First published: Tuesday, November 3, 2009
The health of patients with cataracts is being forgotten by both major parties in the debate about Medicare rebates for cataract surgery and for joint injections. The Federal Government’s main interest appears to be to save money even though it knows that some eye surgeons and arthritis specialists will not reduce their fees, thus leaving patients to pay more or simply not have the vision saving operation or the joint injections which these highly skilled health professionals can perform.
The eye surgeons and arthritis specialists are clearly putting interest in defending their own income in front of providing affordable access to patients for procedures which they know can transform their patients’ lives. Both groups of specialists earn at least three and often many times the average income of their patients, most of whom are elderly and not in paid work. For the eye surgeons there is a cut in the rebate, and it may lead to a substantial cut in income although most surgeons already require substantial copayments as well. For arthritis specialists the elimination of the rebate for injections will mean a decrease of about 5% of Medicare income and as most charge some copayments, it will thus mean a less than 5% cut in income. But the Government’s intention is clear, it wants to reduce their income, and in the case of arthritis specialists, it did so in the May budget with no consultation at all. No group of workers in the country could be expected not to object.
Thus the Government is attempting to use the suffering of patients to make selected specialists reduce their fees. The specialists have responded and are using the suffering of patients to challenge the Government’s attempt at reducing their income. It is a sad reflection on both groups that patients are a secondary consideration. Hippocrates would be turning in his grave at the behaviour of his colleagues. He could quite rightly be disappointed and angry at the confrontational anti-professional attitude of the Government.
But the Government continues to ignore the reason behind the problem. It has come to this because we now have many middle and low income patients relying on the private system for adequate and timely health care. When private care was just for the rich, an extra charge from the doctor was not a barrier to care. Now, for many, it is.
The weakened public hospital system upon which the majority of Australians depend for their cataract surgery and in which outpatient specialist services could be available in a timely manner cannot possibly compete with a private industry which is so heavily taxpayer funded but which is only accessible to those who can afford it. Many elderly are desperate enough to have private health cover because they don’t want to be queuing at the public hospitals to get their lives back by having their vision restored or their joints injected.
It is this taxpayer funding of the private system which sets the scene for private specialists to charge almost what they like, knowing that there are enough patients who are desperate enough to pay extra to avoid public hospital queues.
Rather than ignoring patients and attempting to control a fundamentally flawed uncapped private industry, the Federal Government must adequately fund the public system so that it can compete for patients and doctors against the taxpayer funded private industry.
Dr Tim Woodruff
President, Doctors Reform Society (also arthritis specialist)