Capping Medicare Saftey Net for IVF/ART

[dusty]

I have a bad feeling too. I reallllllllllly hope I am proven wrong.
BUT, even if they bring down a bad outcome for IVF we can still make ourselves heard and try and change the outcome. How to get the general community's support, who haven't faced or experienced infertility in their lives, may be a challenge. Bec good on you for putting your story out there . I feel it is the real stories like yours that will influence attitudes.

[Muppity]

Ok - this is what the news is reporting this morning...

In a nut shell:
* there will be no means testing
* actual medicare rebates for obstetrics and IVF (along with a few other things) will go up
* there will be a cap on the amount that you can claim on the safety net

So, the rebates that everyone gets for the items (regardless of whether you have reached the safety net or not) will go up (no idea how much) and there will still be some form of safety net but not as it currently is - presumably a maximum amount each year - a bit like items on health insurance.

Stay tuned for more info once the media all get hold of it - so far I can only see it in the SMH and I heard a little snippit on early AM on the ABC - I will be listening to the full AM at 8:00.

The Ob interviewed on AM said that about 80% of women who use Obs will be worse off.

[Mak]

Front page of the Age also carried similiar info - maybe worth checking out online?

Talk about disappointing - although may be best to see what the detail is on Tuesday....(trying to stay hopeful).

[dusty]

Crackdown on doctor rorts | theage.com.au

So it seems they are going to try to influence the amount the IVF clinic charges by reducing the amount patients can claim under the medicare safety net.

If the safety net created a rort/incentive for clinics and specialists to increase their charges, why not regulate how much the clinics and specialists can charge rather than penalise patients that access the clinics and who have to depend on what the clinics decide to charge. I dunno seems like they 'hope' this will reduce the prices clinics charge.

[buliej]

Yep - link on front page of the Age online. No real info there, sounds like everything Muppity said is true, but the cap on the safety net will be a cap for specific items like ivf and ob fees. Of course, the last line of the article is that these changes haven't been confirmed or denied by the government. I wonder what the cap will be and how many cycles it will translate into in terms of cycles where you get some money back and cycles where you don't.

My reading is that this will, to some extent, limit the number of cycles people will do in a fiscal year - if it is a reasonable limit, well, I guess compared to what could have happened, I will begrudgingly say OK. But if it's like 2 cycles, that will really stink.

In some ways I could see a LIFETIME cap on cycles in terms of safety net (or cap per live birth and once you have a live birth you go back to zero and get to access the safety net again) IF it is a realistic cap (representative of the average number of cycles & has some correlation to how long it takes people who don't need AC etc). I can understand how the safety net may not discourage people to do a crazy number of cycles which the government has to pay for.....and this is coming from someone who has already gone through 4 cycles and expects to have to do a few more and will in fact do a crazy number if that is what it takes or until I just call it quits.

[buliej]

Dusty - there seems to be little focus on the drs and the clinics - I wonder if that's because they have no power to control anything they do (although they sure exercise their power when it comes to rules about how many embryos/police checks (state rules)/etc....seems like they are as powerless as they are in terms of forcing the banks to pass on interest rate cuts. And little focus on investment in how to improve success rates of IVF - now wouldn't that be great!

[dusty]

Julie, that is food for thought about limiting cycles. In a way depending on how and what the limit on claims under the Safety Net becomes, they could essentially be limiting the amount of cycles you can do under Medicare/Safety Net in a financial year. And depending on where you live, there may be no competition between clinics (eg only one in a region) and hence the price of cycles may remain high and limit the amount someone can do in a region compaired to a city where there is more competition and perhaps downward pressure on prices. Hence someone in a city may be able to squeeze more (cheaper) cycles in than someone in the country/regional area.

I think they are leaking this info out now to see what the reaction is from the community before next week's budget.

Time to email/ring/fax the Treasurer and PM again I reckon with outrage at any limit to the number of cycles we can access under a reduced/limited Safety Net. Why should we suffer because of the impact of the greed of corporate IVF clinics and their shareholders.

The Hon. Wayne Swan MP
Treasurer
T:02 6277 7340 F: 02 6273 3420
E: wayne.swan.mp@aph.gov.au

The Hon. Kevin Rudd MP
Prime Minister
T: 02 6277 7700 F: 02 6273 4100
Email: alister.jordan@pm.gov.au
Email ankit.kumar@pm.gov.au

[Bengal]

This may be a silly question : Does anyone have any idea when these changes would take place ? At the end of this year etc ?

