Nasty surprise … There has been a surge in the proportion of people paying gap fees since the government froze Medicare rebates. Picture: News Corp Source: News Limited
EXCLUSIVE
MORE than a million patients are paying medical gaps when they use their health insurance after the government froze Medicare rebates for specialists.
The effect of the 2014 budget nasty has emerged in the latest government health insurance statistics, which show the proportion of patients paying a gap has hit a five year high.
More than one in seven patients are now paying medical gaps up from almost one in ten at the same time last year.
The 3.4 per cent rise in the proportion of patients paying gaps in the last 12 months is the highest annual rise in gap fees on record since 2000.
The government froze Medicare rebates for specialists for four years to save $1.2 billion in the 2014 budget.
Patients cop it … The AMA says doctors rents and wages bills are rising, and they have to pass these costs on to patients. Picture: Supplied Source: News Limited
And Australian Medical Association president Professor Brian Owler has been warning the budget measure would drive up gap payments for privately insured patients.
“We’re going to see more and more of this,” he told News Corp.
“Many of us are in lease premises and those leases are indexed every year by 3 or 4 per cent, so we can’t continue to charge the same amount when all of the costs are going up,” he said.
“The only way people can combat that is to charge more and more people gaps,” he said.
Minister for Health Sussan Ley said it was more likely due to the flow on effects of consumers heeding calls to shop around in the wake of Labor’s cuts to the private health insurance rebate.
“Australians with private health insurance have witnessed a drop of almost $70 in the average out of pocket costs over the past 12 months — the lowest in seven years,” Ms Ley said.
“These figures suggest Australians are doing the sums and possibly downgrading from top-cover policies, including ‘no gap’ promises, if they’re not seen as delivering the best value.”
Although the proportion of patients paying a gap fee rose, the size of the gap has fallen.
The average patient gap in June 2015 was $135, the figures supplied by the Private Health Insurance Administration Council show. This was lower than the $200 average gap at the same time last year.
Biggest beneficiaries … Anaesthetists and optometrists had the biggest rise in gap fees. Picture: News Corp Source: News Limited
Other Health Department data shows increases in gap fees for specialists rising by almost 8 per cent on average to $79.40, well above the inflation rate.
Anaesthetist gap fees have risen by 19 per cent to $136.42, and the six per cent of optometry patients paying a gap fee saw that gap double to $21.35.
ACT residents face the biggest gap fees averaging $236. Next comes NSW with gaps of $215, while in Queensland the average gap fee was $112. In Victoria, it was $84, $59 in South Australia and $80 in Tasmania.
Medicare covers a portion of a person’s medical bills when patients use a private hospital, and health funds use Medicare rebates to determine their own rebates that cover the rest of the doctors bill.
Medibank, Australia’s largest health fund, has said it would not increase its own rebates for medical care until the government does in 2018-19.
Opposition health spokeswoman Catherine King said: “this is just further evidence of the increasing bills patients are being forced to pay as a direct result of the Abbott Government’s health cuts”.
“The Medicare rebate freeze is increasingly forcing GPs and specialists to abandon bulk billing and raise fees, and now over 1 million patients are being forced to pay a gap for their hospital treatment — the biggest annual, and quarterly increase on record,” she said.