Medicare changes to hit chronically ill

Health Care Homes funding policy could see those with chronic illness turned away.

GP and older woman with chronic condition

Announced on Friday, the Government’s Health Care Homes funding policy could see those with chronic illness turned away unless they’re willing and able to pay.

Under the Government’s proposed changes to how doctors are paid, patients with chronic illnesses, which include cancer and diabetes, will have their Medicare funding for treatment for these illnesses capped. And if they have to consult a GP for issues other than their chronic illness, Medicare will fund only five additional visits per year.

The model is based on that currently used to pay GPs for treating war veterans.  However, according to the Australian Medical Association (AMA) Vice President, Dr Tony Bartone, doctors are paid about 30 per cent more to treat veterans than will be allowed for patients under the Health Care Homes model. "We're concerned that the trial will fail and it's too important an initiative to fail," Dr Bartone said. 

Some doctors who initially supported the new model now claim that the Government is cost cutting and it is therefore likely to fail, with patients being left worse off.

"It sounds more like a cost-cutting exercise or a defunding exercise, and that's the last thing we need if we are to have a sustainable healthcare system that provides quality healthcare for patients," Royal Australian College General Practioners (RACGP) president Dr Bastian Seidel said.

"It's really difficult to see what patients gain. For our patients, I can't see a major benefit compared to the current system," he said.

The two-year trial of the program will commence in July 2017 in 10 regions, with $100 million being allocated. The trial will recruit 65,000 patients in 200 practices with chronic disease. The levels of funding will be tiered, with those who have self-managed chronic conditions being allocated $591 and those with multiple chronic diseases and moderate treatment needs receiving a Medicare benefit allowance of $1267. For those with the highest care needs, about one per cent of the population, the average payment to doctors will be $1795 per year.

A spokesperson for Health Minister Sussan Ley said the key to the program was to deliver services in a more flexible manner. "At the heart of stage one is an attempt to address common patient concerns that there is fragmented care being delivered under existing arrangements and we are looking at delivering Medicare in a more flexible and targeted way to co-ordinate clinical resources to meet patient needs."

In regards to the restriction on funding and the number of additional visits to see a GP, the spokesperson said that this was a trial only and that the funding "is an indicative figure for modelling and planning purposes and no patient's access to Medicare will be restricted or capped".

Read more at SMH.com.au

Read the media release at Department of Health

Opinion: Most vulnerable again at risk

Managing chronic conditions is often a merry-go-round of GP and specialist visits, interspersed with bouts of illness and pain, so worrying about funding for your treatment is the last thing sufferers need.

For those who have more than one chronic condition to manage, be it cancer, diabetes, back pain or mental illness, the future is often uncertain. Being able to work, look after a family and function as part of society is often hindered. And while there maybe no cure for such conditions may be available, there is a certain comfort that you can access medical treatment and support when needed.

So imagine then if this safety net is removed? What will happen to those who have reached their Medicare cap, or who have used up their additional five Medicare-funded GP visits? They will simply stay at home in pain, perhaps causing further complications to already complex medical conditions.

While a revamp of Medicare and a review of funding may be necessary, it simply isn't just to target those who are most in need. According to the RACGP, the sickest 12 per cent of patients rack up 40 per cent of overall Medicare benefits, receiving an average of 51 services a year. Under the new model, funding will only cover 48 GP visits each year. For a disease such as diabetes, the dressing of a resulting sore on the leg would require a GP visit three times per week – the 48 visits won't last long at that rate.

Of course, the Health Care Homes program is only proposed as a trial period, but will there be sufficient patients willing to give it a go if their health is the price of failure?

What do you think? Should access to Medicare benefits be limited for those with chronic pain? Do you suffer from chronic conditions? How would such a limit to treatment affect you?

  

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    COMMENTS

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    TREBOR
    7th Nov 2016
    10:07am
    I read somewhere in the doctor's blurb that they would be getting less money - and like so many others, they equate more money to them as being efficiency. My old doctor (recently moved) functioned well on pensioners etc on bulk billing - it was only with the Fat Joe/Big
    Toe's scare campaign, a flagship in their attack on 'socialised medicine' (read healthcare for all - they don't pay their their top class, precious darlings) that he decided to chop bulk billing and go to full price. The impact was precisely what FatJoe/BigToe wanted - the end user to pay more, and along with the freeze on BB, the government steadily paid less.

    The primary dispute is really between the doctors and the government, with the patient merely the meat in the waiting room, since historically every time the rebate has gone up to 'close the gap' (who remembers that one?) the doctors raised their fees (just like I hear dept Housing do with pension rises), and thus the rebate was perpaeually playing catch-up and thus there was perpetual upward pressure on it.

    I blame both sides - the government and the doctors - in this dispute that only really affects the end user - and proportionately affects the lowest paid end users most.

    I can foresee a time when getting a doc to attend a sick child will be a luxury - I almost died at 13 from double pneumonia that went untreated for weeks..... I know what that means.

    Shame on them all - all too over-fed and too comfy for my liking.
    TREBOR
    7th Nov 2016
    10:09am
    Coupla spelling mistakes above - being hassled by the ex to start tiling... which is more important, I ask you - tiling the bathroom or saving the world? (curses)....
    Rae
    7th Nov 2016
    12:14pm
    Yes TREBOR I'm deaf in one ear due to lack of medical treatment.

    I think this actually breaks the Accord. The agreement we made with business and government to tighten belts and only let those at the top have decent wage rises because there would be government services etc to make up for the lack of pay rises.

