Sky News Live program interview with Dr Rachel David on Medicare rebate changes for some private surgery procedures

Station: Sky News Live
Program: Afternoon Agenda
Date: 7/6/2021
Time: 2:47 PM
Compere: Kieran Gilbert
Interviewee: Dr Rachel David, CEO, Private Healthcare Australia


KIERAN GILBERT: Doctors have voiced their concern that Medicare rebate changes for some private surgery procedures will create chaos for patients. The changes under the Medicare Benefits Schedule will affect orthopaedic, general, and heart surgery. It’ll come into effect on 1 July. Let’s go now to Dr Rachel David, CEO of Private Healthcare Australia.

Dr David, thanks for your time. There’s been some suggestions that people could be out of pocket thousands and thousands of dollars due to these changes, that the private health sector hasn’t kept up or made the necessary amendments to policies. Should people be worried about that?

RACHEL DAVID: Well, look. I saw the stories in the weekend’s press as well, and I was pretty horrified because it’s quite a big beat up on what is actually an administrative change. We’ve known this has been coming for some time, and both the medical specialists and the health funds have been aware of these changes. But the suggestion that was made in the weekend press that certain surgeries that were routinely and commonly performed would now be defunded so that patients would pay thousands of out-of-pocket costs is completely wrong, and we need to be clear that what has happened is that the MBS, or the schedule of fees for which doctors and their patients receive benefits is being updated. And if certain things have been taken off, it’s either because they were obsolete and no longer used or because they’ve been replaced with something else.
KIERAN GILBERT: So we won’t be facing charges of $10,000 for regular procedures?
RACHEL DAVID: Not as a result of these changes, no.
KIERAN GILBERT: So why is the AMA suggesting otherwise in those comments at the weekend?
RACHEL DAVID: Well, look, I’m not sure why the implication was made that we were taking funding away from people. What this is about is modernising the Medicare Benefits Schedule and changing things like- previously, that doctors were being funded for open cut surgery, and clinical practice has now changed to keyhole surgery, so the funding has changed. What the AMA, perhaps, is rightly concerned about is this is a big change administratively and that previously when we’ve done this kind of thing, because of the complexity of the system and the computer systems involved, sometimes there’ve been some teething problems, and some of the payments have fallen through the cracks. But this absolutely does not mean that health funds are going to stop paying claims to cover the costs of their members. And the fact that that came out of some of these reports, I’d like to absolutely reassure patients and health fund members that that is not the case.
KIERAN GILBERT: Now the AMA President has said it will- that the changes will result in larger gaps- patient gap fees from 1 July. That’s guaranteed, he’s said. Is that true? Do you agree with that?
RACHEL DAVID: Well, look, I find it hard to understand that an increase in gap fees would necessarily result from the changes that have been made. I can understand that as a result of the complexity of the system that some claims might fall through the cracks as the changes are going through the system, and in that case it should be a simple matter for the patient and their surgeon, if they’re concerned, to contact the health fund and resolve the situation. But medical specialists have been involved directly in making these changes, and there is no intention that they should result in increased out-of-pockets for patients. If anything, if you look at the Federal Budget papers, the funding for Medicare benefits has gone up, not down. So there’s no reason why these changes should trigger an increase in out-of-pocket costs.
KIERAN GILBERT: Dr Rachel David, CEO of Private Healthcare Australia. Thank you for your time. Appreciate it.
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