23 September 2016

An MBS review is fine – but do it properly

MBS TheHill

 

Sussan Ley certainly created a storm among GPs when launching the interim report of the MBS review, saying if the government was “paying, effectively, too much for small appointments that aren’t necessarily adding to a person’s overall health”, those funds should be used better elsewhere.

While there was some disagreement as to what the minister actually said, there was no doubt as to her meaning. The medical community jumped on her comments, and the Twitter hashtag #JustAGP was born.

GPs around the country tweeted, memed and facebooked about how they’d spent their working day – removing a skin cancer, talking a patient out of suicide, consulting with a new widow, managing a patient with a first disclosure of early sexual abuse, or giving an iron infusion. Another GP said he’d spend two hours that day coordinating the care of a dying patient. And no, there’s not a simple Medicare item for that.

Yet, of 585 health professionals who answered the question, “Do you think that there are parts of the MBS that are out-of-date and that a review of the MBS is required?” 93% said “yes”.

And they were right, even if it’s somewhat of a motherhood question, eg: who wants to see obsolete items remain on the MBS?

Clearly, as GPs, we save the government, or rather the taxpayer, a huge amount of money every day. However, the issue at hand isn’t about the types of consults above.

Many of the submissions were about gatekeeper stuff. I suspect this may fall into the “low value” category in some minds.

“Many health professional respondents argued that referrals through GPs were unnecessary, particularly when accessing allied health services,” the report stated.

However, it also said this: “It should be noted that the prevalence of this issue may reflect the skew towards allied health providers in the health professional respondent group.”

Ah ha! So allied health providers and consumers would like allied health visits to be Medicare rebatable for non-referred patients. Nothing new here. And if the budget could bear it, I wouldn’t have a problem with it.

Another complaint was that while many consumers said the MBS rebate for GP services was adequate, specialist care was often unaffordable. This is true, too.

In my view, it’s undoubtedly time the MBS was reviewed. The question is how do we make sure it’s done well, and without a simple cost-cutting agenda.

Dr Kerri Parnell is the Editor-in-Chief at TMR.
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