Opinion Paul Bongiorno: Medicare is latest victim of government health bungles

Paul Bongiorno: Medicare is latest victim of government health bungles

Medicare changes Paul Bongiorno
The government's proposed changes to Medicare rebates is like history repeating, Paul Bongiorno writes. Photo: Getty/TND
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The shambles that has become a hallmark of the COVID-19 vaccine rollout and quarantine has hit Medicare, putting thousands of operations in jeopardy and patients uncovered.

The Australian Medical Association blew the whistle at the weekend  saying the biggest changes to hit the Medicare rebate schedule in four decades are being implemented with little notice or meaningful discussion.

Not that Health Minister Greg Hunt will admit any of it.

Instead he cites huge increases in Medicare funding, although much of it caused by the popularity of pandemic-induced, bulk-billed telehealth consultations.

One source in the health sector says ever since Jane Halton retired as head of the federal department in 2014, policy management and delivery has been a mess.

The pandemic hasn’t helped – it has only magnified the failings.

There has been a loss of corporate memory and expertise that doctors blame for the bungled vaccine procurement and for the failure to quickly respond with a fit-for-purpose quarantine system.

Last year Australia rolled out 17 million flu vaccines in a couple of months but inexplicably – other than for dumb politics – this year private contractors were used for the COVID vaccine distribution.

And somehow, aged-care workers were left off the list.

Mr Hunt says he and the department have worked “very constructively with the medical profession” and he “thanks them for that”.

He points to the work of the long-running medical taskforce as well as the Medical Services Advisory Committee in reviewing the dated Medicare schedules.

Mr Hunt says they are focused on “patient safety, patient services and patient outcomes”.

That’s certainly not the way the doctors see it.

AMA federal president Dr Omar Khorshid can’t believe there will be a repeat of the chaos caused to doctors and patients in 2018, when the first tranche of the review changes were introduced.

Then “patients were left out of pocket, spinal surgeries were delayed and doctors couldn’t provide patients with informed financial consent”.

That rushed implementation of 70 changes to rebates was a lesson to be learned, but it has been ignored with now 900 changes all expected to be implanted within a month.

Dr Khorshid says the government was told at least six months’ notice was needed for doctors and patients alike.

Coalition strategists believe the ALP’s “Mediscare” campaign cost it several seats in the 2016 election. Photo: AAP

Ignoring these pleas has created mayhem on steroids; he says “we are facing the same problems as 2018, but with more than 10-fold the volume and complexity”.

There is concern the review relied on doctors who weren’t always specialist in the procedures they were reviewing to have cover dropped or reduced.

In some cases, according to the AMA, Australia is the only medically advanced country not to recognise some diagnoses like the relatively common condition called Femoroacetabular impingement syndrome, which causes painful bone growth on the hip.

Shadow health minister Mark Butler accuses the prime minister of an “extraordinary ambush on our Medicare system” under the cover of a national focus on the Victorian outbreak and lockdown.

Butler is backing the doctors calling for the changes to be shelved and for new consultations.

After the Liberals accused Labor of a lethal “Mediscare” campaign in the 2016 election, you would think Mr Morrison and Mr Hunt would be more careful not to give their opponents any ammunition in this area.

If Mr Butler’s catchcry “you can’t trust the Liberal Party when it comes to Medicare” gains traction, the government could be in trouble defending its one-seat majority.

If the latest line ball Newspoll is any guide, the slide in approval for the Prime Minister is linked to the failure in quarantine and vaccines which came to the fore in recent weeks.

Or put another way, health is the Liberals’ achilles heel, causing extra anxiety for thousands of Australians as they face orthopaedic, cardiac or general surgery next month is political folly.

But maybe the Prime Minister thinks he is in the box seat to win the looming election.

According to Liberal sources, that’s what their research is showing and he doesn’t need to worry.

Paul Bongiorno AM is a veteran of the Canberra Press Gallery, with 40 years’ experience covering Australian politics

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