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Experts dissect how much impact Labor’s cancer policy will have on out-of-pocket expenses

Email Is Labor's pledge to provide free specialist consultations to cancer patients feasible? By political reporter Stephanie Dalzell and Michael Vincent

Updated April 16, 2019 00:18:34

Bill Shorten stands at a lectern with "A Fair Go For Australians" written on it, smiling proudly in front of volunteers Photo: Labor leader Bill Shorten insists doctors will choose to bulk-bill patients to attract business. (ABC News: Nick Haggarty) Related Story: Labor's Budget reply promises 'greatest investment in Medicare in a generation' Related Story: Shorten grabbed the mic from Morrison and foiled the Government's tax pitch Related Story: Freyja is battling an aggressive cancer, and travel for treatment only adds to burden Map: Australia

Labor's multi-billion-dollar pledge to provide free specialist consultations to cancer patients has come under the spotlight, with the Coalition slamming it as an "irresponsible hoax" while experts dissect how much of an impact the policy will actually have on patients' out-of-pocket expenses.

Key points:

  • Health Minister Greg Hunt says Labor has made a false promise on out-of-pocket costs, and says it would cost billions more than has been earmarked
  • Labor insists it only ever promised to radically reduce out-of-pocket expenses, not eradicate them
  • Labor's pledge relies on specialists to agree to bulk-bill patients, and critics say doctors could still charge higher fees

The promise was part of the party's big-ticket election promise unveiled earlier this month, with Opposition Leader Bill Shorten vowing he would invest $2.3 billion to slash out-of-pocket costs for cancer patients, if he won the May 18 election.

Part of the plan involves spending $433 million on 3 million free specialist consultations for people with cancer.

Labor has promised to design a new Medicare item to cover the cost of a consultation with an oncologist or surgeon with a $150 rebate, which specialists could only claim for if they bulk-billed their sessions.

Bill Shorten outlines Labor's plans in his Budget reply speech. (Photo: Nick Haggarty) Video: Bill Shorten outlines Labor's plans in his Budget reply speech. (Photo: Nick Haggarty) (ABC News)

But Health Minister Greg Hunt seized on the promise on Monday, producing a list of more than 420 Medicare Benefits Schedule (MBS) items related to cancer treatment.

Based on those items, he said to make all consultations for cancer patients free would cost closer to $6.8 billion.

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"The real point here is they have no idea what they're doing, they made a false promise and they were caught out saying they'd virtually limit out-of-pocket costs without having any idea what they were proposing," Mr Hunt told RN Breakfast.

"It is an irresponsible hoax."

Shadow Treasurer Chris Bowen said Labor had only ever promised to radically reduce out-of-pocket costs — not eradicate them.

"That claim is so wrong, it's scary that a serving minister would reduce himself to making it," Mr Bowen said.

"We've made it very clear that we would create a new Medicare item. Greg Hunt has based his scare campaign, his blowout claims, on existing Medicare items — he's got his facts wrong."

Grattan Institute health program director Stephen Duckett said the Coalition's assessment of Labor's promise was unfair.

"The list of 421 items has honoured all sorts of items — including surgical items done in private hospitals. This was never part of the Labor promise, and shouldn't be counted as a cost blowout," he said.

"On a number of fronts that cost estimate is fallacious."

Labor's policy goes some way to addressing increasing costs — but it relies on bulk-billing

Critics of Labor's policy note that it relies on specialists agreeing to bulk-bill patients.

The new Medicare item will not stop specialists choosing to claim a separate item on Medicare in order to charge patients a higher fee.

Doctors would get a smaller rebate, but ultimately would end up with more money in their pocket.

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John Brashford, a past president of Private Cancer Physicians of Australia, said while some practitioners were very committed to minimising gaps for their patients, there were some who believed they have expertise that allowed them to charge.

Dr Brashford noted the Medicare rebate freeze — which both parties have committed to ending if they win election — had made a significant impact on patients' expenses since 2012.

"You can't get away from the fact that if you don't keep pace with the rises in costs then there will be an increasing gap … certainly the Labor party proposal goes a significant way to addressing that," he said.

Kylie Walsh is among millions of patients who understand the financial burden of cancer treatment first-hand.

Kylie Walsh says "you can't even think about your finances" while going through cancer treatment. Video: Kylie Walsh says "you can't even think about your finances" while going through cancer treatment. (ABC News)

She discovered she had breast cancer in 2015, and it later spread to her lymph nodes. As a private patient, she was left almost $20,000 out of pocket.

"It's like your life stops," she told 7.30.

"I had to stop work immediately and go on the cancer journey.

"The harsh fact is you can't even think about your finances. You're just trying to survive each day."

Ms Walsh noted the costs of treatment were ongoing.

"I had my annual check-up last week and those scans were $140 in out-of-pocket expenses, and you also have to pay the surgeons' fees on top of that," she said.

"So that is very costly for people who may be unemployed or don't have access to financial support."

Kylie Walsh wears sunglasses on the beach Photo: Kylie Walsh was first diagnosed in 2015, and the costs of her treatment have been ongoing. (ABC News)

'It is competition, friends'

Labor estimates the additional Medicare item would see bulk-billing rates for specialists rise from about 40 to 80 per cent, with Mr Shorten saying doctors would choose to bulk-bill to attract business.

"The doctors want patients," Mr Shorten said.

"If you don't want to do that and you want to charge more, someone down the road is going to accept the new, more generous fee, and see more patients.

"It is competition, friends."

But ABC health commentator Norman Swan said the plan would be difficult to deliver, and failed to get to the crux of the issue.

"It will save people some money, but it doesn't get to the core of the problem with cancer care in Australia," Dr Swan said.

"That's about quality, safety, and variation and people not knowing who to go to.

"To actually reform cancer care and really reduce out-of-pockets you've got to look at a broader range of issues than just the consultation, or whether you can get a scan for free."

For more on this story watch 7.30 tonight.

Topics: government-and-politics, health-policy, doctors-and-medical-professionals, medical-research, health, diseases-and-disorders, cancer, australia

First posted April 15, 2019 17:22:46

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