Medicare patient rebates failing to keep pace

Medicare patient rebates failing to keep pace

Friday 7 December 2012

AMA Vice President, Professor Geoffrey Dobb, said today that the new Medicare Benefits Schedule (MBS) patient rebates, to apply from 1 November 2012, fail dismally to reflect the true value of quality medical care in Australia.


The new MBS patient rebate for a standard GP consultation is $36.30, an increase of just 70 cents.


The Government’s own data show that, in 2011-12, the average out-of-pocket cost for patient billed services for GP consultations was $26.97, an increase of $1.72.


Professor Dobb said that the MBS indexation is totally inadequate.


“It is not keeping pace with the increased costs of providing medical care and it is shifting higher costs to patients.


“It is also undervaluing quality medical care,” Professor Dobb said.


The AMA List of Medical Services and Fees better reflects the value of quality medical care and what is occurring at the coalface of health service delivery.


This year, AMA fees have been indexed, on average, by 3 per cent.  This compares with the Labour Price Index of 3.65 per cent and CPI of 1.75 per cent.  The new AMA recommended fee for a standard GP consultation is $71, up from $69 in 2011.


AMA indexation places significant weight on increases in the Labour Price Index in order to reflect increasing practice costs such as staff wages, and operating expenses such as rent, electricity, computers and professional insurance.  These costs must all be met from the single fee charged by the medical practitioner.


Professor Dobb said that the AMA List of Medical Services and Fees provides guidance to AMA members in setting their fees, based on their own practice cost experience.


“Successive governments have failed to index the MBS fees in line with other key indices such as the Labour Price Index and CPI, let alone the increase in the cost of delivering quality medical care,” Professor Dobb said.


“There is now a significant and growing disconnect between MBS fees and the realistic cost of providing the services.”


Professor Dobb said that MBS indexation has also created an anomaly whereby patient rebates for seeing a nurse practitioner are higher than the rebates for seeing a fully qualified doctor.


“Consultations with Other Medical Practitioners (non-vocationally recognised doctors) are not indexed, but nurse practitioner consults are,” Professor Dobb said.


“A nurse practitioner attendance of 30 minutes has an MBS fee of $39.75. The same consult with an Other Medical Practitioner for the same amount of time has an MBS fee of $38.


“It is absurd that a patient will get a lower Medicare rebate for a more highly skilled service.”




Since 2005, MBS fees have been indexed on average by 2.09 per cent per year.


Pathology and diagnostic imaging, and some medical practitioner attendance fees, have not been indexed at all.


Since 2005, the average AMA indexation has been 3.11 per year.


While 81 per cent of GP services are bulk billed, there is cross subsiding by patients who incur a gap, and their gap is increasing.


The AMA Fees List is indexed each year based on the AMA MFI, which compromises Labour Price Index, All Group CPI, Private Motoring CPI, and Medical Defence Insurance (MDI) premiums.

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