    Pity there are no Unions much left as we could do with a long drawn out general strike in my opinion so as to remind them what happens when labour acts up.
    Misty
    7th Nov 2016
    10:15am
    Saving the world Trebor and how come you are tiling the ex's bathroom?, X usually means just that X but then maybe you have stayed good friends and if so good on you both there should be more of it, life is too short to have enemies.
    Rosret
    7th Nov 2016
    11:24am
    What a clever ex she is, Misty! I think we need some training on "How to "
    TREBOR
    7th Nov 2016
    12:42pm
    Cunning as a schiessenhouse rat... got me as carer...... and General Dogsbody - though there was no promotion involved.
    floss
    7th Nov 2016
    10:36am
    Why does all the cost cutting effect the poor that can't defend them selves but never the rich that can afford it . Turnbull you govern for all Australians not the big end of town. For god sake show some back bone.
    particolor
    7th Nov 2016
    12:36pm
    I recon he goes to a Private Hospital to have his Finger and Toe Nails Manicured !!
    maxchugg
    7th Nov 2016
    2:12pm
    Good strategy, always go for the soft target. The poor will pay up or cop it sweet, as the case may be. The wealthy will meet them in court with a QC.
    KSS
    7th Nov 2016
    8:42pm
    Looney so chronic disease only affects the 'poor'? Not sure women in Sydney's North would agree with that, certainly as far a breast cancer goes.
    TREBOR
    8th Nov 2016
    10:01am
    I don't see where he said that, KSS - he is pointing out that it IMPACTS the poor more.
    ex PS
    8th Nov 2016
    12:02pm
    KSS, I think the point is that the illness may affect poor and rich alike, but it has more of a negative affect on the poor who can't afford the treatment.
    Therefore changes to Medicare have a higher affect on the poor. Those who can't afford Private Healthcare.
    Cranky
    7th Nov 2016
    10:46am
    It is always the poor that our Government is attacking. They never say how much they are prepared to give back from their tax payer paid salaries or perks they get. I said it before and I will say it again leave the poor alone and stop sending money supporting countries overseas
    instead of looking after our own first. Australia is one of the richer countries in the free world but treat their aged people like leppers - Max Jackwitz
    Dotty
    8th Nov 2016
    6:28pm
    I agree totally with you Cranky !
    Its always us poor old Pensioners that are hit below the belt and its taken
    from us and the big end of Town get no alterations to their wages or Tax at all !
    Dotty
    mogo51
    7th Nov 2016
    10:48am
    Back bone for Turnbull, a bit too much to expect I am afraid. The far right has him by the goolies and squeezing hard (paraphrasing the independent MP this morning).
    One poster got it 100% poor are easier targets, the rich fight and threaten precious funding. This includes many Multi Nationals.
    greygeek
    7th Nov 2016
    10:48am
    Sounds like my husband and I will be on the "scrap heap"! Between us we worked and paid taxes for 99 years, (not quite the ton!), since retiring he has been treated and is undergoing further treatment for three (3) non related cancers! I have severe osteoarthritis/trapped nerves and other medical conditions and one (1) of the pain relief prescriptions the Doctor is allowed to issue one (1) script only per fortnight!! So, we are both going to be paying more and more (again)!!
    Recent changes to the PBS system has meant our Doctors have had to find other drugs for us both, as some we used are now classified as only be available for "palliative care"!!
    Thankfully, my Doctor bulkbills me, he chooses who to bulk bill, according to their circumstances. Anyone over 65 automatically qualifies, a student working part time also is included, a dole bludger with no interest in finding work is charged!
    Yes, we do have private health cover, have done since we started working, but that does not cover Doctor's bills!
    So much for reaping any "rewards" for working so long!
    Rae
    7th Nov 2016
    12:21pm
    Talk to him about time in hospital while scripts are made up and for tests. Stuff done while in hospital is able to be claimed. We may need a heap more hospitals under this fair and sustainable flexible thingie Sussan Ley proposes.

    As I suggested above we were sold out under the Accord and the government has not fulfilled their part of the bargain.
    TREBOR
    7th Nov 2016
    12:47pm
    Greygeek - never lose sight of one salient fact - you are still paying taxes every time you buy or whatever anything... any time there is an exchange of cash, including to the pokies, you are paying tax.

    Do not be confused by the income tax argument that always holds centre stage - neither your status as pensioners nor this new retirement will keep you above the danger - the sar'major and I, we come from the paratroopers, where the pensioner is always the first out the door... because to follow your instincts and inspire your grand-children - you have to be with 'em where the metal meets the meat.

    Always wanted to do a Mel Gibson on here.... (We Were Soldiers)...
    Rae
    7th Nov 2016
    1:30pm
    Yes TREBOR I saw the USA when all the ordinary people slammed their wallets shut and the rich panicked. Printed off trillions of dollars and brought in universal health care.

    We haven't had a gold standard since 1968 so there is no damn reason we all can't have a better share other than ideology and feelings of superiority.
    Tom Tank
    7th Nov 2016
    11:15am
    This smacks very much of yet another attack on the universality of Medicare.
    To think the Libs got so hot another the collar about accusations levelled at them for this in the lead up to the last election.
    As usual with this lot it will only really impact on those who can't afford it.
    Look at the money they have slashed from Aged Care recently.
    Absolutely disgraceful while so many at the Big End of Town are laughing all the way to the bank to make there next donation to those in power.
    Old Geezer
    7th Nov 2016
    11:18am
    Euthanasia will stop a lot of this profiting from age care and the sooner it comes in the better. Old people should not be allowed to linger on in nursing homes with little if any quality of life.
    TREBOR
    7th Nov 2016
    12:49pm
    You mean, OG - they shouldn't have a Choice ™ in the matter? What a revealing statement........

    Choice-mobile, son - that's what it's all about (damn - Apocalypse Now now)...
    Triss
    7th Nov 2016
    1:30pm
    Old Geezer I'm more than appalled at your generalisation. Nursing home residents are human beings.
    Instead of looking at them with condemnation let's look at the true grit behind many of those elderly and confused looking faces. Many have brought up families on little money and have never asked for much. What about the ones who battled their way through the war and survived. Nursing home residents are people who need, and should get, our help and they don't need folk with low self esteem trying to demonise and condemn them.
    Rae
    7th Nov 2016
    1:33pm
    Well run public hostels employing the minimum wage workers they do would help too. There wouldn't be profiteering then.

    Maybe there might be a bit of quality as well if the owners were not there just to get filthy rich.
    Rae
    7th Nov 2016
    1:39pm
    And no it can't cause inflation in the middle of The Great Recession we are having because derivative traders got carried away. Seeing there are now thousands of trillions of derivatives our central bank could print dollars to build nursing homes with not a care in the world. No need to sell bonds either. It is gone too far now.

