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Medicare is covering less of specialist visits. But why are doctors’ fees so high in the first place?

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/susan-j-mendez-2219444">Susan J. Méndez</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a></em></p> <p>Fees for medical specialists are going up faster than <a href="https://www.abc.net.au/news/2024-09-25/medicare-rebates-only-covering-half-of-specialist-costs/104389360">Medicare rebates</a>, leading to a bigger gap for patients to pay.</p> <p>Recent data from the <a href="https://www.aihw.gov.au/reports/medicare/mbs-funded-services-data/contents/summary">Australian Institute of Health and Welfare</a> shows that in the first quarter of this year, Medicare rebates covered just over half (52%) of the total fees. This is <a href="https://www.abc.net.au/news/2024-09-25/medicare-rebates-only-covering-half-of-specialist-costs/104389360">down from 72%</a> two decades ago, and the lowest proportion on record.</p> <p>Doctors can charge what they like, while the government determines the Medicare rebate. The difference between the two, or the gap, is what impacts patients. For GPs, the government provides an incentive for doctors to <a href="https://www.health.gov.au/our-work/increases-to-bulk-billing-incentive-payments#1-november-2023-changes">bulk bill</a>, but there’s no such incentive for other specialists.</p> <p>Doctors blame large gap payments on rebates being too low, and they’re partly right. After adjusting for inflation and increasing demand, the average dollar amount one person receives in Medicare rebates annually dropped from <a href="https://www.aihw.gov.au/reports/medical-specialists/referred-medical-specialist-attendances">A$349 to $341</a> over the past decade.</p> <p>But this is only a part of the problem. When many people can’t afford hundreds (if not thousands) of dollars for essential specialist care, we need to look at why fees are so high.</p> <h2>How do specialists set their fees?</h2> <p>Although general practice is technically a speciality, when we talk about medical specialists in this article, we’re talking about non-GP specialists. These might include paediatricians, oncologists, psychiatrists and dermatologists, among many others.</p> <p>In determining fees, specialists consider a combination of patient-level, doctor-level and system-level factors.</p> <p>Patient characteristics, such as the complexity of the patient’s medical condition, may increase the price. This is because more complex patients may require more time and resources.</p> <p>Specialists, based on their experience, perceived skill level, or ethical considerations, may charge more or less. For example, <a href="https://www.sciencedirect.com/science/article/pii/S0277953623007104?via%3Dihub">some specialists report</a> they offer discounts to certain groups, such as children or pensioners.</p> <p>System-level factors including the cost of running a practice (such as employing staff) and practice location also play a role.</p> <p>Problems arise when prices vary considerably, as this often signals limited competition or excessive market power. This holds true for medical services, where patients have little control over prices and rely heavily on their doctors’ recommendations.</p> <p>In <a href="https://papers.ssrn.com/sol3/papers.cfm?abstract_id=4909881">recent research</a>, my colleagues and I found fees varied significantly between specialists in the same field. In some cases the most expensive specialist charged more than double what the cheapest one did.</p> <h2>Doctor characteristics influence fee-setting</h2> <p>My colleagues and I <a href="https://doi.org/10.1016/j.healthpol.2024.105119">recently analysed</a> millions of private hospital claims from 2012 to 2019 in Australia. We found the wide variation in fees was largely due to differences between individual doctors, rather than factors such as patient complexity or the differences we’d expect to see between specialties.</p> <p>Up to 65% of the variance in total fees and 72% in out-of-pocket payments could be attributed to differences between doctors in the same field.</p> <p>To understand what doctor-level factors drive high fees, <a href="https://papers.ssrn.com/sol3/papers.cfm?abstract_id=4909881">we looked at</a> data from a representative survey of specialists. We found older specialists have lower fees and higher rates of bulk billing. Practice owners tended to charge higher fees.</p> <p>We also found doctors’ personalities affect how much they charge and how often they bulk bill patients. Doctors who scored more highly on the personality trait of agreeableness were more likely to bulk bill patients, while those who scored more highly on neuroticism tended to charge higher fees.</p> <p>What we couldn’t show is any evidence fees were associated with competition.</p> <h2>Effects on patients</h2> <p>This is not a competitive market. On the contrary, it has high entry restrictions (long training requirements) and a limited supply of specialists, particularly in <a href="https://www.aihw.gov.au/reports/workforce/health-workforce">rural and remote areas</a>. Meanwhile, patients’ access is controlled by the need for referrals which expire, generally after a year.</p> <p>Patients are often unable to shop around or make informed decisions about their care due to a lack of information about the true cost and quality of services.</p> <p>For private hospital services, the fee structure is complicated by the fact that several providers (for example, surgeon, anaesthetist, assistant surgeon) bill separately, making it difficult for patients to know the total cost upfront.</p> <p>Despite efforts to introduce price transparency in recent years, such as through the government’s <a href="https://medicalcostsfinder.health.gov.au/">Medical Costs Finder</a> website, the system remains far from clear. Reporting is voluntary and the <a href="https://doi.org/10.1016/j.healthpol.2020.06.001">evidence is mixed</a> on whether these tools effectively reduce prices or increase competition.</p> <p>All of this contributes to high and unpredictable out-of-pocket costs, which can lead to financial strain for patients. About <a href="https://www.abs.gov.au/statistics/health/health-services/patient-experiences/latest-release#barriers-to-health-service-use">10.5% of Australians</a> reported cost was a reason for delaying or avoiding a specialist visit in 2022–23.</p> <p>This raises important questions about equity and the sustainability of Australia’s universal health-care system, which is built on the principle of equitable access to care for all citizens.</p> <h2>What can be done?</h2> <p>Patients can take steps to minimise their costs by proactively seeking information. This includes asking your GP for a range of options when you’re referred to a specialist. Note the referral from your GP can be used for any other doctor in the same specialty.</p> <p>Similarly, ask the specialist’s receptionist what the fee and rebate will be before making an appointment, or for a <a href="https://www.ama.com.au/articles/informed-financial-consent#Two">detailed quote</a> before going to hospital. Shop around if it’s too high.</p> <p>But responsibility doesn’t only lie with patients. For example, the government could seek to address this issue by increasing investment in public hospital outpatient care, which could boost competition for specialists. It could also publish the range of fees compared to the rebate for all Medicare-billed consultations, rather than relying on voluntary reporting by doctors.</p> <p>Price transparency alone is not enough. Patients also need quality information and better guidance to navigate the health-care system. So continued investment in improving health literacy and care coordination is important.</p> <p>If things don’t change, the financial burden on patients is likely to continue growing, undermining both individual health outcomes and the broader goals of equitable health-care access.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/239827/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/susan-j-mendez-2219444">Susan J. Méndez</a>, Senior Research Fellow, Melbourne Institute of Applied Economic and Social Research, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/medicare-is-covering-less-of-specialist-visits-but-why-are-doctors-fees-so-high-in-the-first-place-239827">original article</a>.</em></p> </div>

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Why isn’t dental included in Medicare? It’s time to change this – here’s how

