So I went to the docs yesterday for the small collection of ailments I have and got relevant referrals to get moving on them, in line with my resolution to get them sorted this year.
For my knee, he gave me a referral to have an x-ray and MRI. I rang to make an appointment later that morning and was told that because I was over 50 the MRI wasn’t covered by Medicare and I would have to pay full whack – $318. If I was under 50 or had been referred by a specialist and not a GP, it would be zero.
I vaguely recalled a discussion about this last year. The issue is that the government believes that GP’s have been making unnecessary referrals for expensive procedures, therefore costing Medicare millions of dollars more. Their solution is to set an arbitrary limit based on age.
I’m guessing the thinking around this is that by the time you’re over 50 wear and tear will have created a lot of extra issues – not that changes anything. If there’s a legitimate issue then age or cause should be irrelevant. And – correct me if I’m wrong – but isn’t this basically discriminatory?
I’m guessing this limit has been imposed because the over-50s have been ‘over’ represented in the referral stats. Well, guess what, maybe that’s because they are sicker more often, which makes complete sense. They’ve created a solution to save money by effectively saying we won’t treat you if you’re crook.
Not surprisingly the Australian Medical Association opposed this change and still does. I have little doubt that some GPs have prescribed unnecessary treatments, but this seems to me a very crude and unscientific way around it. Surely there’s someone in the government who can think of a smarter way to address this?
In my case, I need that MRI to check if I need to see a specialist and, more specifically, what sort of specialist. I can’t afford this expense so now I’m getting an x-ray only and hoping it does the trick. My other option is to get a referral to a specialist of some kind and get him to refer me. But now we’re going in circles – I’ll have to pay the specialist, even if of the wrong ilk, a fee of some dimension, in order to get a free MRI.
In other words, my options are to soldier on without the MRI hoping the x-ray can diagnose the issue. If it doesn’t then I can choose to let it go and hope it doesn’t further degenerate. Or I can go back to the doctor, get another referral to a specialist, visit the specialist, then get the MRI I might have got right at the start of the process – where it belongs.
It’s nonsense the whole thing. Bureaucracy creating more work rather than less, inconveniencing the public, and applying arbitrary, non-medical standards which basically contravene all equal opportunity tenets.
I can’t believe something so poorly considered has become law. Then again, maybe not. This is a totally inept government.