    The monster is out of the box and she won't go back in without a whole heap of wealth destruction. So we may as well have something to show for it other than a few rich pirates and CEOs and a whole heap of fancy houses.

    Anybody noticed the 25% of capital loss on your bank shares yet?
    Old Geezer
    7th Nov 2016
    1:51pm
    Rae do you realise that the most leverage product today is gold?

    Also bank shares like all shares and properties go up and down. You never have a capital loss until you sell.
    Tom Tank
    7th Nov 2016
    2:49pm
    It appears to be a pity Old Geezer that while you have knowledge of financial matters your knowledge and understanding of the human condition is sadly lacking.
    Old Geezer
    7th Nov 2016
    3:06pm
    Unfortunately my knowledge of what ails humans is actually better than my financial knowledge. Most human ailments are more mental than physical. So if you fix a persona's mental state then the pain felt by the body diminishes or goes away all together. Pain is actually mental not physical.
    Rae
    7th Nov 2016
    3:24pm
    Yes OG but that isn't a reason to not supply cheap hostel accommodation for the aged and sick. There is no good reason a few profiteers are raking in all that money.

    I think it will be a very long time before bank shares rise again.

    This government has introduced austerity and look at the european banks now. It is a lazy ideological solution that just does not work in a deflation.
    Old Geezer
    7th Nov 2016
    4:45pm
    Mmmm interesting with most bank shares up over 2% today.
    ex PS
    8th Nov 2016
    12:07pm
    Doctors are not against euthanasia for humanitarian reasons, they see the chronically ill as a good chance to make money and experiment with new techniques and medicines.
    If the government does not want to provide care for chronically ill people they should have the guts to make it easy for them to take themselves out of this life.
    Old Geezer
    7th Nov 2016
    11:15am
    Yes access they should be limited as the doctors are over serving these patients. I am one of those chronically ill patients and I am way over served by way too many doctors. They make many appointments for me and they are really just social visits to see if I am still alive. I reschedule them for all the same day so I don't have to make extra trips.
    Misty
    7th Nov 2016
    12:06pm
    So are you ready for Euthanasia Old Geezer?, you don't seem too happy with the life you are living at the moment, do you want to volunter to be one of the first? No one should be forced to agree to Euthanasia Old Geezer even those in Nursing Homes.
    Old Geezer
    7th Nov 2016
    1:48pm
    Yes I have what is necessary to end my life at my choosing. Alas I am enjoying living and having too much fun at present.

    All I said was that it was simply stupid allowing people to linger on with little if any quality of life especially in nursing homes. One would not allow an animal to suffer like this but we allow humans too.
    Triss
    7th Nov 2016
    1:52pm
    You know you don't have to go to all those appointments, Old Geezer, you can opt out. My doctor's surgery rings me up to have all sorts of tests done 'because of my age'.
    If I don't feel I need them I say 'no'. I'm not interested in having my bone density checked every year and I'm not interested in taking the very dangerous drugs I'll be prescribed if they decide I need it. I'm not interested in meeting the nurses to 'touch base' to see if anything is worrying me. So I stay at home until I think I need to see the doctor not the other way around.
    Old Geezer
    7th Nov 2016
    2:31pm
    I know that I don't have to keep all those appointments but I have a team of specialists that look after me and am part of research that helps others with my condition. So I see all of them on the same day and have a nice lunch as well.

    I also take no poisons (prescription drugs) which also amazes them as many people with my condition take quite a cocktail of poisons. The specialists are trying to work out why? The laugh at me when I tell them that the effect of their drugs has more to do with one's mental attitude than anything else.

    I see it as doing my bit for medical science.
    Rae
    7th Nov 2016
    3:32pm
    I wish you well OG and most certainly agree that mind over matter is a powerful magic.

    I'm surprised they laugh as most intelligent people are realising the power that belief has.

    This government we have has dangerous and destructive beliefs and is doing a great deal of harm to innocents.
    Old Geezer
    7th Nov 2016
    4:25pm
    So many people suffer pain when they should not. They then take pain killers that zonks them out so they don't feel as much pain.

    People need to take responsibility for their own health and no rely upon the government and question doctors ever time they write a prescription. People need to act like adults not kids being given a lolly to take the pain away. I feel cheated if a doctor writes a scrip as I feel they haven't given my condition the time it deserves.
    Not Senile Yet!
    7th Nov 2016
    11:19am
    We are ALL Australians.....we have the BEST Health Care System with Medicare...for those with Chronic Health Conditions!
    Why are the Libs..Party Puppets set on Dismantling it?
    We do not want a CRUEL American System of user pays....when the very condition restricts the ability to pay!
    It would be better to levy everyone a $1 a week for Medicare and retain it....not water it down by Stealth!
    I would rather pay $1.oo a week than Loose it!
    Stop voting for these Corrupt Party Puppets who want everything user pays like the American System...just for profit!
    Sack the lot of them!
    Start Voting & supporting Independents....to remove their Neo facist right wing power to do as they please!
    Old Geezer
    7th Nov 2016
    11:24am
    Medicare is being way over serviced and needs to be curtailed. It is good to see that the government is doing something about this as it is not sustainable in it's present form.

    It is simply stupid that one can not see a doctor without making an appointment sometimes weeks in advance. By that time I would have forgotten what ails me. The more doctors we get the worse this seems to get. Only one reason for this.... over servicing of patients.
    Misty
    7th Nov 2016
    12:11pm
    Old Geezer you really do seem to have a Bee in your Bonnet about being over serviced but then again I think you would also be complaining if you were not able to see the Drs, get out smell the roses, life was meant to be enjoyed but it doesn't seem as if you are doing this.
    Rae
    7th Nov 2016
    12:43pm
    It is only unsustainable due to recent changes.

    1. Too many new immigrants and not enough new hospital, doctors, nurses.All to keep wages low.

    2. A duel system of public and private instead of one really good universal system.All to provide wealth for a few rich health providers.

    3. The AMA , a union that controls the number of doctors and so imposes costs not needed.All to provide wealth for a few rich health providers.

