Medicare Benefits Schedule Review update
The Medicare Benefits Schedule (MBS) Review, announced as part of the “Healthier Medicare” initiative by federal Health Minister Ms. Sussan Ley in April 2015, is about to commence its formal review of all 5,700 Medicare items.
The ASA has a meeting scheduled with Health Minister Ley in Canberra on Tuesday November 10, where the MBS Review will form part of the discussions.
Importantly, the ASA has submitted the names of a number of representatives to join the respective panels charged with reviewing the item numbers.
The Australian Society of Anaesthetists fully supports the Australian Medical Association’s (AMA) view that the aim of MBS Review must be modernisation of the Schedule, not simply cost savings. The fact that we are in the middle of an unprecedented 6 year freeze of Medicare rebates indicates that the current government is firmly committed to cutting Medicare expenditure wherever possible. The AMA has already expressed a lack of confidence in government and Review Taskforce statements that decreasing expenditure is not part of the agenda.
The ASA also supports the AMA’s stance that the process must be clinician led, and that the various specialist Colleges and Societies should be intimately involved. It is not sufficient to simply state that review committee members can consult their College/Society for advice. This risks fragmentation and communication failures between stakeholders. The firm commitment of the entire medical profession will be required if the Review is to succeed in its plan to deliver evidence-based best practice, and to convince the profession that this is indeed the ultimate aim, as opposed to simply cost-cutting.
If the aim of the Review is indeed to modernise the MBS, there must be scope for the addition of new Medicare items, as medical practice develops and improves. The current process involving the government’s Medical Services Advisory Committee (MSAC) is slow, cumbersome, and expensive, and is inappropriately slanted towards economic considerations rather than best patient outcomes. Patients are currently receiving modern, high quality anaesthesia services, backed by sound evidence, but these patients are not being supported by the Medicare system, purely due to economic considerations. If the profession is to be convinced that modernisation of the MBS, based on best available evidence, is indeed the aim, this situation must be given consideration during the Review.
For the MBS to support quality patient care, there must be:
- a clear and overarching vision and specific direction for the Australian healthcare system to guide the final outcomes of the reviews;
- specific and quantifiable aims;
- the direct involvement of specialist colleges, associations and societies;
- full transparency of the individual reviews as they progress and the decisions that will come from them; and
- new items are able to be added to the MBS.
The ASA will be represented at the November 10 meeting with the Health Minister by myself, Vice President David M Scott, Economic Advisory Committee Chair Dr Mark Sinclair, Specialty Affairs Advisor Dr Jim Bradley and CEO Mark Carmichael. Members will be further updated following that meeting.