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/peter-breadon-1348098">Peter Breadon</a>, <a href="https://theconversation.com/institutions/grattan-institute-1168">Grattan Institute</a> and <a href="https://theconversation.com/profiles/kate-griffiths-94706">Kate Griffiths</a>, <a href="https://theconversation.com/institutions/grattan-institute-1168">Grattan Institute</a></em></p> <p>When the forerunner of Medicare was established in the 1970s, dental care was left out. Australians are still suffering the consequences half a century later.</p> <p>Patients pay much more of the cost of dental care than they do for other kinds of care.</p> <p><a href="https://www.commonwealthfund.org/sites/default/files/2021-08/Schneider_Mirror_Mirror_2021.pdf">More</a> Australians delay or skip dental care because of cost than their peers in most wealthy countries.</p> <p>And as our dental health gets <a href="https://theconversation.com/reform-delay-causes-dental-decay-its-time-for-a-national-deal-to-fund-dental-care-217914">worse</a>, fees keep on rising.</p> <p>For decades, a litany of reports and inquiries have called for universal dental coverage to solve these problems.</p> <p>Now, with the Greens <a href="https://greens.org.au/news/media-release/tax-big-corporate-profits-fix-peoples-teeth-greens">proposing</a> it and Labor backbenchers <a href="https://www.theaustralian.com.au/nation/politics/dental-on-medicare-must-be-next-frontier-for-labor-backbenchers/news-story/1c69314d7609815b937ced5af4542ba0">supporting</a> it, could it finally be time to put the mouth into Medicare?</p> <h2>What’s stopping us?</h2> <p>The Australian Dental Association <a href="https://ada.org.au/ada-responds-to-the-greens-dentistry-in-medicare-proposal">says</a> the idea is too ambitious and too costly, pointing out it would need many more dental workers. They say the government should start small, focusing on the most vulnerable populations, initially seniors.</p> <p>Starting small is sensible, but finishing small would be a mistake.</p> <p>Dental costs aren’t just a problem for the most vulnerable, or the elderly. More than <a href="https://www.abs.gov.au/statistics/health/health-services/patient-experiences/2022-23/patient_experience_202223_tables_13_to_15.xlsx">two million</a> Australians avoid dental care because of the cost.</p> <p>More than <a href="https://www.aihw.gov.au/getmedia/a053aa74-c471-436e-ab7e-a82e83ae73a3/aihw_den_231_dentalcare_oralhealthanddentalcareinaustralia_tranche7_21NOV2023.xlsx">four in ten</a> adults usually wait more than a year before seeing a dental professional.</p> <p>Bringing dental into Medicare will require many thousands of new dental workers. But it will be possible if the scheme is <a href="https://grattan.edu.au/wp-content/uploads/2019/03/915-Filling-the-gap-A-universal-dental-scheme-for-Australia.pdf">phased in</a> over ten years.</p> <p>The real reason dental hasn’t been added to Medicare is it would cost billions of dollars. The federal government doesn’t have that kind of money lying around.</p> <p>Australia has a <a href="https://theconversation.com/the-budget-is-full-of-good-news-but-good-news-isnt-the-same-as-good-management-230110">structural budget problem</a>. Government spending is growing faster than revenue, because we are a relatively <a href="https://grattan.edu.au/news/can-we-talk-about-a-fairer-more-prosperous-australia/">low-tax country with high service expectations</a>.</p> <p>The growing cost of health care is a major contributor, with hospitals and medical benefits among the top six fastest-growing major payments.</p> <p>The structural gap is only <a href="https://treasury.gov.au/publication/2023-intergenerational-report">likely to grow</a> without major policy changes.</p> <p>So, can we afford health care for all? We can. But we should do it with smart choices on dental care, and tough choices to raise revenue and reduce spending elsewhere.</p> <h2>Smart choices about a new dental scheme</h2> <p>The first step is to avoid repeating the mistakes of Medicare.</p> <p>Medicare payments to private businesses haven’t attracted them to a lot of the communities that need them the most. Many rural and disadvantaged areas are <a href="https://theconversation.com/if-you-live-in-a-bulk-billing-desert-its-hard-to-see-a-doctor-for-free-heres-how-to-fix-this-204029">bulk-billing deserts</a> with too few GPs.</p> <p>The poorest areas have more than <a href="https://grattan.edu.au/wp-content/uploads/2022/12/A-new-Medicare-strengthening-general-practice-Grattan-Report.pdf">twice</a> the psychological distress of the wealthiest areas, but they get about half the Medicare-funded mental health services.</p> <p>As a result, government money isn’t going where it will make the biggest difference.</p> <p>There are about <a href="https://www.aihw.gov.au/reports/dental-oral-health/oral-health-and-dental-care-in-australia/contents/hospitalisations/potentially-preventable-hospitalisations">80,000</a> hospital visits each year for dental problems that could have been avoided with dental care. If there is too little care in disadvantaged and rural communities, where oral health is worst, that number will remain high.</p> <p>That’s why a significant share of new investment should be quarantined for public dental services, with those services targeted to areas where people are missing out on care.</p> <p>Another problem with Medicare is its payments often have little relationship to the cost of care, or the impact that care has on the patient’s health.</p> <p>To tamp down costs, Medicare funding for dental care should exclude cosmetic treatments and orthodontics. It should be based on efficient workforce models where dental assistants and therapists use all their skills – you might not always need to see a dentist.</p> <p>The funding <a href="https://apo.org.au/sites/default/files/resource-files/2019-06/apo-nid241086.pdf">model</a> should take account of a patient’s needs, reward giving them ongoing care, and have a <a href="https://grattan.edu.au/wp-content/uploads/2019/03/915-Filling-the-gap-A-universal-dental-scheme-for-Australia.pdf">cap</a> on spending per patient.</p> <p>Oral health should be measured and recorded, to make sure patients and taxpayers are getting results.</p> <h2>Tough choices to balance the budget</h2> <p>Those steps would slash the cost of The Greens’ plan, which is hard to estimate but might reach more than <a href="https://www.pbo.gov.au/sites/default/files/2024-09/Putting%20dental%20care%20into%20Medicare.pdf">$20 billion</a> a year once it’s phased in. Instead, the cost would fall to roughly <a href="https://grattan.edu.au/report/filling-the-gap/">$7 billion</a> a year.</p> <p>That would be a good investment. But if you’re worried about where the money will come from, there are good ways to pay for it.</p> <p>Many reforms could reduce government health budgets without harming patients.</p> <p>There is waste in government funding of <a href="https://grattan.edu.au/wp-content/uploads/2016/02/935-blood-money.pdf">pathology</a> tests and <a href="https://grattan.edu.au/wp-content/uploads/2015/06/823-Premium-Policy4.pdf">less cost-effective</a> medicines.</p> <p>In some hospitals, there are <a href="https://grattan.edu.au/wp-content/uploads/2014/03/806-costly-care.pdf">excessive costs</a> and potentially harmful <a href="https://qualitysafety.bmj.com/content/qhc/28/3/205.full.pdf">low-value care</a>.</p> <p>Over the longer-term, investments in <a href="https://grattan.edu.au/wp-content/uploads/2023/02/The-Australian-Centre-for-Disease-Control-ACDC-Highway-to-Health-Grattan-Report.pdf">prevention</a> can reduce demand for health care. A <a href="https://grattan.edu.au/wp-content/uploads/2024/05/Sickly-Sweet-Grattan-Institute-Report-May-2024.pdf">tax on sugary drinks</a>, for example, would improve health while raising hundreds of millions of dollars a year.</p> <p>Measures like this would help the government pay for more dental care. But demand for health care will keep growing as the population ages, and as expensive <a href="https://www.abc.net.au/news/2024-09-11/proposal-to-speed-up-medicine-approvals/104338766">new treatments</a> arrive.</p> <p>This means a broader strategy is needed to meet the three goals of balancing the budget, keeping up with growing health-care demand, and bringing dental into Medicare.</p> <p>There are no easy solutions, but there are many options to reduce spending and boost revenue without hurting economic growth.</p> <p>Choosing Australia’s infrastructure and defence megaprojects <a href="https://grattan.edu.au/report/back-in-black-a-menu-of-measures-to-repair-the-budget/">more wisely</a> could save several billion dollars each year.</p> <p>Undoing Western Australia’s special GST funding deal – <a href="https://www.austaxpolicy.com/western-australia-gst-deal-the-worst-australian-public-policy-decision-of-the-21st-century-thus-far/">described</a> by economist Saul Eslake as “the worst Australian public policy decision of the 21st Century thus far” – would save another <a href="https://grattan.edu.au/report/back-in-black-a-menu-of-measures-to-repair-the-budget/">$5 billion</a> a year.</p> <p>Reducing income tax breaks and tax minimisation opportunities – including by reining in superannuation tax concessions, reducing the capital gains tax discount, limiting negative gearing, and setting a minimum tax on trust distributions – could raise more than <a href="https://grattan.edu.au/report/back-in-black-a-menu-of-measures-to-repair-the-budget/">$20 billion</a> a year.</p> <p>Major tax reform like this offers economic benefits while creating space for better services such as universal dental coverage.</p> <p>No one likes spending cuts and tax hikes, but they will be needed <a href="https://theconversation.com/chalmers-has-a-70-billion-a-year-budget-hole-here-are-13-ways-to-fill-it-203331">sooner or later</a> regardless. Dental coverage might be just the sweetener taxpayers need to accept it.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/239086/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/peter-breadon-1348098"><em>Peter Breadon</em></a><em>, Program Director, Health and Aged Care, <a href="https://theconversation.com/institutions/grattan-institute-1168">Grattan Institute</a> and <a href="https://theconversation.com/profiles/kate-griffiths-94706">Kate Griffiths</a>, Deputy Program Director, Budgets and Government, <a href="https://theconversation.com/institutions/grattan-institute-1168">Grattan Institute</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-isnt-dental-included-in-medicare-its-time-to-change-this-heres-how-239086">original article</a>.</em></p> </div>

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Tax boost announced for 1.2 million people

<p>Low-income earners will receive a tax boost with the Medicare levy threshold set to rise. </p> <p>The income threshold at which taxpayers will have to pay a two per cent Medicare levy will increase by 7.1 per cent, in line with inflation. </p> <p>Currently single people who earn below $24,276 do not have to pay the levy. Under the changes, the two per cent levy only has to be paid by anyone earning over <span style="font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Open Sans', 'Helvetica Neue', sans-serif;">$26,000</span></p> <p>The <span style="font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Open Sans', 'Helvetica Neue', sans-serif;">Medicare levy </span><span style="font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Open Sans', 'Helvetica Neue', sans-serif;">threshold for seniors and pensioners will increase to $41,089, up from the initial benchmark of $38,365. </span></p> <p>For families, this threshold has increased to $43,486 up from the previous $40,939. </p> <p>Treasurer Jim Chalmers said that the increase was part of the broader measures taken to relieve the increase in cost-of-living. </p> <p>“This will ensure people on lower incomes continue to pay less or are exempt from the Medicare levy,”  he said on Tuesday. </p> <p>“It means 1.2 million Australians get to keep a bit more of what they earn.”</p> <p>The boost in the Medicare levy threshold was announced alongside changes to income tax cuts, with those earning under $150,000 set to receive greater benefits. </p> <p>“This is about doing what we responsibly can to ease some of the pressure being felt by Australians right around the country, but especially for people on lower incomes, young people, seniors and women,” Chalmers said.</p> <p>This comes just days after Medicare celebrated it's 40th anniversary, with an exhibition launched at Parliament House.</p> <p><em>Image: Getty</em></p>

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“This is their money”: Aussies to receive cash boost in days