    4. The cutting of taxes when wages stagnated due to the Accord which was supposed to ensure medicare was always available.
    All to keep wages stagnating and low.

    Pity you can't trust a LNP government to look after the ill and aged. Or realise fiat money can just be created at will. There is no gold standard limiting any of it.

    The aged care hostels are only glorified bed wards with minimum wage workers. The whole cost thing is a beat up to make a few owners and investors really rich.

    As most of the providers are multinationals there won't even be inflation because they take the money overseas and don't pay taxes anyway.

    If anything is unsustainable it's the funnelling of all the wealth into fewer and fewer hands. Especially when those hands live in some other country.
    Old Geezer
    7th Nov 2016
    1:58pm
    Rae all businesses are run to make a profit so why would nursing homes be any different?

    The bottom lie is that Medicare has become too expensive. Doctors are now guaranteed a payment for everyone they see so why not make the most of it.

    One has only to compare dentists with doctors. Dentists can only charge what they patient can pay whereas doctors have a guaranteed Medicare payment for everyone. Doctors can get very rich under such a scheme but dentists are constrained by what people can pay. That's what is wrong with Medicare.
    Rosret
    7th Nov 2016
    11:22am
    Isn't this an incredible dilemma. The medical profession found a way to keep us alive longer however there is a limit to what the country can afford.
    There are so many issues here.
    The true cost of medication(Pills) is astronomical, doctors salaries are proportionally too high in comparison to the rest of the community, equipment such as MRIs etc are hugely expensive and lets not even walk through the hospitals doors.
    The vast majority of Australians are on an average salary, hence the word, average. A growing percentage of our population are retiring and living 30 plus years into retirement. So when you say my taxes have paid for my medical bills, I hate to say, but I doubt it.
    In the 1980s a friend of mine had a brain tumor successfully removed at a cost of $250K when the average salary was around $40K. Later he had an Aortic valve replacement while on a pension in the 2000s at a very high medical cost.
    He never paid that much tax in his entire life. The system relies on not everyone needing this sort of treatment. However, the longer we live the more likely this will be the case.
    So how do we pay for it?
    Hopefully cancer treatments will come down to popping a few pills in the future and this horrible barbaric treatment will come to something people from the future will shudder at when they read our history books.
    Hasbeen
    7th Nov 2016
    11:50am
    Well said Rosret
    TREBOR
    7th Nov 2016
    1:40pm
    Your tax dollar was proportionately worth more when you paid it - don't forget that.... and it's hardly your fault that economies of scale don't come into brain tumours...

    The idea is to look at the costs overall - not at the few high price items - it's like the argument I put about penalty rates - the cost of business is worked out over the week - not over one day of the week.... if you can't compete - get out of business because you have no idea.

    You also raise one of the VERY high cost items, which significantly adds to the costs of medications - research, development and accreditation - that last can take ten years.

    Are we to forget all about trying to find that magic pill for cancer because the search adds to the cost of current treatments?

    It's indeed a conundrum.
    Alan
    7th Nov 2016
    10:33pm
    Rosetta
    The government has taken tax in the past to cover the retirees and we were to they put this into a fund to cover the retirees it appears they have used this elsewhere and now they do not have the finance o cover this. Why should we suffer for the governments incompetency.
    Crimmo
    7th Nov 2016
    11:36am
    We have to start assassinating politicians to deliver messages and wake them up to reality.
    Old Geezer
    7th Nov 2016
    11:40am
    They have woken up to reality but no one seems to like the reality of things.
    AussieTuca
    7th Nov 2016
    11:50am
    I totally agree...

    I have cancer and I am thinking in killing myself to avoid all these worries on top of all the ones I already have. If I succeed, please terminate them (the politicians) for me.
    TREBOR
    7th Nov 2016
    1:15pm
    Indeed they've woken up to reality - it's been more and more obvious over the past forty years that they have not only realised that there can be no meaningful opposition to them - but also that they can exercise unconstrained power = despotism at whim and none can gainsay them.

    We've seen that with both Labor and LNP..... hence the reason I have been calling every successive State Premier here 'the Fascist of Macquarie Street'.

    Claiming all the while to do what is best for we, the great unwashed, they do whatever they want or their personal special interest group wants.

    It's called despotism.....
    Young Simmo
    7th Nov 2016
    6:11pm
    Crimmo, include our stupid mentaly defected Judges and Magistrates who let murderers and rapists out to do it again.
    TREBOR
    8th Nov 2016
    10:06am
    What about the ones who abuse defendant's rights and accept conviction on accusation and the 'word' of a person of standing in the community first, or the supported 'opinion' of an expert (required by the Oz Supreme Court to be supported by fact these days) rather than applying the Rule of Law?

    Do we hang them, too? We'd have none left.....

    Now you're talking... we could start again with a clean sheet and men and women of honour in the jobs..... chop out the entrenched perjury and wrongful conviction in they system.... then we can start to work on the genuine bad guys - once the courts and their running dogs leave the ordinary citizen alone for a change and stop milking him.
    Rocky
    7th Nov 2016
    12:08pm
    I am on a Disability Pension already I don't have any super I live from fortnight to fortnight I have chronic illnesses with no cures I am tired of living this way all ways in pain I can really see why people commit suicide
    TREBOR
    7th Nov 2016
    6:08pm
    Hang in there, brother - I went from superbly fit from literally running up to eighteen hours a day etc, to hobbling on crutches and then walking stick for three years - with busted knee and spinal injuries.

    From an ace to an acehole overnight - and the depression that accompanies that can be deadly.

    It's not all that bad, really - and you will come out of it.

    Then it becomes payback time - dedicate yourself to working to better the lot of the ordinary person against the oppressing class....
    Queensland Diva
    7th Nov 2016
    12:30pm
    I had to laugh this morning when turnbull said on the radio with great scorn that Shorten is caving into the left of his party. turnbull is forever at the mercy of the far right of HIS party and it's they who believe that the sick and poor in this country deserve to be bullied and cowed.
    KSS
    7th Nov 2016
    9:03pm
    Doesn't change the fact that Mr Shorten is beholden to the far left, unions and Greens though does it?
    TREBOR
    7th Nov 2016
    11:28pm
    Name this 'far left' - I understand they are part of the Labor party - such types worm their way in, same as far rights do, but generally speaking, the Labor Party is nowadays considered to be just to the right of centre. Certes it has a lot of 'strong centralised government' about it, with its imposition of Party favourites and ideological clones on branches etc.. the 'parachuting' of candidates, but they are not alone in this.

