A PRIVATE company would know whether a patient had an abortion, herpes or was getting mental health treatment if the government proceeds with a plan to privatise Medicare and medicine payments.
And they may be able to make a profit by selling patients’ health information to pharmaceutical companies.
The Health Department revealed in Senate Estimates it is spending $5 million on a taskforce of federal health bureaucrats and consultants to work out how to modernise the Medicare payments and whether to privatise the system.
Privacy groups are warning patients will face increased exposure of their personal details under the plan while getting no tangible benefit to offset the threat.
And an expert in medical billing has warned Medicare is so complex that no private operator would be able to do a better job than the Department of Human Services.
UNDER PRESSURE
He says the AMA would have no objection to privatising the business — as long as privacy and security concerns were addressed and doctors and patients consulted.
The AMA is calling on the government to change the system so a patient’s Medicare rebate could be assigned directly to the doctor.
This would give doctors an incentive to stop bulk billing and charge patients a small copayment.
A doctor who wanted to abandon bulk billing would no longer have to charge a patient a $50 fee upfront if this happened.
Instead the doctor would get paid the patients $37 Medicare rebate and be able charge the patient a $13 copayment.
IDENTIFYING FEATURES
In order to provide a Medicare or pharmaceutical rebate to a patient the private company would need the item number associated with the patient’s treatment and this is where the privacy threat emerges.
In many cases this item number can reveal highly sensitive information about the nature of that person’s treatment or the medications they are using.
It could reveal that a patient was prescribed an abortion pill, was using a mental health medication or had a sexually transmitted disease.
Health Minster Sussan Ley says she wants to drag the Medicare system into the 21st century so Australians can use cards to make ‘tap and go’ payments, and apps to make payments.
But Margaret Faux, founder of Synapse Medical Services, which provides medical administration and billing services told online magazine Pulse IT GPs and chemists are already using EFTPOS to claim government rebates which are paid direct to patients bank accounts.
DAMAGING EXPOSURE
Privacy groups have warned there is a greater risk that sensitive health information could get out if a private company runs the system because companies operate under a different set of rules to government employees.
“There is a privacy risk if this knowledge gets out,” says Privacy Foundation Australia information systems expert Dr Bernard Robertson-Dunn.
He says privacy is not an absolute and that it may be worth risking privacy if you get a greater benefit from a policy change. But that is not the case here because it is only the government — and not the individual — that will benefit.
MONEY TRAIL
“I would suggest that the number of more expensive, private sector employees who will do the very same work if this goes ahead, will be at least double, because they won’t know what they are doing. It won’t take long for the new vendor to understand that it takes an army of
human beings to correctly process Medicare claims.
“You can’t just read the MBS and then think ‘right, got it, now I’ll go program some software to do it’.”
The Opposition is fighting the proposed outsourcing claiming its an attempt to sell off Medicare.
“The Medicare data of Australian citizens is highly sensitive data. It is highly private data and the idea that the government would outsource to a for-profit company our Medicare, our PBS and our Age Care payments data, frankly, is an utter disgrace,” Opposition Health spokeswoman Catherine King said.
IS PRIVATE HEALTH PUBLIC?
Minister for Health Sussan Ley says Labor’s is running an ‘unfounded scare campaign’ on outsourcing.
“The Government would always maintain accountability for protecting the health data of individual Australians, as it does with the nation’s strict privacy laws,” she says.
“Australians are well-known early adopters of new payment technologies — from BPAY to ‘tap and go’ — through which they confidently share private and sensitive information, such as bank
details, every day.
“Consumers rightly expect the Government to keep up with technology needs while managing basic fundamentals such as their privacy.
“As no decision has been made, any possible outcomes on this process is pure speculation,” she said.