<p>The Australian government appears to be on a mission to play Santa, as it attempts to return a whopping $234 million in unclaimed Medicare benefits to one million of its hard-working citizens. Move over, jolly old Saint Nick; it's time for Bill "Santa" Shorten to shine.</p> <p>It turns out that Australians have been missing out on an average of $240 each in Medicare rebates, akin to losing a crisp, green note between the couch cushions – but on a national scale.</p> <p>Apparently, the government has been holding onto this financial treasure trove because some Aussies forgot to update their bank details with Medicare. Who knew that keeping your bank info up-to-date could be more rewarding than finding a forgotten $20 in last winter's coat?</p> <p>Government Services Minister Bill Shorten is riding the sleigh of generosity, announcing that, "We know Australians are doing it tough, and I want to reunite people with millions in unpaid Medicare benefits before the holidays." </p> <p>In the grand spirit of giving, Shorten has a plan. Australians can reclaim their lost loot within three days by undertaking the Herculean task of updating their bank account details on the myGov website. It's like a high-stakes version of changing your password but with a much more tangible reward – immediate funds in time for holiday shopping sprees.</p> <p>According to Shorten, the age group with the most to gain from this unexpected Christmas bonus is 18 to 24-year-olds, collectively owed a jaw-dropping $49 million. It seems like Santa Shorten is making a list and checking it twice, ensuring even the Millennials and Gen Zs get their fair share of financial cheer.</p> <p>While nearly 700,000 lucky Aussies are set to receive a notification about their long-lost financial windfall, there's a Grinchy catch: 300,000 individuals without a myGov account may remain out of reach. It's a modern-day Christmas tragedy – the equivalent of getting coal in your stocking because you forgot to sign up for the "nice" list.</p> <p>Opposition spokesman Paul Fletcher is urging Australians to create a myGov account, stating, "Two minutes on the app, three days later money in your account, good news for Christmas." It's like a financial magic trick - poof, and the money appears!</p> <p>In the midst of this Yuletide monetary magic, opposition spokesman Paul Fletcher throws some shade, claiming the coalition exposed these unclaimed benefits figures in October. "Families are struggling with cost-of-living pressures, and this is their money, not the government's," he declared, sounding like a fiscal superhero fighting for the rights of the underpaid and overtaxed.</p> <p>So, as Aussies rush to create myGov accounts and update their banking details, it's beginning to feel a lot like Christmas. Santa Shorten and his merry band of government officials are on a mission to spread holiday cheer, one direct deposit at a time.</p> <p>Who needs mistletoe when you can kiss your financial worries goodbye, thanks to the jingling sound of unclaimed Medicare benefits? It's the season of giving, after all, and in Australia, Santa Shorten is coming to town.</p> <p><em>Image: Getty</em></p>

Money & Banking

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Everything you need to know about major Medicare shake-up

<p>Medicare is undergoing its biggest shake-up in decades, making it easier for more than 12 million Aussies to visit their GP. </p> <p>Thanks to the sweeping reforms that came into effect on Wednesday, Aussies can now get cheaper visits to GPs and increased access to telehealth services. </p> <p>It is estimated that 12 millions Australians, or three in every five patients, will find it easier to see a bulk-billing GP after incentive payments for the practice tripled in a major boost.</p> <p>General practitioners who bulk-bill concession card holders, pensioners and patients aged under the age of 16 will now receive a $20.65 bonus if they are in a metropolitan area, while the incentive has risen to $39.65 for GPs in regional areas.</p> <p>The previous rates were $6.85 and $13.15 respectively.</p> <p>The tripling of the bulk-billing incentive payment applies to all face-to-face and telehealth GP consultations of up to 20 minutes. </p> <p>The plan was hailed as a "game changer" by the Albanese government, as Health Minister Mark Butler said, "Today is the biggest investment in Medicare for decades."</p> <p>Prime Minister Anthony Albanese added, "Medicare is at the centre of our health system [and] the primary healthcare that GPs deliver makes an enormous difference to people."</p> <p>"[This] happens to be good for the taxpayer as well because... a slight condition dealt with early [and] treated properly ensures it doesn't become an acute condition."</p> <p>Medical and GP advocates welcomed the reforms, saying it will make a big difference to millions of Aussies facing cost-of-living pressures.</p> <p>"But we know more work can be done," Australian Medical Association president Steve Robson said.</p> <p>"We will continue working with the government on developing new programs and initiatives that strengthen primary care and ensure GP-led care is affordable and accessible for all patients."</p> <p><em>Image credits: Shutterstock</em></p>

Caring

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"Ignore, delete and report": Cruel Medicare scam on the rise

<p>The Australian Competition and Consumer Commission’s Scamwatch has warned Aussies against a suspicious Medicare email going around claiming that their services have been suspended. </p> <p>The email states that Medicare services have been suspended because of incomplete customer medical records and contains a link for them to update their medical records to access the service. </p> <p>“Fake emails impersonating Medicare are doing the rounds claiming Medicare services have been suspended," a spokesperson for the consumer watchdog wrote in a tweet.</p> <p>“Ignore the email and the instruction to reactivate your Medicare services — it’s a scam.”</p> <p>"Ignore, delete, and report to Scamwatch." </p> <blockquote class="twitter-tweet"> <p dir="ltr" lang="en"><a href="https://twitter.com/hashtag/scamalert?src=hash&ref_src=twsrc%5Etfw">#scamalert</a>: Fake emails impersonating Medicare are doing the rounds claiming Medicare services have been suspended. <br />Ignore the email and the instruction to reactivate your Medicare services - it's a scam. <br />Ignore, delete, and report to Scamwatch <a href="https://t.co/qPicjZTOSW">https://t.co/qPicjZTOSW</a> <a href="https://t.co/8UhY7JnlFk">pic.twitter.com/8UhY7JnlFk</a></p> <p>— NASC Scamwatch (@Scamwatch_gov) <a href="https://twitter.com/Scamwatch_gov/status/1689849418793566208?ref_src=twsrc%5Etfw">August 11, 2023</a></p></blockquote> <p>Services Australia also advised customers to beware of emails and texts that sound urgent, make promises of financial benefit, and threaten with fines, debts or jail. </p> <p>“If you’ve clicked on a suspicious link or given your personal information to a scammer, call our <a href="https://www.servicesaustralia.gov.au/phone-us?context=64107" target="_blank" rel="noopener">Scams and Identity Theft Helpdesk</a>,” the website states. </p> <p><em>Image: Getty</em></p>

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Should you register with a GP? What is MyMedicare and how might it change the care you get?

