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Pathology companies want less bulk-billing -

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Pathology companies want less bulk-billing

Meredith Griffiths reported this story on Sunday, September 20, 2009 12:20:47

PETER CAVE: Pathology tests help doctors to determine if suspicious symptoms are actually a sign of
serious illness. Patients can claim the expenses on Medicare - but now private pathology companies
have written to doctors asking them to only bulk-bill patients who are financially disadvantaged.

The sector says it can't afford to shoulder the burden of cuts to Medicare rebates which were
announced in the Budget. But consumer groups say its profiteering and will lead to lower quality of

Meredith Griffiths reports.

MEREDITH GRIFFITHS: When patients front up at their general practitioners with dubious symptoms
it's increasingly likely the doctor will order a pathology test. GPs ordered about 18 million more
of them in 2008 than in the year 2000.

The tests cost the Federal Government about $1.8 billion a year and for most patients are
essentially free through Medicare. But now a number of private pathology companies have written to
doctors asking them to only bulk-bill patients who they believe to be financially disadvantaged.

Dr Michael Harrison is the managing partner of Sullivan Nicolaides Pathology which operates in
Queensland and northern New South Wales. He says only people will concession cards should be

MICHAEL HARRISON: I think everybody who has got a pension card or a healthcare card or a DVA
(Department of Veterans Affairs) card obviously they fall into the concessional category.

That is over 50 per cent of referrals but there are many people out there and friends that I've got
who say they don't understand why they are bulk-billed for pathology. They pay a gap for every
other service that they have.

MEREDITH GRIFFITHS: Dr Harrison says he was surprised when the Federal Government cut the fees the
sector can charge - and he says his company cannot sustain the short fall.

MICHAEL HARRISON: There was a fee reduction in the Federal Budget, in this last Federal Budget of a
little over 9 per cent and in the previous Federal Budget of 2.2 per cent. That fee reduction flows
onto to rebate reduction for patients of course.

So if we are going to continue to bulk bill then that is the sort of loss that we are looking at so
we can't make up that through any sort of cost cutting exercises within our organisation. It is far
beyond that and that is because it comes on the back of 23 years without a fee increase within the
pathology area.

So, I would say it is the most efficient part of modern medicine because we have managed to adapt
and have coped without having any fee increases but this Government wants more obviously.

MEREDITH GRIFFITHS: Dr Harrison says if bulk-billing stops, patients will pay on average about $50
for a pathology test and consumer groups estimate the price could reach $100 per test.

Carol Bennett from the Consumers Health Forum says the pathology companies are profiteering.

CAROL BENNETT: This is an area in which consumers are clearly being held to ransom by vested
economic interests. You know, I guess this is the reason that some of these services are operated
by governments in some countries because it removes those vested economic interests.

MEREDITH GRIFFITHS: She says the quality of care will fall.

CAROL BENNETT: Clearly if you have a chronic condition then your need to access these services
increases and therefore the cost becomes really difficult to sustain and you know, that will
obviously impact on the degree to which people feel that they can have a certain level of tests.

MEREDITH GRIFFITHS: Do you actually think some people would not get tests because they couldn't
afford it?

CAROL BENNETT: We do know that affordability is a key factor in access to services and certainly
when we have consulted with consumers very widely across Australia, they will say that, you know,
sometimes it can be the difference between paying their heating bill and having a test.

MEREDITH GRIFFITHS: Dr Michael Harrison from Sullivan Nicolaides Pathology shares the concern that
patient care could suffer.

MICHAEL HARRISON: We don't want to put up any barriers for people to have essential pathology tests
and we don't want people thinking will I or won't I have a test based on whether they're going to
be bulk billed or not. However the Government should have taken that into account when they
decreased the fees.

MEREDITH GRIFFITHS: But the Federal Health Minister Nicola Roxon says the pathology businesses can
afford to shoulder the cuts.

NICOLA ROXON: These companies have enjoyed relatively high profits for many years. They, the day
following the Budget those publicly listed companies had their shares jump. I don't believe this
puts any company at risk.

MEREDITH GRIFFITHS: She says in the current economic climate the Government needs to make savings
wherever they can.

NICOLA ROXON: Patients should be put before profits from these companies. We believe and our
calculations show us that this will remain a profitable industry for people to be in and I think
it's actually pretty unreasonable for pathologists to suggest that they cannot share any of the
burden of the difficult financial circumstances that we are in.

MEREDITH GRIFFITHS: Nicola Roxon is asking GPs to continue to request bulk billing from
pathologists as usual.

PETER CAVE: Meredith Griffiths reporting.