New AMA campaign reveals true drivers of Medicare gaps
This week, we launched a new campaign highlighting the true drivers of Medicare gaps across the healthcare system.
The Medicare Gap seeks to help patients understand the patchwork and piecemeal nature of Medicare funding for general practice, specialist consultations, and surgery.
Recently, doctors have become a convenient target for some people in discussions and media coverage about the out-of-pocket costs of healthcare. But much of this discussion has ignored the reality of what’s driving those out-of-pocket costs.
It is the system that is failing patients and doctors across Australia, including in general practice, with a woefully out-of-date rebate structure that does not support GPs to provide the care that patients need.
Through Modernise Medicare, we are advocating for a new 7-tier rebate structure. Accompanied by adequate funding and reform, this would provide patients with greater access to their GP, including after-hours care at their regular practice.
The Medicare Gap also highlights the truth about the cost of specialist consultations. It provides a clear explanation of why the gaps are so much higher for specialist consultations.
Years of freezes in rebates, a continuing lack of investment, and the absence of much-needed reforms have led to Medicare specialist consultation funding falling woefully far behind what’s required.
The AMA’s accompanying Uncovering the Gaps in Private Health resource highlights the many permutations and combinations that can lead to a gap. Every insurer has a different rebate, despite being labelled with the same government-endorsed gold, silver or bronze stamp.
A variation of just $7 in fees can lead to an $863 increase in the out-of-pocket cost for a patient, and huge windfall for the insurer. Doctors need dozens of different fees for the same service, as insurers can’t agree on a single rebate, but the Medicare rebate never varies.