<p><em><a href="https://theconversation.com/profiles/anthony-scott-10738">Anthony Scott</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a></em></p> <p><a href="https://www.health.gov.au/our-work/mymedicare">MyMedicare</a> is a new voluntary scheme that allows patients to register with their usual GP, in an attempt to improve continuity of care and health outcomes.</p> <p>From October 1, the scheme will give registered patients access to longer telehealth consultations. Then, from next year, GP clinics with patients who are frequently admitted to hospital or are aged care residents will be able to access additional “blended” funding, which sits outside Medicare’s usual fee-for-service.</p> <p>MyMedicare was announced in the May budget, with A$19.7 million of funding over four years, alongside a range of <a href="https://www.health.gov.au/sites/default/files/2023-05/building-a-stronger-medicare-budget-2023-24_0.pdf">other health reforms</a>, including funding for practice nurses to improve team-based care, as well as new incentives to increase bulk billing rates.</p> <p>We’re still waiting on a lot of detail about how the scheme will function. But here’s what we know so far – and what it might mean for patients and GPs.</p> <h2>What do we know about MyMedicare?</h2> <p>The scheme is voluntary for GPs and patients. In addition to patients opting in, GPs will also need to sign up, and have been able to do so since the start of July. There will be a gradual roll out and it will take three years to cover all of Australia.</p> <p>Though details are yet to be confirmed, from mid-2024 individual GPs will receive “<a href="https://www.acponline.org/about-acp/about-internal-medicine/career-paths/residency-career-counseling/resident-career-counseling-guidance-and-tips/understanding-capitation">capitation</a>” payments for patients who have more than ten hospital admissions per year. These patients are likely to have complex needs and multiple conditions and, for various reasons, may not be able to access a GP as much as they should.</p> <p>Though not yet confirmed, GPs are likely to <a href="https://www.ausdoc.com.au/news/the-mymedicare-enrolment-scheme-is-open-for-gp-practices-should-you-sign-up-now/">receive</a> $2,000 per patient per year, plus a $500 bonus for keeping patients out of hospital. The funding provides incentives for the GP to coordinate their care and provide the patient with access to nursing and allied health if required. It’s hoped this will stop patients going to hospital as often.</p> <p>There will also be similar payments for providing regular visits to patients in residential aged care facilities.</p> <h2>Will MyMedicare make a difference to patients?</h2> <p>Let’s consider four key areas patients are concerned about:</p> <p><strong>1) Continuity of care</strong></p> <p>Research shows greater <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1365-2753.2009.01235.x">continuity of care</a> – developing a relationship with and seeing the same provider or team for your care – improves patient outcomes and reduces costs to the health system. People who use MyMedicare to get a regular GP may see some of these benefits.</p> <p>But many patients already see the same GP or visit the same practice, especially those with chronic conditions. So registration with a practice may not make much difference for this group of patients. What are the other benefits of registration?</p> <p><strong>2) Reducing hospital admissions</strong></p> <p>Avoiding hospitals can be beneficial – in hospitals, there are no home comforts, they are inconvenient for you and relatives, there is little privacy, and they can be costly. Patients with ten or more hospital admissions in a year have been targeted as they have more complex chronic conditions and may be from vulnerable populations.</p> <p>Better access to a GP could prevent patients visiting the emergency department or prevent overnight hospital admissions. Research shows financial incentives for GPs to better manage chronic disease <a href="https://journals.sagepub.com/doi/full/10.1177/01410768211005109">can reduce hospital admissions</a>.</p> <p>However, <a href="https://bmjopen.bmj.com/content/5/4/e007342?cpetoc=&amp;int_source=trendmd&amp;int_medium=trendmd&amp;int_campaign=trendmd">hospital admissions could also increase</a> if the scheme identifies significant levels of previous unmet need.</p> <p><strong>3) Reducing barriers to care</strong></p> <p>MyMedicare does not directly address many of the <a href="https://link.springer.com/article/10.1186/1475-9276-12-18">barriers to accessing GP services</a>. If GPs are getting paid more and still getting fee for service payments, will MyMedicare patients be guaranteed to be bulk billed? This has not yet been mentioned, but could be an important part of the scheme to attract patients.</p> <p>People with chronic disease have <a href="https://grattan.edu.au/report/not-so-universal-how-to-reduce-out-of-pocket-healthcare-payments/">two to three times higher</a> out-of-pocket costs than those who do not, and <a href="https://healthsystemsustainability.com.au/the-voice-of-australian-health-consumers/">30%</a> of patients with chronic disease would find it difficult to pay for care if they became seriously ill.</p> <p>Unfortunately MyMedicare will not directly reduce out-of-pocket costs, which may be the real reason why people use “free” emergency department care.</p> <p><strong>4) Making it clear and easy to sign up</strong></p> <p>It is also unclear how the process of registration will work for patients. Will patients be offered a choice of alternative GPs? If chosen, will GPs be obliged to take them?</p> <p>At the moment, there are no public data about out-of-pocket costs and quality of care provided by different GPs, and so it will be impossible for patients to make an informed choice. Information to inform choice on a website would be useful, as is the case for <a href="https://www.health.gov.au/resources/apps-and-tools/medical-costs-finder">specialists</a>.</p> <p>It’s also unclear if patients who chose to register will find it harder to move GPs or continue to see other GPs if they wish to. The advantages to patients of MyMedicare need to be made clear to encourage them to register and be supported to exercise informed choice if they wish.</p> <h2>Will it make a difference for GPs?</h2> <p>Patient registration can mean a more secure and predictable stream of future income for some patients and also less competition (in terms of “losing” patients to other GPs) and more continuity of care.</p> <p>Moving away from fee for service towards a blended payment model is <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD011865.pub2/full">widely recognised</a> to support higher value health care.</p> <p>Yet GPs are wary of moving from fee for service to capitation payment. Capitation payments are fixed, so GPs take on more financial risk if they have more complex patients who are more costly to treat and manage in terms of time and effort. Whether the $2,000, plus $500 bonus, plus normal fee for service payments are sufficient to cover the costs of treating very complex patients is unclear.</p> <p>Overall, GPs will get more money, and along with the other announcements in the budget, will receive a significant investment of resources invested in primary care.</p> <p>Our previous <a href="https://onlinelibrary.wiley.com/doi/abs/10.1002/hec.3572">research</a> has shown a 5% increase in earnings for GPs is predicted to reduce the total number of GPs by up to 1% (equivalent to around 310 GPs in 2021) at a time of significant GP shortages. If they get paid more, they would prefer to work less.</p> <p>But this could also be offset because the increase in funding will hopefully make general practice more attractive as a career and so there will be more postgraduate doctors <a href="https://www.sciencedirect.com/science/article/pii/S0167629612000902">choosing to be a GP</a>.</p> <p>Voluntary patient registration under MyMedicare has potential to strengthen the relationship between patients and their GP, and focuses on keeping patients out of hospital and properly cared for in residential aged care. But the devil is in the detail and we will need a proper evaluation to determine the impacts on health outcomes, costs and access to health care. <!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/206183/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/anthony-scott-10738">Anthony Scott</a>, Professor of Health Economics, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/should-you-register-with-a-gp-what-is-mymedicare-and-how-might-it-change-the-care-you-get-206183">original article</a>.</em></p>

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Federal Budget 2023: How to make the most of the key promises

<p dir="ltr">Treasurer Jim Charles has handed down his first budget for 2023/24, offering a series of measures aimed at tackling the cost-of-living crisis.</p> <p dir="ltr">Millions of Australians will receive a boost from the federal government medical care, bills and welfare payments, amid the forecast that the budget will be be in the black with a surplus of $4bn.</p> <p dir="ltr">Here’s what it means for you:</p> <p dir="ltr"><strong>Bill help</strong></p> <p dir="ltr">Those who are on the pension, a seniors card holder or a recipient of family tax benefits A and B will be eligible to get help with energy bills thanks to a deal between the states and Commonwealth that’s worth $1.5bn.</p> <p dir="ltr">That means over five million eligible households and one million eligible small businesses will benefit from the scheme.</p> <p dir="ltr">The relief will come in the form of credits that apply directly to their power bills rather than cash, and the amount they receive will depend on the state they live in.</p> <p dir="ltr"><strong>Medicare Relief</strong></p> <p dir="ltr">The incentives paid to GPs who bulk bill 11.6m eligible Australians including children under 16, pensioners and other concession card holders will increase.</p> <p dir="ltr">GPs will be able to claim the incentives for in-person consultations over six minutes long and certain telehealth consultations.</p> <p dir="ltr">GPs who bulk bill patients in the city will be paid a new incentive of $20.65 compared to the previous rate of $6.60, while regional GPs will receive a $31.40 incentive, up from $10.05.</p> <p dir="ltr"><strong>Welfare recipients</strong></p> <p dir="ltr">Over 1.1 million vulnerable Australians will benefit from a $40 fortnightly boost from September, if parliament agrees.</p> <p dir="ltr">The increased base rate will apply to people receiving JobSeeker, Youth Allowance, Parenting Payment (partnered), ABSTUDY, Disability Support Pension (Youth) and Special Benefit.</p> <p dir="ltr"><strong>Rental assistance</strong></p> <p dir="ltr">For many renters, this budget means that rent is forecasted to increase over the next year as the market tightens.</p> <p dir="ltr">However, for those currently receiving the maximum Commonwealth Rent Assistance allowance their payments will increase by 15 per cent.</p> <p dir="ltr">Here’s what the Federal Budget will look like at a glance:</p> <ul> <li dir="ltr"> <p dir="ltr">Budget deficit of $13.9 billion in 2023/24</p> </li> <li dir="ltr"> <p dir="ltr">Commonwealth net debt to rise to $574.9 billion (22.3 per cent of GDP) in 2023/24</p> </li> <li dir="ltr"> <p dir="ltr">Economic growth to fall to 1.5 per cent in 2023/24</p> </li> <li dir="ltr"> <p dir="ltr">Unemployment rate to rise to 4.25 per cent in 2023/24</p> </li> <li dir="ltr"> <p dir="ltr">Inflation as measured by CPI to be 3.25 per cent in 2023/24</p> </li> <li dir="ltr"> <p dir="ltr">Wages to rise by four per cent in 2023/24</p> </li> </ul> <p dir="ltr"> </p> <p dir="ltr">And here are the key measures the federal budget has promised:</p> <ul> <li dir="ltr"> <p dir="ltr">Energy bill relief for five million households and one million businesses</p> </li> <li dir="ltr"> <p dir="ltr">Triple bulk-billing incentives and more funding for urgent care clinics</p> </li> <li dir="ltr"> <p dir="ltr">Base rate of JobSeeker and other payments to be raised for 1.1 million households</p> </li> <li dir="ltr"> <p dir="ltr">Commonwealth Rent Assistant rise for 1.1 million households</p> </li> <li dir="ltr"> <p dir="ltr">Housing boost including tax breaks for build-to-rent investors</p> </li> <li dir="ltr"> <p dir="ltr">$4 billion extra for renewable energy</p> </li> <li dir="ltr"> <p dir="ltr">Tax breaks for small business to write-off assets and reduce energy costs</p> </li> <li dir="ltr"> <p dir="ltr">Targeted help for jobless aged over 55</p> </li> <li dir="ltr"> <p dir="ltr">Cut to cost of medicines</p> </li> </ul> <p><em>Image: Getty Images/ Martin Ollman / Stringer</em></p>

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Melbourne mother to be jailed with baby

<p>A Melbourne mother and her son will face up to at least 12 months behind bars after she stole almost $200,000 from Medicare while employed at a medical clinic.</p> <p>Sarah Ward, 31, made more than 1,600 false claims to Medicare, sometimes up to 80 a day, while working as a medical receptionist at the Melbourne Digestive Centre.</p> <p>It was not the first time the mother had committed fraud while working in the medical field.</p> <p>Ward had just completed a sentence for stealing $29,000 from Cabrini Hospital, where she worked for five years before being terminated.</p> <p>The County Court Judge Geoff Chettle sentenced Ward to two years, ordering her to serve at least 12 months in jail after she pleaded guilty to a single charge of obtaining a financial advantage by deception from a Commonwealth entity.</p> <p>The 31-year-old mother of two stole $181,121.75 from Medicare between March 2019 and April 2020.</p> <p>Out of the 1,609 false claims, her name was on 781 and her husband’s name was on 828, with refunds transferred into bank accounts for both of them.</p> <p>Her fraud was discovered when the clinic’s accountants tipped off authorities and Medicare.</p> <p>Ward told a psychologist she believes she was inadequately paid and wished to keep up with her affluent friends, wanting to buy better clothing for her children and a better car.</p> <p>Judge Chettle said Ward had wanted to keep up with the lifestyles she saw on social media.</p> <p>Ward believed if she was not able to accumulate the money to match the affluent lifestyles she so desired, then it would result in her experiencing recurrent rejection and would remain on the periphery of social groups, according to Chettle.</p> <p>Her offending involved planning and sophistication which was both repetitive and long-lasting.</p> <p>She obtained a hefty amount of funds, and breached the trust placed in her by her employees, Chettle said.</p> <p>Ward was fired by the clinic as soon as the offence was uncovered, she then went to work for a psychology practice who were unaware of her fraud.</p> <p>She has been on maternity leave since February 2022, but seems destined to lose that job once she’s behind bars, the judge said.</p> <p>The court was told Ward had repaid the money in full, taking $100,000 from a mortgage offset account and selling a $70,000 car. She also allegedly borrowed money from her mother.</p> <p>Ward has two children, aged one and three.</p> <p>The one-year-old will go into custody with her as part of a Corrections Victoria’s Living with Mum program.</p> <p>Former colleague Vanessa Whitelaw attended Ward’s court hearings to get closure after a traumatic period within what was described as a tight-knit workplace.</p> <p>Co-workers had wondered about Ward’s luxurious lifestyle, Whitelaw said.</p> <p>We thought it was very strange — she was very young, (with a) new family, mortgage, driving around in a $150,000 vehicle, Gucci scarves, fancy shoes,” she said.</p> <p>“But never in a million years did we think that this was going on behind the scenes.”</p> <p>We thought it was very strange — she was very young, (with a) new family, mortgage, driving around in a $150,000 vehicle, Gucci scarves, fancy shoes,” she said.</p> <p>“But never in a million years did we think that this was going on behind the scenes.”</p> <p><em>Image credit: Getty</em></p>

