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Budget 2018: government is 'miles short' in Medicare

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BUDGET: GOVERNMENT IS “MILES SHORT” ON MEDICARE The Turnbull Government’s promise that it would “guarantee Medicare” is now looking hollow following a Federal Budget that leaves nine million patients worse off.

Although there was a long-overdue announcement of a new $400 Medicare rebate for MRI scans for prostate cancer in Scott Morrison’s budget, the nine million Australians who need access to essential x-rays and scans every year were again hung out to dry with: - NO end to the 20-year freeze on Medicare rebates for radiology, despite this being a Turnbull

Coalition election promise; - NO more GP-referred MRI scans for knee patients over 50 from November 1, hitting around 80,000 patients a year; and - NO funding for Medicare rebates for breast cancer MRI scans, with women paying $600+ out

of pocket for the service.

“The Turnbull Government made a big show of saying it would guarantee Medicare for all Australians,” ADIA President Dr Siavash Es’haghi said.

“Despite all the smoke and mirrors, a clear-sighted analysis of the budget shows that they are miles short of achieving this for patients.

“With average gaps for radiology services now at $100, the Turnbull Government is continuing to create a two-tiered health system - one for the haves, and one for the have nots. And we know that there are now 300,000 Australians every year are not getting the scans they’ve been referred by their GP or specialist because they simply don’t have the money.”

To add insult to injury, the Budget also confirmed that from 1 November 2018, GPs will no longer be able to refer patients over the age of 50 who injure their knee for an MRI.

“This decision is ageist and discriminatory and, as the health sector has repeatedly told the Government, it has no clinical basis,” Dr Es’haghi said.

“We are deeply concerned that patients over 50 who injure their knee face long waits - often in pain - and out of pocket costs for an appointment to a specialist, just to get referred for an MRI. Patients who don’t want to wait will be up to $500 out of pocket to have the MRI outside of Medicare.

“Along with the Royal Australian and New Zealand College of Radiologists and Australasian Musculoskeletal Imaging Group, we condemn this decision which is quite clearly the action of a Government that is not at all committed to Medicare.”

The Consumer Health Forum (CHF) - the peak body for healthcare consumers - also voiced its concerns about the MRI cuts, saying “…it will put many older people to the additional expense of having to consult a specialist in order to get a referral”.

This comes on top of the CHF’s calls for the Medicare radiology rebate freeze to end from 1 July, with its Out of Pocket Pain survey finding that radiology was the most frequent healthcare cost concern mentioned by patients (27% of respondents).

“The Turnbull Government had another opportunity to fix the problems with this budget, but they have - once again - failed patients and failed Medicare,” Dr Es’haghi said. “They need to be held account for their rhetoric.”

Measure ADIA Analysis

Indexation The Government will not index Medicare rebates from 1 July 2018 - breaking the Prime Minister’s promise to the Australian public before the 2016 election.

Negative. • No relief for patients, who are paying an average $100 gaps for x-rays and scans, and over $150 for CT and MRI scans. • A record number of patients paid gaps for x-rays and

scans last year, and this number will continue to grow until the Government ends the twenty-year Medicare freeze.

Cuts to MRI knee scans GPs will no longer be able to refer patients over 50 for MRI scans for acute knee injury.

Negative. • This policy is solely a cost-cutting measure which is not supported by any clinical evidence. • The Government is discriminating on age.

3D breast tomosynthesis The Government will introduce two new time-limited MBS items for 3DBT and removing rebates for plain film tomography. The new items are an interim measure (for two years) to enable an application for long-term funding to be lodged by the sector and considered by MSAC.

Neutral. • 3DBT is already available on Medicare. • The Government is introducing dedicated 3DBT items on Medicare, but access to 3DBT will not change. • The new items are only for two years. Patient access

beyond 2020 for this vital service is not guaranteed.

MRI prostate scans The Government will list MRI diagnostic scans for prostate cancer on Medicare.

Positive/Negative • This listing will enable men suspected of prostate cancer to receive a Medicare rebate for MRI scans, which are the “gold standard” for prostate cancer diagnosis. • However, the Government continues to drag its feet on

MRI for breast cancer, which is essential for treatment planning in 10-15% of cases. Women are paying $600 or more for this service while the application to list the service is mired in bureaucracy.

ADIA represents radiology practices throughout Australia, both in the community and in hospitals. It promotes the ongoing development of quality accreditation standards and appropriate funding settings so that Australians can have affordable access to quality radiology services. This supports radiology’s central role in the diagnosis, treatment and management of a broad range of conditions in every branch of medicine. For interviews, please call Phil Martin, Michels Warren on 0418 817 876