients best friend' just to line his own pockets

Do you get a diesel subsidy for your farm scoot?