    Of course, their attitude towards government is no different in reality from the LNP - 'we' are the government and you'll do as we say or we'll legislate against you and/or deprive you of your living.

    Both, of course, follow the demands of their own personal special interest groups and look after themselves first and foremost and adhere to an ideological base - but the reality is that as governance goes, there is the thickness of a cigarette paper between the two sides of The Tag Team we are forced to endure.

    Tag Team - one lot gets in, gives us mere mortals a pounding, then hand-slaps the other in, who then do nothing about the previous pounding, but hand us another one... then they hand-slap the other ............

    Hands up anyone who actually believes that a Labor government next time around will fix all the things the LNP are striving so earnestly to undo at this time? Anybody?......

    We all know it will just be - "Oh, yes - we were going to fix that.. and the people quite obviously wanted it fixed which is why they voted us in .. but let's make the announcement that not much can be done too quickly due to budgetary constraints placed upon us by the LNP when they were in.... that'll hold 'em for a while until we get on a bit more with our agenda - more women, more gays, more affirmative action - less rights and less earning power and thus social and economic power to the damned men who might stand up to us... can't have that!"
    Eddy
    7th Nov 2016
    11:57pm
    But remember KSS while it may be true that labour policy is 'dictated' by the unions (both left, right and centrist) they do it publically at their annual conference, the unions are 100% Australian. However Liberal policies are dictated by BIG BUSINESS who, in many cases, are nowhere near 100% Australian, and it is done in secret. I know which version I prefer.
    Eddy
    8th Nov 2016
    1:40am
    Be Fair Trebor, the previous Labour Government tried many things but was hamstrung by the same situation now facing the Liberals, a Senate over which they had little control, the only way to get their legislation through was to 'negotiate' with Greens/independents etc in a quid pro quo basis As for the Liberals they were not so stupid to 'undo' everything Labour introduced unless they could manufacture some political advantage, the so called Carbon Tax is a prime example. They 'undo' anything they don't like by stealth, eg Medicare/Medibank. They haven't started on NDIS yet. but that is coming.
    For those currently receiving the OAP there is a proposal to index pensions by CPI rather than PBLCI. I am not sure people understand what this means in monetary terms so looking at Military and public service pensions, which are indexed by CPI, could be useful. In the period from 1989 to 2009 military & PS pensions were indexed by about 70%, in the same period OAP indexation was about 130% and MP pension indexation was about 140%. This is what Liberal governments call 'not cutting pensions' rather they will slowly strangle them by not using an appropriate indexation method, just like that are now doing with Medicare
    TREBOR
    8th Nov 2016
    10:13am
    I'm going back over the past forty years or so, Eddy - and looking at track records and also at future direction at this time. Labor is lapsing deeper and deeper into their self-created ideological mire, and has been over-run by special interest groups of its own, largely of its own making, and beginning when the Union movement deserted its own and started to become a strong right arm of affirmative action in the 1980's.

    I know - I was there as a Union delegate, copped all the flak from management, lies and all - and then applied, after being wrongfully sacked, for a full-time job with the Union at a time they were recruiting - to be told they were 'considering applications' from women and ethnics.... meaning they were offering those groups affirmative action, and were abandoning their own who had lost a great deal standing for them.

    No, sir - I cannot be convinced of the merits of such social engineering projects - and their outcome is clear to see right now in the utter lack of cojones in Labor.

    Livelihoods and personal power are not playthings for social engineering - leave that to the academics in their glass castles.
    TREBOR
    8th Nov 2016
    10:17am
    "This is what Liberal governments call 'not cutting pensions' rather they will slowly strangle them by not using an appropriate indexation method, just like that are now doing with Medicare .

    Too true, Eddy - the death of a thousand cuts is a far better way to go, for the LNP.

    I doubt the retirement benefits for the public service senior management people went the same way as the rest......... a clear distinction between the cattle in the fields pulling the ox cart and the drivers sitting with a beef sandwich on the front seat....

    The strategy of cutting Defence pensions was different in approach only from that of Thatcher - she just cut them.....
    Eddy
    8th Nov 2016
    12:22pm
    I do not want to get into a tit-for-tat argument with you Trebor but all Labour governments in the last forty years have never had absolute control of the Senate. The Libs when they controlled both houses bought us the GST (after Howard stated there would be 'no GST') and Workchoices. I don't think there is any doubt that Workchoices was a disaster for the non-managerial workforce. Whether having a GST is the best for Australia is a moot point as a proper debate on tax reform was stifled by Howard.
    tactful
    7th Nov 2016
    12:49pm
    Pensioner do not contribute anything to Medicare. Pensioners and other receiving welfare payments are not charge a levy.
    In fact welfare recipients, including age pensioners, do very nicely thank you, they receive their medical treatment without putting anything in towards the payments.
    Those who work or put in tax returns pay a Medicare Levy, it is these people who are funding the medical/hospital treatment of welfare recipients.
    Everything MUST be put into perspective. It also comes down to this:
    1. G.P.'s get their older patients to come in regularly, whether or not they need to.
    2. Specialists prefer not to see pensioners, they do not want to bulk bill
    3. How often does the G.P. double check the medications he/she has prescribed to ensure there will be not unnecessary side effects.
    4. This type of "service" can be performed by the practice nurse or by the patient's Pharmacist.
    5. Due to age are we pensioners' being ripped off, are we subject to many and varied tests, x-rays, prescriptions to simply bolster the G.P.'s patient quota.
    6. This also applies to pensioners' in aged care facilities, the G.P. drops by has a quick look at each resident, does not usually write a script and he gets payment for each resident he says "Hello" to.
    7. It is high time that Medicare is wage based, I would surmise many of us know highly paid working people who can easily afford to pay for their own health care by way of Private Health Insurance, yet they happily join waiting lists to use a public hospital.
    My understand was Medicare is the safety net for those who cannot afford to pay.
    greygeek
    7th Nov 2016
    1:16pm
    "My understand was Medicare is the safety net for those who cannot afford to pay. " Your last line, tactful is interesting!
    two years in a row now, we have reached the Medicare "safety net" limit by the first week in February!!
    We are using a huge amount of our savings on medical bills, private health cover and prescriptions.
    Savings which were to be used to allow us to have some enjoyment in retirement, is being gobbled up by the healthcare system!
    I could earn an income, if a newspaper decided to have a weekly "waiting room" review, based on the same format as the "restaurant" reviews!!
    Topics covered, receptionist - attitude, ability. waiting room - comfort of chairs, age of magazines, atmosphere, appearance (need painting?), any tea/coffee/water facilities? Toilets in close proximity? ease and cost of parking and accessibility to the Doctor's rooms.
    Does the Doctor generally "run on time"? Is the Doctor "human" in verbal interaction with the Patient? That is, using terminology non medical persons will understand! Attitude of the Doctor?
    I could go on, and I have visited enough waiting rooms to keep myself employed for quite some time!!
    Then I could pay more taxes to fund health services for those who have never paid tax in their life!!!
    TREBOR
    7th Nov 2016
    1:19pm
    Yes, they do - pensioners and unemployed etc are taxed on every movement of every dollar - unlike say, your international companies.

