Smoke & mirrors.The Politics of Medicine


Canberrans woke up this morning to the sounds & sights  of the Media lamenting the fact that “Canberrans are the most likely to be slugged fees for Medicare services

A dramatic description followed describing how the latest AIHW report had shocking statistics about healthcare costs for our local community.

Healthcare Consumer representatives passionately urged us to dispel the “myth”that Canberra is a wealthy community and wanted us to believe that the average GP consultation in the ACT costs $85-$95 per visit !

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It really sounds atrocious does’t it ?

Until we do a bit of factchecking:

Question:

Does the average GP consult in the ACT cost $85-$95 per visit ?

Answer:

The median out of pocket cost for a GP visit in the ACT is $32.

The Medicare rebate for a standard GP visit is just under $38

The median cost to visit a GP in Canberra is thus $70. In most Clinics the medicare rebate is refunded on the spot so these patients are only out of pocket $32 when they walk out of the door.

Even at the high end of the range (90th percentile) the out of pocket cost is only $51 which is a fair cry from the claimed average cost for a consult.

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The preceding discussion makes the assumption that all Canberrans pay to see a GP which could not be further from the truth.

The data shows that 36% of all Canberrans did not pay a cent out of pocket when they saw their GP – their GPs discounted their service to the paltry $38 that the Medicare rebate is worth.

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Question:

Is it a myth that the ACT is a wealthy community ?

Answer:

Our most reliable source of information on this matter is the Census and the numbers are very clear:

ACT Household weekly incomes in 2016 were $300 more than the national median pay !

(As ironically also reported by the same Canberra Times)

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Research tells us that Australians attend their GPs 4 – 7 times a year. Assuming that we are at the upper end of the scale (which would not be true) the mean approximate out of pocket cost per year for a Canberran to see their GP is $32 x 7 x 64% which adds up to $143 a year or less than $3 per week.

And this is a community with an average weekly gross household income of $ 2, 070.

The numbers speak for themselves – We ARE a wealthy community in the ACT!

And let’s not forget that 36% of Canberrans are not paying at all to see their GPs.

Question:

Why are GPs simply not bulkbilling all of their patients ?

Answer:

I have discussed this matter in great detail in the past.

The short answer is that the unthawing of the medicare freeze is a massive conjob and reflects a current increase of less than 60 cents on a standard bulkbilled GP consult.

The so-called freeze started in in 2013 however the Government’s indexation of Medicare rebates has never kept pace with the rising cost of medical practice.

On average AWE and CPI increases by 3% a year. Practice costs rise by the same amount.

Medicare rebates, from the 1980s up to the freeze has only been rising by 1.7% on average per year.

It is therefore not rocket science to understand why the current recommended AMA fee for a standard GP consultation is more than double the current Medicare rebate for the same service.

GP Clinics are small businesses and the income from the Clinical work need to pay for all expenses, not just the GP’s income.

The cost of running a business in the ACT is extraordinarily high and small clinics such as ours are struggling to survive.

Many of us are recognising the writing on the wall and it has an impact on us and our patients.

In our case we have had to fold and join another clinic and we hope & pray it will be to the benefit of all, doctors and patients.

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2 Responses to Smoke & mirrors.The Politics of Medicine

  1. maxkamien says:

    Vote Thinus for MOH !. Enjoy and learn from the rants and raves. But will Ochre put conditions on them? I remember the Kippax Health Centre of the Whitlam era. Through the entrance and Private doctors on the left and salaried doctors on the right. The private doctors called their salaried ‘colleagues’ “Government Bludgers”. The Salaried returned the compliment with “rapacious bastards’ over there. As a true blue academic (then a rare and reviled species) I counted the number of patients seen per day for the previous 2 months by each group. The GBs averaged 3 more patients per week.
    The young Centre receptionist looked like an advertisement for hay fever. I suggested she see one of the doctors. She was not keen: ” I wouldn’t see any of them” , she said, ” They ask you all about your family and your sex life. I go to old Dr D…. down the road. He just asks you what’s wrong and gives you some pills. Gets on with it ‘e does”..

    • Thinus says:

      I checked Ochre out very carefully before we made the decision.
      They may a Corporate but my feedback from doctors working there and patients I share with them are positive.
      I trust that my clinical work will only improve once I am no longer distracted by the “business of medicine”

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