[Muppity]

I think that Dusty is right - There should be a limit on the amount that these people can charge in the first place - rather than a limit on the amount that patients can get back.

From what I heard this morning there will be a maximum amount that you can get from the safety net for particular services. And it won't be particularly large. But, the actual medicare rebate will go up for the services so the amount that you get back before you hit the threshold will be more and also the amount that you get back if you exhaust your safety net will be more than you would get now if there weren't a safety net. Does that make sense?

It's still awful and will hurt but not nearly as much as if they excluded certain treatments entirely.

But it will effectively limit the number of cycles that people can do a year because while the first few will be covered the ones after that won't be. It's going to be much easier to get into a clinic in the last months of the year than the first.

To answer your question WLAB - no way of knowing. But, it will be one of four - either as of 12 May (budget night), 1 July or 1 January or a random date that they make up but the other three are the most likely possibilities. I hope that it is 1 January because I will have already exceeded pretty much any cap for this year already, and while I could theoretically start another stim cycle before 1 July I won't be finished it.

Arggghhhh!!!!!

[dusty]

Muppity did you get a sense of whether they will also be limiting the number of times you can claim the increased Medicare rebate, as opposed to a limit on the Safety net?

[buliej]

I'm in a taxi bet mtgs. This is all over the news (radio) but focus of news seems to be OB fees.

[Lenny]

A double blow for those of us who need ART and who's DH has SHOCKING varicose veins! Wonder why they included that in there?!

Anyway, many thanks to Dusty and Muppity for keeping us all well informed. It will be intereseting to see if the real Budget and the 'leak' are exactly the same...let's hope for the best.

[Sara69]

Sorry girls but I am devastated - I know that I will need at least another two cycles to have any chance of ever having a baby, I already had two this year (The Medicare Saefty Net is not for the financial year but for the annual year) and so if this is true I'll probably won't be covered for any more - especially as my clinic is probably one of the most expensive ones in Australia.

Dusty: thanks for the email contacts again I've sent of another email. I didn't get any response to my earlier one. I think they just don't care.

Sara

[Sara69]

Lenny, sorry but I don't think there is any more hope in hoping for the best - this decision is 95% made - they usually leak all the bad news before budget night so that only the good news is left.

The worst thing about it is that they have a good chance to get this through the Senate - while the Liberals may not have supported means testing it is pretty close on what Tony Abbott suggested a few years back.

Sara

[dusty]

Sara . It does suck that we seem to be hit hard with this measure. Together, hopefully we can change things to be a better outcome for those of us that need IVF to have a family.

Reading the news reports this morning, shows that the media are focusing on the fact that there have been increasing rorts of the system by clinicians and clinics. However, there doesn't seem to be any (or limited) focus on the impacts of this on the patients who the Safety Net was originally designed to protect. The conversation is the wrong way around IMO. It seems the media are lapping up the Government's reasoning for making the changes without questioning the impacts of such rorts and hence the impact the Gov'ts move to stop those rorts will have on the those of us that need medical intervention to create Australia's next generation.
It then smacks of "go forth and procreate, but only if you can do it by having a fun time doing the BD and not by expensive invasive medical intervention".
.

[Bengal]

To answer your question WLAB - no way of knowing. But, it will be one of four - either as of 12 May (budget night), 1 July or 1 January or a random date that they make up but the other three are the most likely possibilities. I hope that it is 1 January because I will have already exceeded pretty much any cap for this year already, and while I could theoretically start another stim cycle before 1 July I won't be finished it.

Arggghhhh!!!!!

If you pay up front for a cycle before July 1 for example, you would have to get 80% back under the old regime. I just rang the clinic, rumours abound of July 1 or Jan 1. I am now on the phone to medicare, who said "it's speculation" .. This is insane

[Sara69]

WLAB, just rang SIVF - prepaying for cycle is unfortunately not possible, they can only bill from the date you're starting the FSH otherwise Medicare won't accept the claim.

Dusty: Fully agree with you - I am angry that clinics like mine are overcharging and costing Medicare so much money, but it's awfully unfair that we should have to pay for it.

Sara

[briggsy's girl]

the changes won't come into effect until Jan 1 next year if they come in - they can't disadvantage people who are currently using the safety net - they have to wait until the year is finished and given the medicare year is jan 1 - dec 31, they have to run with that

it's like the changes to the baby bonus that happened - it came into play from start of new calendar year so that women who were already pregnant (apart from those due in the first fortnight of the new year) wouldn't be disadvantaged at all