Vulnerable: A study suggests the proposed Medicare co-payment will hit over-65s the hardest. Photo: Michelle Mossop
New research has backed concerns the federal government's
proposed Medicare co-payment will hit vulnerable groups the hardest and
could deter them from seeking medical care.
The Sydney University study suggests the combined impact of
the higher co-payments will hit those 65 and over the hardest. A
pensioner couple will face additional out-of-pocket costs of $200 a
year.
If the Senate approves the changes, the $7 fee will apply not
only to GP visits but to out-of-hospital pathology and imaging tests
from July 1, 2015. A higher co-payment will be charged for medicines on
the pharmaceutical benefits scheme starting in January, meaning general
patients pay an extra $5 per script and concessional patients an extra
80¢.
''The introduction of co-payments won't be shared equally,'' report co-author Clare Bayram said.
''It will particularly affect people who need to use more
medical and related services, such as older people and those with
chronic health conditions.''
The study examined clinical data collected from the
university's ongoing national survey of GP-patient encounters. The
Bettering the Evaluation and Care of Health (BEACH) program records
details of visits to a changing random sample of doctors.
It found one in four adult GP visits involve at least one
additional pathology or imaging test, meaning the minimum out-of-pocket
cost for the consultation was $14. About 3 per cent of visits involved
both tests or $21 in expenses.
The full impact of the co-payments and PBS changes will mean a
self-funded retired couple can expect, on average, an extra $244 a year
in health costs, or $199 for a pensioner couple, according to the
study. The average patient with type 2 diabetes would face additional
bills of $120 a year regardless of age, while families would pay $38
extra per child under 16.
Although pensioners with concession cards will only pay an
extra 80¢ for each PBS script, they have more prescribed medications
that will incur the co-payment increase than those without concessions.
Hence, they would be hit harder by the PBS changes than self-funded
retirees, the study found.
Dr Bayram said she was surprised by the size of the financial
impact on pensioners. ''It really emphasises that it's not going to be
evenly distributed,'' she said. ''These people need to use the services,
they're not making a choice.''
The university's findings echo concerns voiced by
professional health bodies. Australian Medical Association president
Brian Owler said it was ''good data'' that bears out the issues doctors
have identified with the planned co-payment.
''It actually shows it impacts the most vulnerable in our
society more than anyone else,'' Dr Owler said. ''It's the sort of
modelling that really should have been done before the proposal came
out.''
A recent COAG Reform Council report found 5.8 per cent of
patients were already delaying a visit or not seeing a GP because of
cost. That figure rose to one in eight for indigenous people. Similar
findings have been made by the National Health Performance Authority.
(Image by John Graham / johngraham.alphalink.com.au) Disability support pensioner Cathy McQueen says DSP
changes foreshadowed by Kevin Andrews and the Abbott Government border
on evil and may kill Australians.
While my disability has seen me scheduled to four different public
psychiatric hospitals and two private ones, nine times over a period of
18 years, I don't believe that will be enough to placate Mr Andrews.
You see, I am what they call a high functioning person with a mental
illness. That is in normal day to day life, I cope quite well and I can
certainly work at a high level too. I look and act completely “normal”.
It is just when I am put under stress – like in a high powered
journalism job for example – then I run the risk of becoming ill and
having my symptoms rear their ugly head.
I was a journalist for 17 years before my experiences in life and
journalism created such a severe case of PTSD that I could no longer
work. I couldn't even go out my front door at various stages, such were
the severity of the symptoms of this serious mental illness.
Psychological trauma
is a terrible thing, my psychiatrist says, and it actually damages the
brain. However, in Kevin Andrews eyes I would look healthy; I act
normal, apart from a bit of nervousness in public, and my PTSD is quite
possibly not permanent — with the right therapy and medication, one day I
might be cured.
Don’t get me wrong, I want to work just like he wants me to, which is
why I am studying for a law degree. I actually want to work for a
political Party as a policy adviser when I graduate. I know it is a job I
would be passionate about and I would adore so the chances of getting
ill are slim. I thrive on certain sorts of stress, for example.
But it would have to be the right job. If you stuck me in a job
waiting on tables or being a check out chick, for example, the stress
would trigger an episode of illness and I would be in trouble.
But this would be just what Kevin Andrews would want me doing.
He is also unlikely to let me get my law degree while being supported
by the DSP: I am sure the review will find anyone studying at
university can be considered to be working full time and, because it is a
law degree, I can almost guarantee I will lose my measly $300 — money
which enables me to get the distinctions and high distinctions I
achieved this semester, because I didn’t have to try to earn money to
support myself.
Andrews has it wrong — people on the DSP want to work, it is work
that doesn’t want us. Were I to have a PTSD episode at work, I would
lose my job — as I have twice in the past.
People – bosses and work colleagues – freak at mentally ill behavior.
If Andrews was serious about getting people off the DSP and into
work, he would be doing things like introducing quotas to the public
service, introducing draconian legislation to ensure that employers who
discriminated against people on the grounds of disability were dealt
with severely by the law and introducing financial incentives for
private enterprise to support disabled employees.
Instead – presumably as a pre-emptive strike to ensure people thrown
off the DSP have no-one to turn to – the Abbott Government has abolished the role of Graeme Innes, the Disability Discrimination Commissioner. (They retained their handpicked IPA 'Freedom Commissioner', however.)
If I wasn’t so anti Godwin’s law I would suggest some sort of fascist eugenicist policies at work.
It sounds dramatic, but I am starting to think it is quite possible they want to cull the disabled. According to The Guardian, when similar measures were introduced in Britain, people committed suicide and some even starved to death.
One way of getting rid of the burden of disabled people on society, eh?
The DSP is difficult to get, it is difficult to live on and it is
difficult to get off because employers don’t want to know anyone with a
disability.
Even if you try to hide your disability, when you sign on in paid
employment, the tax office informs the employer you are a DSP recipient,
which can often mean you get through your three month trial period.
This nearly happened to me with a part time job.
People on the DSP are, literally, the most vulnerable people in the Australian society.
The Abbott Government, with its overhaul to the DSP, it is not only
likely to harm and hurt them, it is abusing them and may quite possibly
kill them.
And Kevin Andrews? Just another Abbott Government example of a good
Catholic man — like Tony, like Pyne, Joe Hockey and God knows who else. Eight out of 19 cabinet ministers are Catholic, double the proportion in mainstream population. Four others belong to other Christian denominations.
Where has the Catholic Church gone so horribly wrong in producing these men without a modicum of compassion who want to harm the vulnerable. Where is their Christianity?
The changes to the DSP are bordering on evil and I am glad Labor will probably try to block them, given how supportive of disability issues Opposition Leader Bill Shorten is.
But until then, people like me will be living in fear of the phone
call or letter from Centrelink telling us our DSP is being reviewed.
