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Obstetricians rort the "safety net"

As we toured around Australia recently with the Future Birth program, the subject of the huge cost of obstetric care to the Australian public came up several times. Apart from the 30% subsidy that all taxpayers give to those who choose to take out private health care (which I consider to be a gross misuse of my money), the Federal Government has established a “safety net” designed to ensure that no-one is disadvantaged by being unable to afford the high cost of medical care (with both GP and specialists) when fees are charged over the basic scheduled Medicare rates that cover all Australians

The “safety net” was part of the Federal Governments platform for re-election last year. Those with private health cover are also included in this safety net, because private insurance cover does not cover all additional medical expenses and people find themselves paying for the extra charges, on top of their insurance premiums.

The obstetricians have been the big winners from this arrangement. They charge way above the scheduled fees for their services, and insurance cover still leaves a large gap to be funded by expectant parents. A neat story in the latest edition of “Birth Maters”, the journal of the Maternity Coalition, illustrates this well:

A Melbourne woman who was considering making a booking with a private obstetrician phoned his office to ask for the details of his charges, and exactly what the safety net covers. This is what she was told:

“ I pay him $3600.00 and the safety net picks up $1600. Apparently the safety net picks up 80% of out of pocket expenses which are incurred over $700.00 in any one year.”

Here is a simple calculation: If 30% of all women giving birth in one year (250,000 x 30% = 75,000) give birth in private hospitals, under the care of obstetricians, who each charge $3,600 for their services, Medicare is rebating $1600.00 x 75,000 = $120,000,000 via the safety net alone. There is also the ordinary Medicate rebate”.

No wonder this marvellous safety net scheme is so loved by the doctors. It is already known that the blow out in the funding for the scheme is hundreds of millions of dollars (and we haven’t yet reached the end of the first year of operation) and it seems that the obstetricians may be the main cause of this. Rumour has it that the Australian Medical Association (AMA) is aware of the way the obstetricians are using this scheme to make money for themselves and can see that this rorting of the system is giving doctors as a whole a bad image. It will be interesting to see if the AMA decides to take action internally to rectify this, or whether the obstetricians (who have a long history of going it alone within the medical fraternity) decide to tough it out with their colleagues until they are forced to change their ways by the Government.

Meanwhile, us poor taxpayers are again footing the bill for those extra little luxuries enjoyed by the obstetricians.

Posted by andrea at March 26, 2005 06:52 AM