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“So tone deaf”: Karl loses it over Medibank bosses' massive bonuses

<p dir="ltr">Karl Stefanovic has slammed the top bosses at Medibank after it has been revealed they will be taking home millions in bonuses amid the company’s cyber attack crisis.</p> <p dir="ltr">While ten million of Medibank’s customers are learning whether their personal data has made it onto the dark web - and fork out cash to keep themselves safe - bosses will still be collecting a total of $7.3 million in bonuses.</p> <p dir="ltr">Joel Andrews, one customer whose data has been stolen, told <em>Today </em>that “it’s disgusting” that bosses aren’t willing to give up their bonuses despite affected customers facing financial losses.</p> <p dir="ltr">“I’m furious,” Andrews said.</p> <p dir="ltr">“To think that it’s taken them a month to get this information out to us and say what’s been released, I understand it takes time to find these things out but it’s taken them that long. </p> <p dir="ltr">“They promised early on that they would act quickly because it’s such a time-sensitive issue, and it feels like they have just left it up to them, on their timing.”</p> <p dir="ltr">“I mean you’ve got the Medicare boss getting $1.5 million in bonuses last financial year,” co-host Ally Langdon said.</p> <p dir="ltr">“He also receives 150 percent of his fixed salary in shares … it’s pretty tone deaf, isn’t it?”</p> <p dir="ltr">“It’s disgusting,” Andrews replied.</p> <p dir="ltr">"To think that all of the customers out there, ten million customers, if each of them have to pay for their own software to do data protection, losses to them are around $100 each,.</p> <p dir="ltr">"That's a significant loss to each person and they are not willing to give up their bonuses."</p> <p dir="ltr">Stefanovic, who found out he was also a victim of the attack just two days ago, said he had “no sympathy” for the company as it faces declining share prices and hefty costs as a result of the attack and agreed the bonuses were “disgusting”.</p> <p dir="ltr">“It’s a failure across the board and they’re giving themselves bonuses,” the <em>Today Show</em> host said.</p> <p dir="ltr">“It’s unbelievable.</p> <p dir="ltr">"This is so tone deaf, it is one of the most tone deaf things I have seen a corporation do in Australia for a long, long time.”</p> <p dir="ltr">The health insurance company has come under fire for how it handled the cyber attack, with customers’ data being leaked onto the dark web after it refused to pay a ransom and affected customers finding out if they’ve been targeted more than a month later.</p> <p dir="ltr">As the Australian Federal Police continue their investigation into the attack, they have promised to take swift action against anyone who accesses the private data shared on the dark web.</p> <p dir="ltr">Affected customers who aren’t happy with Medicare’s actions or its handling of the situation have also begun proceedings to file a lawsuit against the company.</p> <p><span id="docs-internal-guid-bf090b99-7fff-1249-0ed1-ac63862a591b"></span></p> <p dir="ltr"><em>Image: The Today Show</em></p>

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Cost of prescription meds to be slashed

<p>From the beginning of 2023, the price of prescription medications will be slashed in a new cost-of-living measure by the federal government.</p> <p>Australians' co-payment for scripts under the Pharmaceutical Benefits Scheme (PBS) will be capped at $30 as opposed to the current maximum co-payment of $42.50. </p> <p>That will save people who have multiple regular medications hundreds of dollars each year.</p> <p>The measure will also help prevent people having to decide between spending their money on medicines or other essentials.</p> <p>Measures won’t come into effect until January 1, with the Albanese government tabling the bill in parliament on Wednesday.</p> <p>Health Minister Mark Butler said almost a million Australians delayed or avoided filling prescriptions, citing recent research.</p> <p style="box-sizing: inherit; margin: 0px 0px 5px; padding: 0px; border: 0px; font-size: 16px; vertical-align: baseline; color: #323338; font-family: Roboto, Rubik, 'Noto Kufi Arabic', 'Noto Sans JP', sans-serif; background-color: #ffffff; outline: none !important;">“This change will put close to $200 million back in the pockets of Australians each year."</p> <p style="box-sizing: inherit; margin: 0px 0px 5px; padding: 0px; border: 0px; font-size: 16px; vertical-align: baseline; color: #323338; font-family: Roboto, Rubik, 'Noto Kufi Arabic', 'Noto Sans JP', sans-serif; background-color: #ffffff; outline: none !important;"><em>Image: Getty</em></p>

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Why bulk billing may be on the verge of collapse

<p dir="ltr">If you’ve noticed that trips to the doctor are getting more expensive, you’re not the only one.</p> <p dir="ltr">With a continuing decline in the number of local GPs, a shortfall of doctors trained overseas arriving in Australia, rising operating costs and plummeting revenue from Medicare rebates, many clinics have been left with no other choice than to start charging fees, including those who need their services most.</p> <p dir="ltr">Over the past decade, the average out-of-pocket expenses for GP services have risen by 60 percent, as reported by <em><a href="https://www.dailymail.co.uk/news/article-11081047/Australian-GPs-say-bulk-billing-brink-collapse.html" target="_blank" rel="noopener">The Daily Mail</a></em>.</p> <p dir="ltr">As a result, a growing number of GPs are starting to advise their patients that they can no longer bulk-bill, a practice the Royal Australian College of General Practitioners vice-president Bruce Willett says is no longer sustainable.</p> <p dir="ltr">“It’s now got to the point where practices can no longer sustain bulk billing,” he told The Australian.</p> <p dir="ltr">Director Peter Stratmann said bulk billing no longer being a viable option has resulted in the sector heading to the brink of collapse, with clinics closing and a need to charge fees to make ends meet.</p> <p dir="ltr">“We've seen practices having to close and increasingly in the last number of weeks we've seen practices impose private billing fees, because otherwise they won't make it,”  Dr Stratmann said. </p> <p dir="ltr">“They just can't make ends meet without imposing some private fees.”</p> <p dir="ltr">Dr Stratmann admitted that this will put pensioners in a difficult position and that he fears they will overwhelm the hospital system for non-urgent care.</p> <p dir="ltr">In 2021, almost nine out of ten GP visits in Australia were bulk billed with no out-of-pocket expenses for the patient, with GP bulk billing rates growing to a record high of 88.4 percent in the December quarter according to Medicare data.</p> <p dir="ltr">The news comes just days after health minister Mark Butler addressed the issues facing primary care at the annual Australasian Medical Association conference, saying it is in “worse shape than it’s been in the entire Medicare era”.</p> <p dir="ltr">“It's hard enough to get a GP right now and we know that the current generation of older GPs are pretty exhausted, particularly over the last two and a half years, and we just do not have the pipeline coming through,”  Mr Butler said.</p> <p dir="ltr">'It is probably the most terrifying trend that I see in primary care.'</p> <p dir="ltr">As part of its commitment to general practice, the federal government has established the Strengthening Medicare Taskforce, boosted by a $750 million Strengthening Medicare fund.</p> <p><span id="docs-internal-guid-8a4eaa76-7fff-8b93-4b86-3e4ae2dcce49"></span></p> <p dir="ltr">“The government is committed to ensuring Australians get the care they need, when they need it and without worrying about the cost,” Mr Butler said.</p> <p dir="ltr"><em>Image: Getty Images</em></p>

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Mental distress is rising, especially for low-income middle-aged women. Medicare needs a major shakeup to match need

