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HomeminewsThe Battle to Restore the Cataract Surgery Rebate

The Battle to Restore the Cataract Surgery Rebate

At the time of publishing this edition of mivision, the battle to restore the Medicare rebate for cataract surgery was still raging. The rebate had been cut by 45 per cent despite threats from Coalition and cross bench senators that they would block it in the Upper House. To that extent, the Senate will vote on, and more than likely block the plan to reduce the cataract rebate when it sits again. What happens from that point is still unknown at the time of publication, but there have been further developments in the rebate war.

HCF Covers Members for Cataract Shortfall

Australia’s largest not-for-profit health insurer has shamed the Federal Government by increasing benefits for cataract surgery.

This follows the Rudd Government’s decision to slash the Medicare rebate originally by 50 per cent, but then by 45 per cent when the legislation hit a hurdle in the Senate.


“The fight to reinstate the full Medicare benefit is far from over with federal coalition teaming up with independent senators to disallow the lower rebate.”

HCF says its move means members won’t face any additional expenses following Labor’s decision to cut the standard government rebate from AUD$624 to AUD$340.

“Without passing judgment on the government’s decision, HCF intends to cover, for a period of up to six months, any increase in out-of-pocket expense for our members caused by the Medicare decision, so that they are no worse off financially,” HCF chief medical officer Andrew Cottrill said in a statement.

The health fund will also increase benefits for angiograms. The Medicare rebate for those procedures has been cut by 18 per cent. HCF says boosting the two benefits will cost AUD$1.7 million a year. But it’s only promised to cover any shortfall until next April, when a new benefits schedule will kick in.

“We will work constructively and in collaboration with relevant medical organisations to agree on a fair cost of providing cataract surgery and angiography, to be covered in our new medical benefit schedules,” Dr. Cottrill said.

Health Minister Nicola Roxon claimed patients wouldn’t be left in the lurch with the new AUD$340 rebate if eye doctors simply lowered their fees.

She argued that advances in technology means standard cataract surgery takes just 20 minutes, and doctors are raking in millions as a result of the excessively high Medicare payments.

This has been denounced by ophthalmologists who say the surgery takes longer than the time stated by the Minister. Doctors argue the move will hurt elderly patients and the indigenous community in particular.

The fight to reinstate the full Medicare benefit is far from over with federal coalition teaming up with independent senators to disallow the lower rebate.

This positive news follows an announcement by Australia’s largest health fund Medibank Private, which said it will no longer be able to provide any rebates to its members who have cataract surgery.

Doctors have already warned that they will have to cancel operations because patients will not be able to afford the bill.

“It’s not just the doctor’s fee. Health funds won’t be able to provide a refund for the implants, the theatre fees, the hospital bed fee and the anaesthetist,” ophthalmologist Dr. Russell Bach has told the media.

The Opposition and all the minor parties in the Senate have moved to axe the rebate as part of a fight with the Rudd Government when Health Minister Nicola Roxon tried to circum vent their efforts by raising the rebate by a paltry AUD$28.

In the May Budget, Health Minister Nicola Roxon announced plans to slash the Medicare rebate for cataract surgery in half from AUD$623 to AUD$312, wrongly claiming that technological advances meant the surgery now took just 15 minutes to perform.

The Opposition and minor parties demanded the Government pass new legislation they have introduced to restore the rebate to AUD$623.

The announcement came after two days of parliamentary manoeuvring, with Ms Roxon dismissing as “unconstitutional'” a move by the Liberals to reinstate the existing rebate with a private member’s bill.

The Clerk of the Senate, Harry Evans, rejected Ms Roxon’s claim. “I cannot imagine what the basis of it is,” he said in an opinion for the Opposition. But Ms Roxon said there had been a longstanding conflict between Mr. Evans and Federal Government lawyers on the issue.

Veterans Affected

An experienced Sydney ophthalmologist and former President of the Royal Australian and New Zealand College of Ophthalmologists (RANZCO), Dr. John Milverton, is another person who has concerns regarding the actions of the Health Minister in halving the rebate.

He is concerned about the fate of Australia’s war veterans, particularly after perusing the website of the Department of Veterans’ Affairs.

“What appeared about a week ago (early November) when we looked up the website for Department of Veterans’ Affairs in the new schedule, they had halved the fees for cataract surgery (item 42702) for out-of-hospital surgery. That means day surgery where most cataract operations are done,” said Dr. Milverton.

“It means that veterans would have to go into the public system or into a private hospital. Why would the government do that for such a small number of people in Australia – it doesn’t make any sense to me? It also upset me because the Minister had told RANZCO that there wouldn’t be any tampering with the veterans.”

Dr. Milverton said he was so concerned for the veterans that he called the Returned Services League to let them know.

“What’s happened since I did that is that they (Veterans’ Affairs) have put up another statement on their website saying that the fee schedules are no longer available. They’ve taken it off. There is now no scheduled fee displayed. “We don’t know what’s happening with veterans. What they’re saying is that if a doctor submits a form to Veterans’ Affairs to get paid, this wonderful statement says “you will be paid the correct amount”. What the correct amount is, no one knows”.

Dr. Milverton added that Minister Roxon was wrong when she described ophthalmologists as greedy and that cataract surgery now only takes 15 minutes due to technology.

He pointed out that the overheads for ophthalmologists in private practice, with equipment, staff and rental of premises is anywhere from 50 to 75 per cent of the fee and that the average cataract operation takes about 30 minutes with some taking up to an hour.