    Every member of society, even those earning on the black market, pay taxes......
    Rae
    7th Nov 2016
    1:53pm
    All workers from the 80s onwards went without pay rises after the ACCORD was signed. Medicare was part of that trade off.

    Howard didn't have to privatise it and spend billions making profiteers wealthy.

    Admittedly a lot of people don't need the over servicing either.

    In a fully public system there would be no need for profits at all nor over servicing. Or billions of rebates for private insurance because there would be no private system except a few places for the excessively rich.
    Tom Tank
    7th Nov 2016
    3:01pm
    Sorry Tactful but Medicare was never meant to be a Safety Net.
    It started life as Medibank and we all contributed a percentage of our salary into that.
    The LNP tried from the outset to destroy it because it worked against their ideological beliefs and they looked on Medibank as Socialised medicine. Wow the next thing would be Communism, a touch of the Reds under the Beds thinking.
    It had to be reborn as Medicare following one of the LNP Governments of the past but we all still paid into it from our wages.
    If it is short of funds then why not take the millions of dollars used to prop up the Private Medical Insurance Funds as without taxpayer's money going into them they would collapse.
    It is funny how the LNP put all that money into that but refused to provide any support for the car industry.
    Rae
    7th Nov 2016
    3:55pm
    Hey Tom the LNP is in the bed with the Reds not under it. I said that Robb was after a cushy job with the Chinese government sponsored corporations and got howled down if I remember. Sorry to say I was right.

    Yes take the Private Medical Insurance money and possibly renationalise the Lottery and Lotto. Remember when they were used to support hospitals and aged care?
    Alan
    7th Nov 2016
    6:20pm
    When are you guys going to realise that we have worked all our lives paying into a so called fund which the government was supposed to use when we retire. I think you need to change your sign on as you are obviously not tactful. And at a guess you have an super system which will make you independent unlike the the current retirees who have virtually nothing.
    Old Geezer
    7th Nov 2016
    7:39pm
    I know nothing of the existence of fund the government is supposed to use when we retire other than one called general revenue. I also realise that welfare in the form of the OAP is only available to those who haven't the means to support themselves. Unfortunately a lot of people have found ways to get this welfare when they shouldn't. This makes it more difficult for everyone and especially those who really need it.
    Eddy
    8th Nov 2016
    2:12am
    Wow, I have to agree with OG again. OAP have been paid from General Revenue since 1909 (prior to that there were some state based schemes). However I really dislike using the term 'welfare' , it was always Social Security until politicians started 'Americanising' our language to try to demonise recipients of pensions and allowances.
    For the record I do not receive the OAP, our source of income in my military and public service pensions plus a disability pension from DVA. From that I paid tax of over $7000 plus $1400 Medicare levy.
    Eddy
    8th Nov 2016
    11:02am
    Hi Tactful, you may be right that pensioners do not pay the medicare levy, but in a lot of cases they did. The exceptions would be those mothers who did not do paid work (but raised their children, supported their husbands, looked after grandchildren, did volunteer work etc), long term prisoners (axe murderers, child molesters, rapists etc), the mentally ill, the chronically ill, and probably some others I have forgotten. Are these people to be excluded from Medicare simply because they did not actually contribute. They are like the cyclists who use our roads but pay not a cent in fuel taxes and registration fees to pay for the roads.
    Medicare is not a 'buy in' scheme (like private health insurance) but a universal care system, the only qualification is being ill and being eligible (due to citizenship or permanent residency). I am happy to pay my taxes and levies for the common good. Are not you.
    Rene
    7th Nov 2016
    1:13pm
    At the moment I have to wait 6 to 8 weeks to see my Doctor, only to have him tell me I just have to manage the pain....went to someone else got in straight away managed to get a referral to Rheumatoid Clinic at Monash, still waiting for appointment 5 months later, seems no-one gives a hoot about someone suffering pain, and not been able to hardly get around, hate to think what it is going to be like if they continue to bleed the Health System for the aged....all I can say to all you Liberal Voters just remember one day your going to get old and in need of pain relief too....maybe it is time for Euthanasia Bill to be passed....if your going to just lets us suffer we may as well have a choice to at least die with some dignity.
    TREBOR
    7th Nov 2016
    2:24pm
    The system is replete with such stories - myself I had very serious cardiac artery issues and the doctor I had in Queenslund (where they do things diff'runtly) shilly-shallyed around - two people with the same name as mine (pretty common) died while waiting.

    We (the now ex and I) were about to head south and I just said - "Let's go and take the chance!" Saw a doctor within a couple of days down South, into the Cambra Hospital in a month, and fix done by the top specialist in the country - and a good man, too, who deserves a medal, and who charges me Medicare rebate.