<p>Mental health services are poorly targeted, outcomes are getting worse, and out-of-pocket payments are increasing. The new government faces a tough challenge in improving mental health.</p> <p>This year marks 30 years since the first <a href="https://journals.sagepub.com/doi/10.1080/00048679309075767">national mental health policy</a>. The latest <a href="https://www.health.gov.au/resources/publications/the-australian-governments-national-mental-health-and-suicide-prevention-plan">national mental health and suicide prevention plan</a> is the sixth of its kind. But services are increasingly <a>fragmented and chaotic</a> and the number of people reporting <a href="https://doi.org/10.3389/fpsyt.2022.815904">very high psychological distress</a> was rising even before COVID.</p> <p>Medicare spending and out-of-pocket mental health-care costs are increasing but those most needing care aren’t getting it: mental health services use <a href="https://theconversation.com/when-its-easier-to-get-meds-than-therapy-how-poverty-makes-it-hard-to-escape-mental-illness-114505">goes up in better-off areas</a> where mental health-care needs are lower. A new government needs to address this mental health triple-whammy of spending, costs and areas of need.</p> <h2>Middle-aged women on low incomes are struggling</h2> <p>Very high psychological distress is rising most steeply in the middle-aged; <a href="https://doi.org/10.3389/fpsyt.2022.815904">more than doubling</a> for women aged 55–64 (3.5% to 7.2%) from 2001–2018.</p> <p>Earning less is associated with much <a href="https://doi.org/10.3389/fpsyt.2022.815904">worse mental health</a>. When we combine gender and income, we see that of men in the highest 20% income bracket, just 0.4% have very high psychological distress. The rate of this high level of distress is 28 times greater (11.9%) for women in the lowest 20% income bracket.</p> <p>So, mental health services should be targeted to people with low incomes, particularly middle-aged women. But Medicare for mental health fails any reasonable <a href="https://doi.org/10.5694/mja14.00330">test of universality</a> that would mean equitable delivery of mental health care for all Australians. </p> <p>Rather, it follows an “<a href="https://theconversation.com/three-charts-on-why-rates-of-mental-illness-arent-going-down-despite-higher-spending-97534">inverse care law</a>” that sees those needing the most getting the least. Often, poorer individuals in mid-life and in poorer communities – who really need psychological, allied health and psychiatric services – only get a minimal level of GP treatment, sometimes so restricted in range that it <a href="https://doi.org/10.1177%2F0004867419857821">makes mental health worse</a>.</p> <h2>Help is out of reach for many</h2> <p>This mismatch between need and services follows from a market-driven service model. </p> <p>Most Commonwealth government mental health-care support is through Medicare rebates – supporting services by GPs, psychiatrists and psychologists. </p> <p>Medicare rebates are for services provided by individual clinicians, rather than oriented toward team-based care. A GP can unlock additional mental health support through a “mental health treatment plan”, or a psychiatrist referral, allowing Medicare rebates for visits to psychologists or other professionals. </p> <p>But here’s the rub. These visits often require out-of-pocket payments of more than <a href="https://grattan.edu.au/wp-content/uploads/2022/03/Not-so-universal-how-to-reduce-out-of-pocket-healthcare-payments-Grattan-Report.pdf">A$200 per year</a>, with only about 40% of people having all their Medicare-subsidised psychologist services bulk-billed. And these plans are only [reviewed by their GP about <a href="https://www.mja.com.au/journal/2019/210/7/runaway-giant-ten-years-better-access-program#panel-article">half the time</a>.</p> <p>So Medicare support for psychiatrists and psychologists is inequitable and poorly targeted. Essentially, both psychologists and psychiatrists are out of reach for people on low incomes.</p> <h2>Agree on where we’re heading</h2> <p>Taxpayers get better value for money when there is a closer alignment between spending and need. The first step in service redesign is agreeing on a destination. </p> <p>The current expression of what the mental health system should look like, in operational terms rather than policy waffle, is the <a>national mental health strategic planning framework</a>. But this does not consistently guide planning and it needs revision. It should incorporate how social drivers of health, including relative disadvantage, affect community mental health-care needs. </p> <p>The government also needs to decide whether it will direct more money into mental health; there was no pre-election commitment to this. Mental health needs – especially for people on low incomes – are not being met. Without extra money, redistribution of funding will be required. The current “haves” will argue vociferously against redistribution to the “have-nots”, causing political pain.</p> <h2>A fresh frame</h2> <p>Commonwealth responses to addressing mental health needs have been siloed and poorly integrated into broader health care. Labor’s pre-election <a href="https://www.alp.org.au/policies/strengthening-medicare-taskforce">Strengthening Medicare policy</a> provides new context and the potential for a more integrated response to mental health needs.</p> <p>In the next five to ten years, <a href="https://www.smh.com.au/politics/federal/australians-encouraged-to-register-with-a-gp-under-new-funding-model-20211111-p59858.html">block payments to GPs</a> for patients enrolled with their practice will supplement fee-for-service and performance payments. But where will mental health fit in? And what opportunities might enrolment present for improving access to integrated primary mental health care for everyone? </p> <p>Enrolment-based funding will need to be risk-adjusted, with higher payments for patients with greater needs. Mental health status should be calculated as a health factor in the new formula. Then, general practices caring and supporting more people living with mental illness would attract higher funding. </p> <p>Risk-adjustment also should be higher for people with social or economic drivers of poor mental health, such as unemployment. Then we need to figure out what services and support GPs would provide for the new enrolment payments. </p> <p>A low payment, implying few extra services, would not drive the significant transformations needed in mental health-care provision. A higher payment, perhaps phased in, could help reshape mental health care. Existing funding for mental health-care plans could be collapsed into the enrolment payment. So could the cost of a psychologist and other services which these plans unlock. </p> <h2>A new funding model</h2> <p>Funding should allow allied health professional such as social workers and occupational therapists to use their discipline-specific skills. GPs would be able to employ psychologists and other providers directly or subcontract them. Primary health networks might also have a role here in accrediting services or developing service networks with GPs.</p> <p>A new funding model, involving funding weighted for those in greatest need, and more closely integrated into general practice, could transform access to mental health services. It would be more equitable and seamless, leading to higher quality care for the same cost.</p> <p><em>Image credits: Getty Images</em></p> <p><em>This article originally appeared on <a href="https://theconversation.com/mental-distress-is-rising-especially-for-low-income-middle-aged-women-medicare-needs-a-major-shakeup-to-match-need-184635" target="_blank" rel="noopener">The Conversation</a>.</em></p> <div style="caret-color: #000000; color: #000000; font-style: normal; font-variant-caps: normal; font-weight: normal; letter-spacing: normal; orphans: auto; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: auto; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; text-decoration: none; --tw-translate-x: 0; --tw-translate-y: 0; --tw-rotate: 0; --tw-skew-x: 0; --tw-skew-y: 0; --tw-scale-x: 1; --tw-scale-y: 1; --tw-scroll-snap-strictness: proximity; --tw-ring-offset-width: 0px; --tw-ring-offset-color: #fff; --tw-ring-color: rgba(51,168,204,0.5); --tw-ring-offset-shadow: 0 0 #0000; --tw-ring-shadow: 0 0 #0000; --tw-shadow: 0 0 #0000; --tw-shadow-colored: 0 0 #0000; background-color: transparent; border: 0px; font-size: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;" data-react-class="Tweet" data-react-props="{&quot;tweetId&quot;:&quot;1514384866103947268&quot;}"> <div style="--tw-translate-x: 0; --tw-translate-y: 0; --tw-rotate: 0; --tw-skew-x: 0; --tw-skew-y: 0; --tw-scale-x: 1; --tw-scale-y: 1; --tw-scroll-snap-strictness: proximity; --tw-ring-offset-width: 0px; --tw-ring-offset-color: #fff; --tw-ring-color: rgba(51,168,204,0.5); --tw-ring-offset-shadow: 0 0 #0000; --tw-ring-shadow: 0 0 #0000; --tw-shadow: 0 0 #0000; --tw-shadow-colored: 0 0 #0000; background-color: transparent; border: 0px; font-size: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; caret-color: #000000; color: #000000; font-family: 'Libre Baskerville', Georgia, Times, 'Times New Roman', serif; font-style: normal; font-variant-caps: normal; font-weight: normal; letter-spacing: normal; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; word-spacing: 0px; -webkit-text-stroke-width: 0px; text-decoration: none;"> <div style="--tw-translate-x: 0; --tw-translate-y: 0; --tw-rotate: 0; --tw-skew-x: 0; --tw-skew-y: 0; --tw-scale-x: 1; --tw-scale-y: 1; --tw-scroll-snap-strictness: proximity; --tw-ring-offset-width: 0px; --tw-ring-offset-color: #fff; --tw-ring-color: rgba(51,168,204,0.5); --tw-ring-offset-shadow: 0 0 #0000; --tw-ring-shadow: 0 0 #0000; --tw-shadow: 0 0 #0000; --tw-shadow-colored: 0 0 #0000; background-color: transparent; border: 0px; font-size: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> </div> </div> </div> <p style="caret-color: #000000; color: #000000; font-style: normal; font-variant-caps: normal; font-weight: normal; letter-spacing: normal; orphans: auto; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: auto; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; text-decoration: none; --tw-translate-x: 0; --tw-translate-y: 0; --tw-rotate: 0; --tw-skew-x: 0; --tw-skew-y: 0; --tw-scale-x: 1; --tw-scale-y: 1; --tw-scroll-snap-strictness: proximity; --tw-ring-offset-width: 0px; --tw-ring-offset-color: #fff; --tw-ring-color: rgba(51,168,204,0.5); --tw-ring-offset-shadow: 0 0 #0000; --tw-ring-shadow: 0 0 #0000; --tw-shadow: 0 0 #0000; --tw-shadow-colored: 0 0 #0000; background-color: transparent; border: 0px; font-size: 18px; margin: 0px 0px 18px; outline: 0px; padding: 0px; vertical-align: baseline;"> </p>

Mind

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Oatlands tragedy: Family faces costly medical bills after no access to Medicare

