The health costs of getting older: Medicare schedules needs review

Ok, so I’m old and crankier by the day but let me ask Toowoomba’s thousands of Age Pensioners - one in seven of us, according to the Census, is aged 65 and over - whether they go along with the following?

That Howard Lot had a lot to learn about the perils and expenses of getting older, frailer, and increasingly prone to illness.

It should be plainly axiomatic, even to the political young bloods of the Rudd Government that the older people get the more their health fails, the more their income shrinks, and the more their health bills grow.

Medicare bulk billing for General Practice reportedly has reached record levels – but the Rudd Lot appears unaware also of the increasing costs of Specialist medical care which evidently becomes more necessary with ageing.

You would think that a long-term Blue Ribbon Member of Parliament, like Toowoomba’s Liberal Cabinet Minister Ian Macfarlane, whose Groom electorate boasts a huge and growing electorate of the Ageing, would have some idea.

If he does, he should make it publicly obvious. I never heard Macfarlane, even when Cabinet Minister, insisting that his Government should review Medicare benefits AND scheduled fees to bring them into line with actual practice.

Nor, to be fair to Macfarlane, have I heard any regional Federal Member of Parliament or for that matter any regional State Member asking for a review of Medicare’s Scheduled Fee and Rebates.

Take a look at these medical costs born by one Pensioner on an pre-tax annual income, including Age Pension, of about $25,000-$26,000 who has run into a series of costly medical encounters over the nine months or so. And compare them with your experience.

A comparison of actual fees and Medicare’s scheduled fees and rebates make no sense. They’re all over the place.

(Note that the asterisks ** denote that the Medicare Safety Net has been reached – after having incurred $519 out “of pocket expenses” within the calendar year, the Safety Net increases the Medicare benefit to 80 per cent of the Actual Fee rather than the Scheduled Fee. The Government has increased the Safety Net threshold from $300 at introduction).

> Visits to a Nephrologist (Kidney Function Specialist) (including return travel costs to Brisbane because Toowoomba lacks the speciality) – First visit: Actual Fee $153.35, Medicare Scheduled Fee, $133.35, Medicare benefit $113.35. Second visit ** Actual fee $76.75. Benefit $72.75

> Two visits to a Urologist – First consultation: Fee $140 (Scheduled Fee $75.60, Medicare Benefit $64.30) Second consultation (an In Rooms procedure not covered by Private Health Insurance) Actual Fee $305.00 (Scheduled Fee $147.30, Medicare Benefit $125.25).

> First visit to a Cardiac Specialist: Fee $180 (Medicare Benefit $113.35, Scheduled Fee $133.35) PLUS ECG Actual fee %40Medicare Scheduled Fee $27.60 Benefit $23.50). Second visit $70. Medicare rebate $67.35, Scheduled Fee $66.75.**

> New spectacles $449. Medicare Private Medical Insurance Benefit $180

> Two visits to a Specialist Skin Clinic for cancer excisions, (covered only by Medicare as this In Rooms procedure does not attract Private Insurance benefit) - First visit $815 Medicare rebate $687 (84%). Second visit ** $140, Scheduled Fee $122.50 Benefit $122.15.

> Three Remedial massage for back and leg problems - $60 a visit; top-scale Medibank Private benefit $15 a visit. That is $180 in fees, $45 benefit.

> Dental appointment, covered only fractionally by Medibank Private.

Some points should be made clear here ….

First, I have no quarrel with those Specialist doctors charging fees, exceeding the Scheduled Fee, they believe their practice costs warrant.

Secondly, I acknowledge the assistance to the Aged of the Bulk Billing of GP services, the total subsidy of optometrist visits, X-rays, patholody and ambulance charges.