Note: Where available, the PDF/Word icon below is provided to view the complete and fully formatted document
Disclaimer: The Parliamentary Library does not warrant the accuracy of closed captions. These are derived automatically from the broadcaster's signal.
7.30 -

View in ParlViewView other Segments

(generated from captions) now. Sarah Whyte reporting. The Federal Government's come under heavy fire for its decision to remove the incentive it pays pathology companies to encourage bulk-billing. The controversial measure was revealed in the mid-year budget update to save about half a billion dollars, and critics are describing it as a co-payment by stealth. Here's political correspondent Sabra Lane. Remember the controversial Medicare co-payment?Some people are screaming about $7 co-payment. It was announced in last year's budget. It was later modified after a huge public backlash, before the policy was dumped.It is clear the proposal for a co-payment and associated $5 cut to the rebate do not have broad support, and will not proceed. The opposition argues removing the bulk-billing incentive for pathology is pretty much the same thing - a co-payment for pathology by stealth.It is wrong and Labor will oppose the idea that Malcolm Turnbull's Liberals have that the only way that Australia can get ahead is by attacking Medicare.The Treasurer, Scott Morrison, won't cop the co-payment by stealth argument.I reject that, and I think it's unhelpful to get into those sorts of political debates, which any area that is the subject of some savings measures in a budget have every right to raise issues, but to immediately partisanise this and to immediately politicise it in those terms is not a mature way to a helpful debate about the issue.The Treasurer argues the incentive payment is only paid to companies not patients and it's akin to a corporate subsidy that businesses have become accustomed to and don't want to give up. He argues it's time to turn off the tap to those taxpayer dollars.These incentives are paid to the companies, not to patients. We were seeing the rise in all abouting billing occurring regardless of these incentive payments. I have no doubt that they would not welcome the fact that they have a revenue stream that was previously coming to them that won't be coming in the same way that it was before. And they have every right to raise that commercial interest.This is just a cash grab for the Treasurer to make the budget bottom line look better and at the end of the day, it's about taking money out of patients' pockets. There's no way that pathology providers, diagnostic imaging providers can continue to provide the same services and not pass the costs on to patients. For diagnostic imaging it will mean that patients have to pay sometimes hundreds, $400 out-of-pocket expenses for an MRI scan, for example, and then have to try to claim some of that money back.The Treasurer's argument that the change will affect companies not patients doesn't convince people like Saleem Remi who has Type 1 diabetes.It absolutely does worry me that that incentive to pathology reps is being removed - Renza Scibilia. I have a number of checks throughout the year. I have one check which looks at the long-term average of how my diabetes management and control is going. And that's a really, really important tool for me. It's information that I can then act on. Now, it does concern me that I will be chargeed to are that. She doesn't know if scrapth incentive to apply to that regular test she has. She says if it does, it will be costly..It would be very expenseive. I'm very fortunate that it's bulk-billed. I have this done four times a year. It would certainly make me and other people as well question the frequency that we're having this check. It's not a luks reap. It's something that we need to do to manage our condition the best that we possibly can. The government says the incentive payment was introduced in 2009 under Labor to increase bulk-billing rates and that it hasn't been effective. Five years before the incentive was introduced, the bulk-billing rate for pathology was at 85%. The year before the incentive kicked in, the rate had crept up to 86.3%. And after the incentive started, the bulk-billing rate had increased by just 1.5%. Axing the incentive will save $650 million over four years. The government says it's already cost half a billion during the past five years. Pathologists are muscling up for a fight.I'm not sure what companies are going to do. They could in fact lay off staff. They clearly will have to make financial decisions to ensure their financial status, but I think it's much more likely that in fact co-payments will be introduced. And patients who have been used to many years are not paying any out-of-pocket expenses for pathology will be asked to pay significant out-of-pockets or co-payments. Late today the Health Minister conceded the changes could leave some patients out of pocket.Some may be worse off, but overall, I don't expect patients to be worse off because what we will see is further competition. Government insists bulk-billing incentives will remain for concessional patients like pensioners and children under 16 and it says patients who have high out-of-pocket medical costs will still be covered by the Medicare Safety Net.This is the sort of policy that you get when you outsource health and education to the business sector rather than actually speaking to people in the health and education sectors.What's very clear from the last 24 hours is that the government engaged in no consultation with anybody about these changes, these cuts, not with the AMA, not with health care professionals, not with consumer groups, with nobody. So of course, what we're seeing is a repeat in many senses of Joe Hockey's disastrous 2014 budget. The blowback shows once governments put incentives in place they eventually become regarded as entitlements and they're hard to remove. Given the structural position of the budget pretty much every decision any government takes will be a hard political sell as there aren't easy cuts to be made any more. What's truly befuddling about this decision is that it's pre-empted the government's own clinician-led review of Medicare, that's not expected until some time next year and that's left some scratching their heads.We were working on the principle that there's a review that's looking at the MBS, including the pathology items, and the pathology payments. And they would not be affected until the review was complete. So it came as an enormous surprise to us. Perhaps this shows the new Treasury team has learnt nothing from the misstep n and