<div class="post_body_wrapper"> <div class="post_body"> <div class="body_text "> <p>Rania Geagea Kassas is dealing with every parent’s nightmare as she begged people to pray for her son who has been in a coma for over a week.</p> <p>Earlier this month, the young boy was walking with his cousins to get ice cream when an alleged drunk driver mounted the footpath and hit the children.</p> <p>The child suffered critical injuries to his head and spine and was placed in an induced coma.</p> <p>Sadly, he is yet to realise that the accident took the lives of his four cousins and best friends; Antony, Angelina and Sienna Abdallah and Veronique Sakr.</p> <p>“He needs your prayers now,” his mother told<span> </span><em>10 News First</em>.</p> <p>“I think he is happy with his cousins like he is in heaven, and then he’s going to come back after the funeral and he’s going to tell us about … his trip.”</p> <p>The three Abdallah children were laid to rest in a beautiful ceremony held at the Maronite Catholic rite at Our Lady of Lebanon Co-Cathedral in Harris Park yesterday.</p> <p>Two more children were injured in the crash, but they have since been discharged from hospital and being taken care of by their family.</p> <p>The boy remains in the intensive care unit at Sydney’s Westmead Children’s Hospital. He is in a stable condition and is in an induced coma and is being monitored every two to three hours.</p> <p>His uncle, Anthony Geagea revealed that he could remain in a coma for up to six months and they won’t know just how much damage has been caused to his brain and spine until after he wakes up.</p> <p>“When he wakes up, the doctor will give us a full diagnosis,” he said.</p> <p>Currently, the driver’s Compulsory Third Party (CTP) insurance will cover the immediate hospital bills but the family’s neighbour has set up a<span> </span><a rel="noopener noreferrer" href="https://www.gofundme.com/f/team-charbel-kassas" target="_blank">GoFundMe</a><span> </span>page to help ease the financial burden once the boy has woken up.</p> <p>His parents do not have access to Medicare as they’ve only been in Australia for a short time.</p> <p>“All medical expenses are out of pocket and will increase dramatically,” says the fundraising page.</p> <p>“Any donation made towards this beautiful humble family is greatly appreciated.”</p> <p>The boy’s parents have not been able to return to work, and won’t be able to for some time as he needs full-time care.</p> <p>“We don’t know what is going to happen – maybe he will need medicine, maybe he will need lots of equipment,” said his mother.</p> <p>So far, close to $130,000 have been raised as they attempt to reach their $150,000 goal.</p> </div> </div> </div>

Caring

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The “worst of the worst” products that are “ripping off and misleading” Aussie shoppers

<p>Consumer group Choice has called out some of the “worst-of-the-worst” products being sold to Aussies in their 14th annual Shonky Awards. </p> <p>Choice CEO Alan Kirkland said in a statement the award aims to highlight the items Australian consumers should avoid as they are “ripping off” and misleading” shoppers. </p> <p>“Choice’s job is to stand up against companies doing the wrong thing. The Shonkys draw upon our unique testing, reviews and advocacy to help you identify the worst-of-the-worst,” Mr Kirkland said.</p> <p>“In a time of fake reviews, cash for comment, salespeople and lobbyists everywhere, it’s more important than ever for independent voices to tell the truth.</p> <p>“Following the banking royal commission, it’s no surprise that financial services businesses are such a feature of this year’s Shonkys.”</p> <p><strong>2019 Shonky Winners </strong></p> <p><strong>Kogan</strong></p> <p>The online retailer has earnt themselves a shonky award this year for their “poor” customer service. </p> <p>Topping the NSW Fair Trading complaint register, the retailer has clocked over 300 complaints from January to July in 2019. </p> <p>Mr Kirkland says Kogan should “stop beating around the bush when its products are defective”.</p> <p>“Kogan must simplify the process for refunds, repairs and replacements to meet community expectations and the law”. </p> <p>He also mentioned the company must improve its customer service, and their refunds and returns policy. </p> <p><strong>Medicare </strong></p> <p>Medicare has been called out by Choice for their “basic” cover health insurance actually costing more than the cheapest “bronze” cover in NSW, the ACT, Northern Territory, South Australia, Western Australia and Tasmania.</p> <p>Mr Kirkland said: “2019 is the first year that private health insurance has topped the list of financial worries in Choice’s regular national surveys, and it’s easy to see why.</p> <blockquote style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" class="instagram-media" data-instgrm-permalink="https://www.instagram.com/p/BsZlUPMlzNV/?utm_source=ig_embed&amp;utm_campaign=loading" data-instgrm-version="12"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"></div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"></div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"></div> </div> </div> <div style="padding: 19% 0;"></div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"></div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" rel="noopener" href="https://www.instagram.com/p/BsZlUPMlzNV/?utm_source=ig_embed&amp;utm_campaign=loading" target="_blank">A post shared by Artyguy (@aussieartyguy)</a> on Jan 8, 2019 at 8:04pm PST</p> </div> </blockquote> <p>“A new system that was meant to make things simpler has turned into a mess.</p> <p>Medibank’s ‘basic’ junk cover costs more than many higher-cover bronze policies. Medibank deserves a Shonky for failing at the basics — simple and affordable health insurance.”</p> <p><strong>IKEA</strong></p> <p>The Swedish furniture retailer has taken a spot on the 2019 Shonky Awards list for their Nedkyld fridge after it's score came in at just 35 per cent for food and freshness, and further failing an energy test. </p> <blockquote style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" class="instagram-media" data-instgrm-permalink="https://www.instagram.com/p/B077R4PnK5z/?utm_source=ig_embed&amp;utm_campaign=loading" data-instgrm-version="12"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"></div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"></div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"></div> </div> </div> <div style="padding: 19% 0;"></div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"></div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" rel="noopener" href="https://www.instagram.com/p/B077R4PnK5z/?utm_source=ig_embed&amp;utm_campaign=loading" target="_blank">A post shared by Arjun Singh Jain (@arjunsinghjain)</a> on Aug 9, 2019 at 1:21am PDT</p> </div> </blockquote> <p>The Ikea Nedkyld is one of the worst fridges we’ve ever tested,” Mr Kirkland said.</p> <p>“Not only is it terrible at keeping your food cold, when Choice tested the Nedkyld’s energy use against its star rating, it failed the test.</p> <p>“It’s hard to understand how this fridge is still on sale in Ikea stores, especially with a misleading energy label.”</p> <p><strong>AMP superannuation</strong></p> <p>Choice has given AMP superannuation a Shonky award for their being over one million “zombie” super accounts eating away at the retirements of Aussies. </p> <p>Based on APRA  data: “AMP received some of the strongest criticism from the banking royal commission — and it was deserved. If your superannuation is with AMP, chances are you’ve had your retirement leeched off of to fund its executives’ lifestyles,” Mr Kirkland said.</p> <p>“Choice has partnered with the new consumer group — Super Consumers Australia — and found that AMP holds the largest number of zombie accounts of any other super fund — accounts that sit there being wasted away by fees and insurance.</p> <blockquote style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" class="instagram-media" data-instgrm-permalink="https://www.instagram.com/p/BacX4Bkjp1X/?utm_source=ig_embed&amp;utm_campaign=loading" data-instgrm-version="12"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"></div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"></div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"></div> </div> </div> <div style="padding: 19% 0;"></div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"></div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" rel="noopener" href="https://www.instagram.com/p/BacX4Bkjp1X/?utm_source=ig_embed&amp;utm_campaign=loading" target="_blank">A post shared by AMP Australia (@amp_au)</a> on Oct 19, 2017 at 1:39pm PDT</p> </div> </blockquote> <p>“For AMP, it’s money for doing nothing. Managing people’s retirement funds isn’t your average business — there’s a higher moral standard to meet when it comes to people’s security and comfort in older age, and AMP have failed this standard.”</p> <p>An AMP spokeswoman told<span> </span><a rel="noopener" href="https://www.news.com.au/finance/business/retail/choice-shames-products-in-2019-shonkys-awards/news-story/a8c1bd878dd75cedee4a417a501fd412" target="_blank">news.com.au<span> </span></a>it “can be difficult to draw accurate comparisons and conclusions in relation to inactive accounts due to the varied characteristics of products within trusts and across superannuation providers.”</p> <p>“For example: a large proportion of the AMP accounts classified in APRA’s data as inactive receive a capital guarantee. It is often in members’ best interests to maintain these accounts given the future benefit they will provide.</p> <p>“AMP supports legislative measures that identify and aim to reduce duplicate or inactive accounts.”</p> <p><strong>Freedom Foods XO Crunch</strong></p> <p>The XO Crunch cereal received a Shonky after having 22.2 per cent sugar in their product that they claimed was “a fun and nutritious way to start your kids’ day”. </p> <p>“Freedom Foods proudly displays four health stars on this bag of sugar. Choice says it should be one-and-a-half if health star ratings accurately reflected the amount of added sugar in a product — something that industry groups have lobbied to prevent,” Mr Kirkland said. </p> <blockquote style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" class="instagram-media" data-instgrm-permalink="https://www.instagram.com/p/6Lnvb-MNK0/?utm_source=ig_embed&amp;utm_campaign=loading" data-instgrm-version="12"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"></div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"></div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"></div> </div> </div> <div style="padding: 19% 0;"></div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"></div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" rel="noopener" href="https://www.instagram.com/p/6Lnvb-MNK0/?utm_source=ig_embed&amp;utm_campaign=loading" target="_blank">A post shared by Freedom Foods (@freedomfoods)</a> on Aug 9, 2015 at 4:46pm PDT</p> </div> </blockquote> <p>“This Shonky shows why the food industry needs to be kicked out of (the) room when it comes to health star ratings. The food industry has gamed the health star system to make a big bag of sugar look like a healthy choice for your kids — and that’s a disgrace.”</p>

Home & Garden

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Government reveals that they received 90,000 tip-offs about welfare cheats