    If I'd waited for the turkey up north, I'd be overseeing the daisies I'd be pushing up......

    Doctors need to be regularly analysed to detect any signs or symptoms of God Disease - same as politicians....
    Charlie
    7th Nov 2016
    2:18pm
    I'm quite prepared to reduce my doctors appointments if the government stops making such a fuss about the security, on the pain medication I will be taking the rest of my life. All they have to do is give me a 12mth script instead of 3mths.
    Old Geezer
    7th Nov 2016
    3:09pm
    Have you considered doing a pain management course instead of taking pills? If you can train your brain to accept pain life is so much easier.
    babyboomer
    7th Nov 2016
    4:00pm
    no. chronic pain is only one of a miriad of chronic conditions. My sister has been diagnosed with 2 incurable conditions at only 63 years of age. She has already used up all her sick leave. long service leave etc and is now having to fall on the mercy of centrelink. No private health fund for her on small income. She's looking at a life of increasing dependence, pain, immobility etc. How will she have any quality of life with very limited doctor appointments?
    Young Simmo
    7th Nov 2016
    5:37pm
    I apologize for the slight change of subject but Kaye, can we please have a discussion about that Fictitious thing called Pain Specialists. Nobody I have spoken to says that their Pain Specialist has reduced their pain. I know from my own experience that the "Pain Specialist" could not have cared less about my pain. All he wanted to do was get my pain medication stopped at any cost. He told my Doctor that I didn't need it and to give me something like Bex or Asspro. These guys get flown out of capital cities all over the country, put up in Hotels with free food and I assume a salary that is better than my pension. An absolute rip off.

    7th Nov 2016
    5:40pm
    I must have read the article wrongly because it says to me that there is a trial period and no patient's access to Medicare will be restricted or capped. Then we have a doctor quoted as saying that he is concerned that the trial will fail. In all fairness, it may have been better to lead off the article with the government's proposal rather than the negative doctor's response to the proposal. I wonder if the doctor quoted has seen all of the proposed trial.

    How do we really know whether this will work until the trial has been carried out with the good points being adopted and the bad points amended. The reaction so far reminds me of those in parliament who will rush to the media with doom and gloom without actually reading a new Bill but are prepared to castigate the other side and manufacture problems that may never arise. Surely we can allow the trial to rise or fall on its own merits as I'm sure the opposition will let everybody know if it fails.
    KSS
    7th Nov 2016
    9:23pm
    Yes well Old Man the contributors on this forum are an athletic lot, climbing on their high horses, jumping to conclusions, balancing chips on both shoulders and running off with the wrong idea!
    TREBOR
    7th Nov 2016
    11:31pm
    Well - why not just hang 'em on suspicion? Their track record validates that position....
    Alan
    7th Nov 2016
    5:47pm
    I could be one of the ones who may loose out because of this stupid government. I have copd and i am slowly deteriating. How come this Susan lea is punishing the most vulnerable. Most people with chronic illness are close to retiring if not already retired, we cannot afford to pay for our treatment. I guess labour was right, the LNP are trying to get rid of Medicare and go to the American system where everyone pays. The MPs aren't worried as they are covered for life and couldn't give a stuff about the real people. Sometimes, I know it's not nice, but I hope one of their poorer relatives gets the disease and can't pay for it. We work all our lives and get left in the lurch by these so called humans.
    KSS
    7th Nov 2016
    9:42pm
    And most people with chronic conditions have made poor lifestyle choices that have had these consequences. For the most part chronic conditions are avoidable, most are manageable long term and some even reversible with a bit of effort and a lot less self pity.
    TREBOR
    7th Nov 2016
    11:35pm
    It's a poor lifestyle choice to grow up in an industrial city filled with smog and iron particles? I also have copd, as does my ex.... it's a form of Gulp War Syndrome.... you gulp down that air and it settles in your lungs and starts to grow ...

    Some people get it over a long period working in wheat areas etc - that can cause allergies beyond belief... and eventually all such things have an end effect much like the lung diseases that used to affect cotton mill workers and miners (White Lung and Black Lung Disease?)... gasping for breath, shortness of breath, feeling of drowning sometimes, and permanent medication to keep the passages clear.
    Alan
    7th Nov 2016
    11:48pm
    Trevor
    You are making assumptioms as to how the disease started and it shows lack of knowledge and this is why the government are making big mistakes also. In my case it started due to several childhood illnesses which were beyond my control. Should I be penalised for this. You appear to have know knowledge in this are
    Alan
    7th Nov 2016
    11:50pm
    Sorry I had typo
    Trevor should be trebor
    Misty
    7th Nov 2016
    11:55pm
    What a load of rubbish KSSS, some chronic diseases maybe caused through poor lifestyle choices such as drug and alcohol abuse but there are many other causes of chronic diseases also, and so to say that poor lifestyle is the main cause is incorrect and insensitive to say the least. I am sure your statement will offend a lot of people commenting on here who have, or know someone with a chronic disease not caused by poor lifestyle choices and not filled with self pity.
    Misty
    7th Nov 2016
    11:59pm
    And who are you Alan to say Trebor is wrong about how his condition started?, do you have expert knowledge of how all chronic diseases start?.
    TREBOR
    8th Nov 2016
    10:26am
    You are taking it very personally, Alan - which is understandable - but let me assure you that your case is but one way such illness can start... I by no means said the ways I described were the only ways. There are many people who grew up in sickly industrial cities who have this problem.

