What is wrong with medicare

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MJA 196 (3) · 20 February 2012

The Medical Journal of Australia ISSN:

0025-729X 20 February 2012 196 3 2-2

©The Medical Journal of Australia 2012

www.mja.com.au

Letters

millions of dollars in the health

with Medicare?

TO THE EDITOR: Since the claims

made by Webber in his recent article1

were, in his own words, not based on

any substantiated data, it is

disappointing that the Medical Journal

of Australia did not seek to contact

either the Australian Society of

Ophthalmologists (ASO) or the Royal

Australian New Zealand College of

Ophthalmologists (RANZCO) for

comment.

Certainly, considerable work can

be done to improve the operation of

Medicare. We are on record as having

raised our concerns with successive

governments.2 However, Webber’s

generalised, sensationalist and

unsubstantiated claims add nothing to

constructive debate about Medicare.

It is disappointing that the Journal

would risk damaging its reputation, by

choosing to publish a perspective

without offering an alternative view to

demonstrate balance and evidence, as

one would expect in a peer-reviewed

journal.

Ophthalmology involves more than

just removing cataracts, and while

technology has made cataract

procedures safer and less invasive,

they remain complex and the

technology very expensive.3

The RANZCO and ASO have

worked with government through the

Medicare Benefits Schedule Review to

address concerns and shortcomings,

as well as providing supportive

evidence.4 On at least two occasions,

2 Royal Australian and New Zealand College of

Competing interests: No relevant disclosures.

doi: 10.5694/mja12.10146

1 Webber TD. What is wrong with Medicare?

Med J Aust 2012; 196: 18-19.

2 Australian Society of Ophthalmologists.

Grandma’s not happy Mr Rudd! Brisbane: ASO,

2009. http://www.grandmasnothappy.com.au/

(accessed Feb 2012).

3 Access Economics. Ophthalmology practice costs

study, 2008–2009. February 2011. Report by

Access Economics for

Australian Society of

Ophthalmologists Incorporated. Canberra:

Access Economics 2011. http://aso.asn.au/

images/stories/Ophthalmology_practice_costs_

study_2008-09.pdf (accessed Jan 2012).

4 Mundy T, Merlin T. Draft protocol. Review of

Medicare-funded ophthalmology services

(second stage). July 2011. Canberra: Australian

Government Department of Health and Ageing,

2011. http://www.msac.gov.au/internet/msac/

publishing.nsf/Content/65A4239557E05A98

The Access Economics

ophthalmology practice costs survey,2

commissioned by the Australian

Society of Ophthalmologists (ASO) in

2011, analysed the costs of delivering

ophthalmic services for the financial

year 2008–09. The report showed that

the average overhead cost per full-

time-equivalent ophthalmologist was

$506000, compared with $232617 in

19993 — an average annual increase of

9%, during which time fees for

ophthalmology items on the Medicare

Benefits Schedule (MBS) increased by

only 2.1% annually.4 Thus, the MBS

items become increasingly irrelevant in

the context of a small private

ophthalmic business model.

The cost to the taxpayer of a

cataract procedure in New South

Wales public hospitals is about $3500

(diagnosis-related group), compared

The average eye surgeon performs

fewer than half the cataract

procedures per week than the 20

which Webber anecdotally claimed

(and then multiplied by the entire

Peter M Sumich Eye Surgeon

Hunter Street Eye Specialists, Sydney, NSW.

psum125@bigpond.com

Competing interests: No relevant disclosures.

doi: 10.5694/mja12.10210

1 Webber TD. What is wrong with Medicare?

Med J Aust 2012.196: 18-19.

2 Access Economics. Ophthalmology practice costs

study, 2008–2009. February 2011. Report by

Access Economics for Australian Society of

Ophthalmologists Incorporated. Canberra:

Access Economics, 2011. http://aso.asn.au/

images/stories/Ophthalmology_practice_costs_

study_2008-09.pdf (accessed Feb 2012).

3 PricewaterhouseCoopers. Medicare Schedule

Review Board. A resource-based model of private

medical practice in Australia — final report.

Volume 2 — the model practice for each specialty.

December 2000. http://www.health.gov.au/

internet/main/publishing.nsf/Content/

D5805C64E0C2D09ECA256F180048DBDA/

$File/pcsvolumetwo.pdf (accessed Feb 2012).

4 Australian Medical Association. AMA Gaps

Source: www.researchgate.net

Category: Insurance

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