<p><span style="font-weight: 400;">The Australian government has revealed that they received more than 90,000 tip offs from members of the public about welfare cheats.</span></p> <p><span style="font-weight: 400;">According to </span><a href="https://www.news.com.au/finance/economy/australian-economy/90000-welfare-cheat-tip-offs/news-story/8e72f2a8a29ad296fb64c35f0ec5e979"><span style="font-weight: 400;">news.com.</span><span style="font-weight: 400;">au</span></a><span style="font-weight: 400;">, the Department of Human Services received this number of tip offs from the public about welfare, Medicare and Child Support fraud in the 2019/19 financial year.</span></p> <p><span style="font-weight: 400;">This has led to 200 investigations.</span></p> <p><span style="font-weight: 400;">Federal government frontbencher Stuart Robert is thrilled with the results, as it means that more than $100 million has been raked back from welfare cheats.</span></p> <p><span style="font-weight: 400;">“Ninety thousand tip offs tells me the average Australian has had a gut full of it,” Mr Robert told </span><span style="font-weight: 400;">Sky News</span><span style="font-weight: 400;">.</span></p> <p><span style="font-weight: 400;">“It’s not about defrauding the government ... it’s actually taking money from the next door neighbour and the lovely lady across the street who pays tax, that’s who you are stealing from.”</span></p> <p><span style="font-weight: 400;">Mr Robert said that 49 cases were now before the courts.</span></p> <p><span style="font-weight: 400;">In one case, a worker was jailed after lying about their income by $47,000 and another had to pay back $14,000 in overpayments.</span></p>

Money & Banking

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The Medicare mistake that's costing travellers thousands

<p>Medicare has helped Aussies cover the cost of many essential medical and hospital expenses – but the safety net could only expand so far.</p> <p>Many Australians are unsure whether Medicare covers them when they are going on trips. According to a new survey by Compare Travel Insurance, 82 per cent of travellers do not know whether the health care system provides the same level of protection for them on a domestic cruise.</p> <p>The answer is quite tricky. The Department of Foreign Affairs and Trade said cruise passengers can access Medicare benefits only if they are travelling between two Australian ports with no stops outside the country. You also have to be treated by a Medicare-accredited doctor.</p> <p>Medicare will not cover passengers making journeys between an Australian port and a foreign port or between two foreign ports.</p> <p><a rel="noopener" href="https://smartraveller.gov.au/guide/all-travellers/getting-around/Pages/cruises.aspx" target="_blank">Smartraveller</a> advised travellers to check before their trip if their ship has a Medicare-accredited medical professional onboard. However, that may not be enough to ensure that you’re covered, said Compare Travel Insurance director Natalie Ball.</p> <p>“It’s astounding to see how many Aussies are under the misconception that Medicare covers you while cruising domestically,” Ball said.</p> <p>“In fact, Medicare coverage is restricted to around 20km from Australian ports, which means that once you’re out on the water, you’re on your own in terms of healthcare.”</p> <p>Ball warned that medical costs on a cruise ship can be far more expensive than passengers expected. “With passengers restricted to health care on board, medical costs and doctors’ fees on a ship can be unexpectedly pricey,” she said.</p> <p>“Infirmary bills can be as much as $5,000 per day and consultations and medications are usually charged at private, costly rates. Then there are the frightening fees you’d expect to pay for helicopter evacuation while at sea.”</p> <p>Smartraveller advised holidaymakers to purchase travel insurance that covers onshore activities and shore excursions.</p> <p>Frank Armstrong said he managed to <a rel="noopener" href="https://cruisepassenger.com.au/how-i-survived-a-59000-heart-attack-on-a-cruise/" target="_blank">avoid a $59,000 bill</a> incurred on a cruise trip between Australia and America thanks to his travel insurance.</p> <p>The 81-year-old, who was travelling with his wife Leah on Ovation of the Seas, suffered a heart during his 16-day vacation. “It was a holiday filled with such excitement and then absolute disaster – I had a heart attack,” Armstrong said.</p> <p>“As soon as we reached land in Tahiti, an ambulance rushed me to the main hospital which had been informed of my situation. There was a cardiologist already waiting as I went straight into surgery where they operated on me for over two hours putting two stents into my arteries.</p> <p>“After the surgery I spent five days in hospital and five days recuperating. When I was fit to fly, I was flown back home to Australia which was all paid for by my travel insurer.”</p> <p>The total costs of medical treatments, hospital stay, cruise cancellation and flight rescheduling amounted to about $59,000. However, Armstrong’s medical claims were taken care as he had paid $1,100 for his travel insurance. “It’s hard to imagine how they would have covered these expenses had they not had travel insurance,” Ball said.</p>

Travel Tips

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Why your health insurance is useless

<p>A quarter of cancer patients had to pay out of pocket expenses of more than $10,000 because health funds and Medicare rebates did not cover the full cost of treatment a survey has found.</p> <p>The Consumer’s Health Forum, which conducted the survey of 1200 people, has found that significant out of pocket expenses are becoming the norm for many patients.</p> <p>They say high fees charged by surgeons and inadequate cover by health funds is undermining the private health system.</p> <p>One in four breast cancer patients, and more than a third for people with chronic conditions like multiple sclerosis, were paying out-of-pocket expenses of thousands of dollars. </p> <p>One in six of those surveyed said the medical costs had a “significant impact” on their lives, and one-third of respondents said they were not fully informed of expenses before treatment.</p> <p>In many cases, the survey found even those with private health insurance are incurring huge expenses.</p> <p>“A concerning finding to emerge from the survey was that there is a perception among consumers that using PHI is more expensive than not using it,” the report says.</p> <p>The report warns we are at risk of creating a “two tier system where your income determines your health care”.</p> <p>The Forum’s chief executive, Leanne Wells, backed Labor’s call for a Productivity Commission report on private health insurance while launching the report at Parliament House on Thursday.</p> <p>“What we found is that, in a nutshell, being sick in Australia these days is a very expensive business,” she said.</p>

Retirement Income

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“Secret” documents reveal doctors are charging 10 times more than they should

<p>If you’ve recently undergone surgery only to be slugged with an outrageous bill, you’re not alone. A “secret” Australian Medical Association “List of Services and Fees” file explains why Aussies are being left $1.6 billion out of pocket each year.</p> <p>In some cases, doctors were charging up to 10 times the fee recommended by Medicare for everything from births to hip replacements and cancer treatments.</p> <p>AMA President Dr Michael Gannon defended the document, saying Medicare rates have not changed since 2014 but that AMA rates had been consistent with inflation and wage growth.</p> <p>“The vast majority of doctors deliver services well below the AMA fees, but certainly the AMA list is closer to a list of truth than the Medicare schedule, which lost pace with the true cost of health care 10, 15, 20 years ago,” he told <a href="https://www.9news.com.au/health/2018/03/25/10/44/medical-payments-that-leave-patients-ill" target="_blank"><strong><span style="text-decoration: underline;">9 News</span></strong></a>.</p> <p>However, Dr Gannon did admit that some doctors are charging even more than the AMA recommended rate. “If a doctor charges more than the AMA fee they need to explain to their patients why that is the case.”</p> <p>Dwayne Crombie, Head of Health Insurance for Bupa Australia, told the <a href="http://www.dailymail.co.uk/news/article-5540541/Doctors-charging-three-times-Medicare-fee.html" target="_blank"><em><strong><span style="text-decoration: underline;">Daily Mail</span></strong></em></a> the excessive charges undermined the value of health insurance.</p> <p>“If customers have to pay out of pocket gaps because a fee is high, then people question what benefit insurance provides them, without realising where the cost is coming from and why they are having to pay it.”</p>

Caring

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Government approves Medicare subsidies for life-saving treatments

<p>Medicare subsidies to treat epilepsy, stroke, lymphoma, heart diseases and other life-threatening conditions have been approved by the federal government, <strong><span style="text-decoration: underline;"><a href="http://www.smh.com.au/national/health/thousands-of-patients-to-access-medicare-subsidies-for-lifesaving-treatments-20171031-gzbnbx.html">Fairfax reports</a></span>.</strong></p> <p>From November 1, women with a family history of breast and ovarian cancer will also be able to access free Medicare rebates for BRCA1 and BRCA 2 genetic testing. The tests have previously cost between $600 and $2000.</p> <p>Health Minister Greg Hunt will announce on Wednesday that the federal government has approved all the latest recommendations from the independent Medical Services Advisory Committee (MSAC).</p> <p>"The Turnbull government has a rock solid commitment to Medicare, bulk billing and the PBS and our Long Term National Health Plan will ensure that Australians will continue to be supported by one of the best health systems in the world, long into the future," Minister Hunt said.</p> <p>The new Medicare subsidies include:</p> <ul> <li>Patients with slow growing non-Hodgkin lymphoma can now access PET (positron emission tomography) imaging to monitor the progress of the disease</li> <li>About 800 patients pet year will be eligible for a transcatheter aortic valve implantation (TAVI) to replace aortic valves</li> <li>Patients with irregular heart rhythm who cannot take blood-thinning medication will have access to a new service (a transcatheter occlusion) to insert a device that can lower the risk of stroke</li> <li>Around 200 stroke patients every year can access mechanical thrombectomy, a procedure that dissolves blood clots, minimises damage to the brain and improves patients' prognosis</li> <li>Epilepsy patients can access vagus nerve stimulation therapy, which is designed to prevent seizures by sending mild pulses of electrical energy to the brain via the vagus nerve</li> <li>Patients with liver tumours who cannot be treated by conventional surgery will be able to access an alternative radio frequency ablation treatment</li> <li>Pregnant women and new mothers will be serviced by better access to mental health assessments during pregnancy and in the early postnatal period </li> </ul>

Caring

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