NACCHO Aboriginal Health : Pap smear misleading claims


There are no changes proposed in MYEFO regarding the cost of either receiving or delivering a physical pap smear examination undertaken by your GP or specialist, nor their billing practices.

Nor is there any reduction in the dollar-value of the Medicare rebate a patient receives to undertake associated pathology tests.

Changes in MYEFO relate to an inefficient payment – worth between $1.40 and $3.40 – that is paid direct to pathology corporations separate to the Medicare rebate.

It is therefore not part of the patient’s Medicare rebate, as some have tried to claim today.

Alleged claims by pathologists about the potential cost of raising their prices as a result of any changes are also misleading, because they have omitted the value of the Medicare rebate a patient receives from the Government to help cover this very cost.

This payment was also only introduced in 2009 at a cost of $500 million over five years – it is not a long-standing or fundamental pillar of Medicare.

This is evidenced by the fact bulk billing rates for pathology are at similar levels now as they were prior to the introduction of this alleged incentive payment.

The Government made this MYEFO decision in acknowledgement of the growing competition for the nation’s health dollar and the need to ensure our investment in Medicare remains sustainable into the future.

For example, the Government also invested $1.6 billion in MYEFO on new breakthrough medicines, including a cure for Hepatitis C, which affects over 200,000 Australians.

It is important to acknowledge complaints from stock exchange-listed pathology companies about this MYEFO decision have revolved around impacts on ‘shareholders’ – not patients – exposing what is really motivating these criticisms.

Medicare is not designed to be a guaranteed bankable revenue for corporations, nor is a taxpayer-funded payment like this provided to cross-subsidise other costs of doing business for pathology companies.

As for Labor, they have no credibility on this issue after they were recently exposed for cutting $550 million from pathology and reinvesting it back into the budget, not health, as they like to claim.

Responding to articles like “Pap Smear tests not free “

Who wants to pay $30 to have a cold piece of plastic shoved inside them so their cervix can be scraped.

No? I didn’t think so.

But this is the reality facing women who need their pap smear once the federal government’s cuts to bulk-billing incentive payments kick in this July.

Pap smears, blood tests, urine tests and imaging services are all going to start costing you something (or, costing you more if you’re already paying for them).

Which doesn’t seem to make a lot of sense.

A Hospital Corpsman with the Blood Donor Team from Portsmouth Naval Hospital in Portsmounth Virginia takes samples of blood from a donor for testing on January 5, 2006. The Blood Donor Team visits multiple commands throughout the area in efforts to boost the blood supply for the Armed Forces around the world. (US Navy photo by PH3 Jeremy L. Grisham)(Released)Pap smears help detect cervical cancer before it’s too late.

Blood and urine tests are used all the time in preventative health care. They help doctors to catch heart, kidney and liver problems, and chronic diseases like diabetes. They are also the main way that we screen for STIs.

So this funding cut could spell the end of free sexual health check-ups, which sounds risky.

Sexually active teenagers are probably not that enthused about getting their STI checks. I can’t imagine making them pay for it is going to increase the number willing to do it.

There are also plenty of adults who will be less likely to get screened if they have to pay, some because they simply can’t afford it.

These changes were announced in the week before Christmas. They have also been made “at arms length” from the government.

It will be up to the companies that provide these services to decide whether to recoup their lost rebates directly from patients, enabling the politicians who removed the subsidies to wipe their hands of the impost.

“Not our fault the company passed on the cost,” they will probably say. “We didn’t force them to.”

But the reality is that these tests cost money, and the government is now providing less ($650 million less over four years to be exact) to cover the cost of doing the tests.

It seems pretty much certain that the for-profit companies that provide these services are going to be asking you to cover their losses.

The money has to come from somewhere.

This was confirmed by one major provider, Sonic Healthcare.

“The vast majority of patients do not have to pay any out-of-pockets for their pathology and radiology, so we really believe this is a co-payment by stealth because the only way we can cope with cuts of this magnitude is by introducing a co-payment,” chief executive Colin Goldschmidt told the Sydney Morning Herald.

“It creates a financial barrier to receiving medical services and it discriminates against those who can’t afford services. It creates an incentive for patients to miss important tests or scans that can lead to a misdiagnosis or a delayed diagnosis.”

Women are currently advised to have a pap smear every two years (although this is moving to every five years soon), then there’s the annual STI check (or more regular for some), and a lot of people need blood tests to monitor things like iron levels and cholesterol.

If you’re pregnant there will be plenty more of these types of procedures.

These services are the basics of medical diagnosis. Doctors rely on these tests and images to diagnose and treat you. They catch the things you cannot see.

Pathology Australia chief executive Liesel Wett told the AFR that about 70 per cent of medical decisions and 100 per cent of cancer diagnoses rely on pathology tests.

Medicare rebates for pathology and diagnostic imaging services haven’t increased for over a decade, and now more money is coming out of the system.

Over Christmas, Health Minister Sussan Ley announced the first tranche of items they want to drop from the Medicare Benefits Schedule.

image:×315.jpgPap smears medicare
Sussan Ley’s Medicare balancing act is proving a tough sell.

Doctors were furious that these proposed changes were announced over the break. They accused the government of trying to sneak an unpopular policy through while people are tuned out.

Medicare wasn’t set up to be a safety net. It was designed to provide healthcare to all Australians, regardless of their situation.

And it’s one of the most efficient health systems in the world. We have a higher life expectancy and spend less than many comparable nations in the OECD.

We should be careful to ensure that in trying to find “savings” the government is not allowed to take apart what is a wonderful Australian initiative.

Cold, uncomfortable pap smears for everyone. Not just those who can afford it.



One comment on “NACCHO Aboriginal Health : Pap smear misleading claims

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