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Clinical Radiology
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Inside News
In the debate over the Federal
Government’s rebate cuts
for diagnostic imaging (DI),
a number of central points
have become confused.
So the Australian Diagnostic Imaging
Association (ADIA) has been working with
journalists and politicians to ensure the
facts are clearly understood.
For example, the bulk billing (so called)
“incentive” for DI is not a separate
payment but rather is paid as part of the
Medicare patient rebate.
Similarly, the claim that bulk billing rates
for DI have only grown by about 1 per
cent since the incentive was introduced
are wrong—the Medicare statistics show
rates increased from 66.1 per cent in
2008–09 to 76.9 per cent in 2014–15.
Another misconception is that the bulk
billing incentive is “just a few dollars”.
For DI, bulk billing rebates are 10 per
cent higher than non-bulk billing (15 per
cent for MRI) - on average $6 for X-ray,
$12 for ultrasound, $34 for CT and $62
for MRI.
When patients need more than one DI
service, these costs are multiplied.
For instance, a patient presenting with
suspected breast cancer might have
a diagnostic mammogram, a breast
ultrasound and possibly a core biopsy or
fine needle aspiration.
A general patient (previously bulk
billed) can expect to pay $282 to $554
up-front, and $29 to $302 in gaps for
these services. Patients who can afford
the upfront costs will only be out of
pocket for a few days, but patients who
can’t afford them effectively have their
healthcare access reduced.
This payment discrimination means
breast and many interventional
procedures are already out of reach of
many patients.
If practices that bulk bill a lot of general
patients need to transition from bulk
billing to private billing then equitable
patient access to diagnostic imaging will
be put at risk with some services available
only to those with the financial means to
pay the high out-of-pocket and up-front
costs.
This is a significant danger which ADIA
has had to communicate.
Also, there has also been confusion over
the rebates and indexation.
In 2010, Access Economics found that
Medicare rebates did not cover the costs
of delivering DI services. And because
DI rebates have not been indexed for 17
years, the real value of the rebates has
fallen between 20 and 40 per cent.
ADIA has consistently argued that
patients must be able to access
affordable, high-quality DI services so
they can benefit from early diagnosis and
treatment.
To ensure that, we need sensible policy
based on accurate information.
Dr Christian Wriedt
ADIA President
ADIA Update
Let’s correct the debate
on bulk billing rebates
The views expressed are those of ADIA and
publication of this article does not in any
way constitute an endorsement by The Royal
Australian and New Zealand College of
Radiologists (RANZCR).