Specialists accused of charging different rates based on what a patient looks like
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There are also claims that doctors are reneging on deals meant to ensure patients have no out-of-pocket expenses. The head of the insurers’ lobby group, Private Healthcare Australia (PHA) CEO Michael Armitage, claimed some specialists would charge more if a person arrived in an “Armani suit with a chauffeur”. A less-well-dressed person would be charged less, Dr Armitage said. The CEO of a leading insurer volunteered a similar view but declined to be named. Australian Medical Association president Steve Hambleton said charges were meant to be based on actual costs, not whether someone looked wealthy or turned up “in stubbies and thongs”. Dr Hambleton called on the insurance industry to provide evidence so that the claims could be acted upon. “It should be stamped out,” he said. PHA’s Dr Armitage said that doctors were charging some private health insurance policy holders extra “despite our very best efforts, which include paying (treatment) providers more”. These are payments on top of the Medicare Benefits Schedule fee, on the basis that policy holders will not have an out-of-pocket cost for the treatment. For example, industry no.2 Bupa’s “Medical Gap Scheme Benefit” pays a doctor nearly $2000 towards the delivery of a baby – 184 per cent more than the MBS fee of just under $700. However, industry players say that in some instances, specialists who sign up to these “no gap” schemes still decide to charge an additional amount. In such cases, the patient doesn’t just pay the amount over and above the gap scheme benefit – they pay everything above the MBS fee.
Australia needs more doctors — but does it need more medical schools?
So medical student numbers were cut back More recently, about a decade ago, the federal government began a massive increase in the number of medical students.The first phase of this increase has nowgraduated. The average member of the public has only a hazy view of medical training.On graduation from a medical school, these doctors cannot practise independently but require graduated and supervised training.In round terms, one can double the length of training, so to producea fully fledged GP or specialist will be of the order of 12 years (sometimes longer) after leaving school. For the first year after graduating, these doctors have to work as interns. As interns they contribute to patient care.But they need close supervision, but the supervisiongradually becomes less as they become more senior.So the service provision at more junior levels is less, but increases with increasing level of seniority. But and a big but there wereinitially too few jobs for the graduating interns.Each state has then increasedthe number of intern positions (by 120 last year and this year in Queensland, for example).Next year, there is a need for a similar bulge in the numbers of slightly more senior doctors and this continues up the training scale. The increase in interns will flow on like global warming giving rise to increased numbers at each stage after graduation. Eventually, they will become advanced trainees, then finally fully fledged general practitioners or specialists.The process has begun, and will yield more GPs or specialists in 4-6 years from now. Training positions require salary and infrastructure.The states have to find money.But junior doctors do not treat as many patients as fully trained doctors. So the states spend more now, and hope for a dividend in 4-6 years from now with increased GPs and specialists. What will happen next?How about bedding down the increase of medical graduates?Well, um, no Two universities have applied fora new medical school Charles Sturt University in NSW and Curtin University in WA. There are strong lobbyists for each. A popular one is rural focus.They forget that each of the older Australian medical schools has a rural clinical school where students spend a full year studying in rural areas. Who is lobbying forCurtin University?Some well-connected people. Jim McGinty is chair of Health Workforce Australia, and former Minister of Health in the previous ALP governmentHealth Workforce Australiahas a budget of several billion to pay for undergraduate training in the health professions.