I’ve got a bad case of loving you (for which I’ll need to book a second appointment)
The government is sick and tired of doctors treating physical and mental health issues in the one appointment and would like them to stop charging Medicare for all this wasteful efficiency, thanks.
That’s the gist of a new “compliance push” from the Department of Health, reminding GPs that they shouldn’t make claims to Medicare under two different consultation lines.
Instead, one presumes, assiduous doctors should instead tell the patient breaking out in stress-hives that today they can deal with either the skin problem or the stress problem but not both (apparently Medicare is a big fan of the philosophy and adhere to Descartes’ theory of the separation of mind and body).
This has led to a massive GP backlash, with a petition circulating demanding that this onerous condition be changed since it puts extra pressure on the doctor, the patient and the medical and mental health systems.
Those critics include RACGP president Dr Harry Nespolon, who declared that it is “entirely counterproductive … Many patients have both physical and mental medical concerns and it’s entirely within the scope of general practice to treat the whole person.”
Descartes could not be reached for comment.
Duluk runs out
Things have got real in SA with sexual harassment allegations against state Liberal MP for Waite Sam Duluk now being referred to the police after the Marshall government’s strategy for swift action turned out to be “going very quiet about things for two months”.
You might recall reports that Duluk made unwanted approaches to SA Best MLC Connie Bonaros after turning up uninvited to the crossbench Christmas party last December, including an alleged bum slap.
Bonaros reported this to Premier Steven Marshall who pledged immediate action, Duluk issued a public apology of sorts and stepped down from his committee work while Speaker of the House Vincent Tarzia announced that an independent investigation into the allegations would be put in place.
And then, with progress on this independent investigation seeming to have gone suspiciously stationary, a frustrated Bonaros decided to report the incident to the police instead.
And now the Liberals are torn between actively supporting Duluk, or condemning what he allegedly did and hoping the whole matter just blows over.
Duluk had initially suspended his membership of the party in contrition, but then held the Waite State Liberal Electorate Committee meeting in his office, where the members reiterated how much they support him and moved a motion to that effect.
Which, as federal MP Simon Birmingham correctly described, was not “a helpful thing to do”.
No. No, it was not.
‘Fantastic. Great move. Well done Angus.’
It would be entirely reasonable, dear reader, for you to currently suffer from rort-exhaustion, where new revelations of public money being deployed to seemingly election-winning strategic ends by the Morrison government across a number of programs and portfolios draws and exasperated shrug rather than incandescent fury.
So you might have avoided delving too deeply into the recent report by Jommy Tee into the Commuter Car Park Fund — a $149 million solution to congestion and traffic that would create new carparks along railway corridors “that, miraculously, were all located in Liberal-held electorates”.
And it’s a predictably depressing read. But one little detail might have escaped notice involving the ever-blessed Angus Taylor, minister for energy, occasional water magnate and scourge of native grasses.
He was celebrating the government’s decision, and his apparent influence, in getting 1000 new car parks at Campbelltown station, despite said station being in the seat of Macarthur rather than his own seat of Hume.
In any case, this magnificent triumph of car-parkery was the topic about which he was posting on Facebook in May 2019 when he legendarily forgot to change profiles in order to post the reply “Fantastic. Great move. Well done Angus”, meaning that this piece of unsolicited praise for something in a different seat came up under his own name rather than that of a totally legitimate fake member of the public.
That bit of transparent up-screwage is just one of the many, many things Taylor has avoided losing any serious skin over, including his office’s use of an allegedly doctored document in an attack on Sydney Lord Mayor Clover Moore, about which the Australian Federal Police declined to interview him during their “investigation”.
The man sidesteps scandal with such spry dexterity it’s a wonder he’s not on Dancing With The Stars. He and Celia Pacquola would be electric.
RE Doctors getting in trouble for being more efficient. In the hospital sector, the is less of a rebate in private hospitals for multiple procedures being done at once, so the patient is overall out of pocket more than if procedures done separately (eg Adenoids and tonsils / Double knee replacement).
Overall impact is Medicare pays more, and patients spend more time in recovery. Hmmmm… Something wrong here.
How did you try to reach Descartes for comment?
Used a Medium as a Modem
Greedy doctors have long been a target for the Health Insurance Commission, and there is a bar on you providing the one patient more than one service on any one day to stop you gaining too much from the system. It is well known that we doctors care nothing for our patient’s well beeing, but instead are only interested in purchasing our 14th negatively geared investment property, having a holiday in five star luxury, bathing in Grange, or making the next payment on our AMG Mercs.
I feel for GPs who have been hit between the eyes by this rule. Like so many Government edicts it was created with good intentions, but is actually counter productive in practice. As a practicing anaesthetist I get it all the time. Epidural placed at 0800, Caesarean section at 2200 – Doctor, you’ve claimed for two services in one day, you do know that’s a no-no? A stunning example of a failure to comprehend the realities of labour and delivery, and clearly an example of a rule that can only have been made by a committee comprised entirely of men. Similarly, a reutrn to theatre for a surgical complication requires a second anaesthetic. Same thing happens, two services on one day, no money for you mate, you rorting sod (BTW, epidural at 2350 and Caesar at 0005 is perfectly fine according to Medicare). There are even specific item numbers for subsequent visits to adjust infusions and the like, again getting Medicare to pay them is like pulling teeth. There IS a way of getting around this with a system called the multiple procedure override, but it is so cumbersome and it so often fails to work that I suspect many practitioners simply acknowledge the rule of diminsihing returns, give up, and can’t be bothered expending the time and money it takes to get paid. The cynic in me can’t help but wonder if this is deliberate.
I’m a strong advocate for keeping public services in public hands, but in this case if the Medicare payments system was put out to a private provider that was capable of a nuanced understanding that sometimes patients really do need two (or more) things done to them on the same day, or in general practice two things attended to in the one consultation the system would be a whole lot more efficient, and patients would be the better for it.
The question one has to ask is “Would Angus # Gates still be in cabinet, if his wife was not involved in Gerard Hendersen’s Sydney Institute of Public Affairs?”.
I think the combo of no spare backseats and wife’s position are the glue required, so far.