    7th Nov 2016
    7:59pm
    typical labor article, this trial is stated as a certainty, a doctor's statement is called as proof, yet same doctor agreed with this trial and then realized his purse was not big enough to pocket the extra dough!
    reading the comments in this column it is not hard to see the political sides on this issue, some comments even had their opinion on the tiling, what that had to do with this article only god or allah knows. to me the issue is so simple, it is between the doctor and medicare and as for my opinion and regardless of the status everybody should contribute to their health, I do, when I visit my doctor he charges me $ 74.00 and I receive about $ 37.00 back, I visit him at least 2 to 3 times a month, he recommended a specialist, who turned out to be a great guy, cheaper than my doctor and he put me on what was mentioned in the replies in these these columns a pain management course, it made a hell of a difference to the condition I have and yes it would be great to be a 21 year old again, however being close to 80, I accept and love to be able to read the comments of the so called hard to be done by's, only wish as I am, that they knew how lucky they are, to still be able too see the sunrise, feel the rain, listen to the birds singing and to meet up with their families, their grandchildren, their great grandchildren. instead of worrying about how hard life is, just ask yourself what age were you when your Mother or Father were able the last time to give You or your children a cuddle? and yes as we are getting older and life becomes harder it is still better than to be six feet under!
    Mimi
    8th Nov 2016
    10:15am
    Hi, most of the attitudes revealed here make me wonder why I still bother to work as a family GP after 39 years.You people do not know what goes on in general practice. These medical homes will be taken up by the big corporate centres, which will try to attract the patients of local GPs, to make the extra money. Patients will then likely see different GPs at each visit and be referred to the allied health practitioners at the centre, with no choice. They may not get on with those practitioners. Meanwhile the average GP will lose patients, be forced to charge some patients whom they usually bulk-billed, and many older GPs like myself will retire. There is value in having a GP whom you see regularly, and who knows you and your family, and, in my case, your family history and social situation.I earn little more than the average wage as I can only work part time. At the age of 65 I can't afford to retire, and being self employed, get no benefits such as sick leave, holiday pay etc.I like seeing patients and will try to work for a few more years.
    These 'medical home' models are only being formulated to save money.
    I do have patients who need to be seen at least monthly, if not more often, and I am not over-servicing, as one post suggested doctors are doing. And as for doctors charging a gap for GP services,we are not allowed to do this, and if we choose to bulk-bill we receive about half of the recommended AMA rate, and this rebate has been frozen till 2020. What other profession gives you a 50% discount?
    TREBOR
    8th Nov 2016
    10:33am
    I think the question is whether or not the 50% is an adequate remuneration for the work performed, Mimi. You say you work part-time, so your income is relatively low, so it seems that if you worked full-time, your situation would be different. Appreciate your issues, and agree with much of what your say, but I think the main issue here is not nursing homes per se, but the attack on the same Medicare that affect you as well.

    How much is enough to live on and run a small business?

    Personally - as a doc, which I view as a calling and not a living, I would be in harness until I dropped in the traces.... but that's just me.
    TREBOR
    8th Nov 2016
    10:45am
    Oh - and you need to look at the comparative spending power of a pensioner compared with many.... $70 out of $1000 may not be much, but out of $440 it is.
    KB
    8th Nov 2016
    10:29am
    Only the wealthy will be able to afford health care. Pensioners will not be able to access medical care and will end up not visiting the doctors for chronic health conditions.The trial will not be ethical I have had to have numerous test and without Medicare and pensioner card I would not have been able to pay for all the medical tests. A CT scan cost 237 dollars.Struggling pensioners would not be able to afford to pay that amount. Mediical require upfront payments.How about allowing people struggling to make arrangements to pay off ijnstallments.
    KB
    8th Nov 2016
    10:29am
    Only the wealthy will be able to afford health care. Pensioners will not be able to access medical care and will end up not visiting the doctors for chronic health conditions.The trial will not be ethical I have had to have numerous test and without Medicare and pensioner card I would not have been able to pay for all the medical tests. A CT scan cost 237 dollars.Struggling pensioners would not be able to afford to pay that amount. Mediical require upfront payments.How about allowing people struggling to make arrangements to pay off ijnstallments.
    ex PS
    8th Nov 2016
    12:17pm
    Pensioners have themselves to blame, most of them would have voted for one of the so called major parties in the last election. You don't try to pat a snake and then complain when it kills you.
    Misty
    8th Nov 2016
    12:24pm
    Well exPS some of the Independents are hopeless and some are aligned with the major parties so we don't have a lot of choice do we, damned if we do and damned if we don't.
    PlanB
    8th Nov 2016
    2:00pm
    I voted Independent -- not for the two -- or 3 main crooks
    TREBOR
    8th Nov 2016
    2:37pm
    Same here and proud to state so in public.
    PlanB
    8th Nov 2016
    2:04pm
    I would love to see those that bring in these ideas -- in the same position as many less well off and ill people are and see how the hell they would like it.

    I would not trust that Sussan Ley as far as I could kick her uphill with a lead boot another smirking scum
    terrib
    8th Nov 2016
    2:22pm
    I have just had my monthly visit with my Doctor & he has organised a Facet joint injection to the spine to help me with my pain. However I had to ring to cancel due to the fact they wanted me, a pensioner, to pay $546 up front then get a rebate with Medicare. I only have the pension as income no super, no house, no assets, so could not afford the upfront payment. Rang another radiologist & thank goodness they still bulk bill. Heaven help us if they all decide to go down the same road because the government has cut spending to Medicare.
    TREBOR
    8th Nov 2016
    2:36pm
    Yes - had that experience - some docs think everyone is on the same level of income as they are... I've had to cancel due to cost - about a week's pension just to get in and if the doc took a look at my throat, that was double.

    Pay me first for my consultation, and if I so much as take a look at your problem - the sky's the limit.

    I seriously doubt most of them are that good.

    All the good ones - best in their field - that I've had have charged me nothing.
    Dotty
    8th Nov 2016
    6:41pm
    Now lets get back to the actual question we all started out complaining about and that was the cost of Medicare and how it will affect those of us with Chronic illnesses ,Diabetes etc !
    We are drifting off that and now we are on to the part where some of like this one in one Party and the other like's another in another party !!
    I am getting confused about what we are talking about !! Dotty
    elephants
    9th Nov 2016
    11:44am
    Well it sounds like those that are in cronic pain day in day out with no help are lost. Let with terrible consequences one way out..that will be how they feel. We are becoming so Americanised in our health system. We hear the terrible stories of the lower class over there.SO IF YOU DONT HAVE PRIVATE HELP OR A MILLIONAIRE GOD HELP YOU. What is this government coming to. There are countries out there that have wonderful health care. Unemployment plans. Aged care plans etc but what do they do NOT LEARN FROM COUNTRIES THAT WORK no why do we have to take on things that DON'T


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