In Your Say, readers tell Crikey what they think about our stories. Today you react to the Medicare fraud reports, our “sovereign” state, and on journalists who should say sorry.
On a broken Medicare
Dr Paul Nisselle writes: Bob Hawke opened a Pandora’s box when he waved his green and gold card and said: “This is all you will need for your healthcare.” Our healthcare has been chronically underfunded for many, many years. Healthcare costs have soared due to an ageing population, a rising population, new drugs costing huge sums, an explosion in elective surgery etc. Medicare was never intended to be a universal health insurance scheme; it was and remains a health cost reimbursement scheme. Bulk-billing, meaning assignment of the Medicare benefit to the doctor at the time of service, processed in bulk, meant there was no cost met by the patient at the point of service.
There was no evidence advanced to back up the assertion the “up to $8 billion” in Medicare fraud. “Up to” is a standard obfuscation when there is no data to support the figure. Yes, there is fraud. We must have better systems of surveillance to detect and punish it, no question. But Health Minister Mark Butler, it’s your job get the system right — get rid of the loopholes and make sure good medicine is properly funded.
The Crimes Act defines fraud as knowingly issuing a document which can be used to inappropriately obtain a benefit. In the Health Insurance Act, the word “knowingly” is removed. Thus the burden is placed totally on the doctor to know the arcane minutiae of the Medicare Benefits Schedule. The vast majority of the doctors I know are not rorting the system and not wilfully overservicing. That $8 billion figure is just wrong.
Professor Fiona Haines writes: Yes, Medicare fraud is an issue — and a serious one. So, too, is an overly complex Medicare numbering system to manage government (our) funds — and overworked doctors who are pushed to the limit. Can we please have a conversation that is not based on false binaries — that if one statement is true (e.g. Medicare fraud), the other is not (overly complex Medicare number system), or the reverse? A royal commission may well be the place to do this, but we need one premised on the complexity of the problem of keeping Australians healthy — equitably and sustainably — not one narrowly focused on “an overhaul of Medicare” with solutions already in mind.
Peter Gaskin writes: The investigation is a joke that makes robodebt look benign. Medicare is too important to be politicised like this — it needs a much closer look without grandstanding reporting. (I really enjoyed how the article was written.)
Malcolm Harrison writes: In a recent conversation with my doctor, he told me his clinic is going to have to introduce gap payments, not because of inflation, but because the government will not raise the rate presently offered and has refused to do so for years. By his metric, governments are deliberately undermining the bulk-billing process so necessary for those on fixed incomes such as pensions. So it seems Bill Shorten was right after all when some years ago he said the Lib-Nats were trying to hollow out the Medicare system. Unfortunately it also seems Labor won’t raise the gap payments either.
On manufacturing nonsense
Bill Wallace writes: Australia cannot rely upon overseas suppliers. It needs to have the capability to stand on its own two feet. Part of what is required is a manufacturing capability — heavy industry, medicines, technology etc and a workforce to support it. Obviously building resilience into all aspects of social and business life needs to be a long-term objective with a plan to get there. In the meantime, purchases to fill short-term gaps are OK, but not the desirable long-term solution.
Edward Down writes: I totally agree with the push for sovereign capability in essential industries. The supposed extra “cost” is nonsense. The money stays in Australia, circulates in Australia, and due to the multiplier effect (go read an economics textbook) the government and the economy clip the ticket every time the money goes round. This push for sovereign industry, with the full economic benefits being costed, may actually prove to be more profitable than sending money overseas to go round and round in someone else’s economy. Lack of skilled labour is a definite problem, but can be solved in the medium term through immigration. There is no shortage of skilled people wanting to move to the best country on earth.
Richard Gray writes: While I generally like reading Bernard Keane’s articles I think he’s missed a few points here. Australia (until infected with Liberal governments) had extensive manufacturing capacity and capability. We used to make our own trains, ferries and — dare I say — missiles. Well, admittedly the missiles weren’t very good but the trains and ferries served and continue to serve Australian commuters very well.
Also, the reason the Rail, Tram and Bus Union advocates for locally made trains is that the new South Korean-built trains are not fit for purpose and have significant safety issues, such as extremely poor camera visibility in the wet which could lead to passengers being stuck in doors. Furthermore, the extreme shortage of some prescription medicines highlights the lack of local manufacturing and shows up when global supply chains are disrupted.
Come on, Bernard, shake off your neoliberal hat.
On journalists admitting their errors
Colin Ross writes: The print media in particular is a mishmash of reporting, journalism and commentary. However, it seems that no one wants to be known as a reporter. Everyone wants to be called a journalist and entitled to an opinion, which makes them a commentator — often on subjects on which they have no particular expertise. Olivier Bost has plenty of counterparts in Australia who should be making mea culpas.
On data breaches
Frank Nicholson writes: Yes, corporations should be legislated to report all data breaches to affected individuals. And they should not be allowed to keep individuals’ personal information on file any longer than necessary to undertake their work. This includes wiping personal information when people leave an organisation whether from employment, contract for services etc.
I recently received a letter from my former employer that it had had a data breach on its payroll software supplier, saying it was notified in August 2022 that my data was exfiltrated (stolen). The cyberattack occurred in November 2021 and I was advised in September 2022. I had retired from the company in 2019. Why do these companies keep information dating back so far?
On whether protest stunts work
Gerard De Ruyter writes: I believe they do often work, but it depends on what you mean by “work”. If you mean stunts done by, say, Extinction Rebellion, which fights for real action on climate change, and you ask does gluing hands to the ground in front of Parliament House work, does it solve climate change? Of course not. Does it attract media? Often it does. But then you need to ask is it good or bad media. Or is all media good media? In my view, if the stunt attracts any media, it has worked as it gets people thinking, talking about XR and what it wants. Viewers will have their own opinions, but it keeps climate change in their minds for a while. XR also writes to stakeholders urging action, holds “normal” protest marches, and lobbies local members. It doesn’t only do stunts.
Lynn Benn writes: I have been part of the environmental/climate movement for many years. What the media and the public do not understand is the colossal effort that has been put in by that community: lobbying, petitions, networking with pollies, social media campaigns, writing to papers, outreach at markets and field days, marches, rallies etc etc. They have taken a huge toll. Two people gluing themselves to a painting gets far more media coverage than any number of corporate office sit-ins. The fact that the media fails to cover most non-confrontational protests means they are complicit in driving the trend to more extreme actions. Unfortunately this is what it takes to get media attention. The Picasso was called War and Famine, both of which are becoming increasingly common because of our lack of climate action. Almost none of the coverage mentioned that despite it being in the press release.
I also take issue with your characterisation of the “spectrum” of activists. In my experience the people most active in this space are often the same people on the ground supporting stricken communities and doing citizen science and wildlife recovery work. On motivation it is very simple: we want to stop the destruction of the ecosystem that supports us. We are rapidly going in the wrong direction. Labor may be less bad than the previous government but its enthusiasm for opening up coal and gas fields shows that it does not get the urgency of the problem we face. The question is not “Do protest stunts work?” but “What will it actually take for our society to realise the danger and take serious action?”
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Of course they are. They have been since it was introduced. Of all the public services, Conservatives seem to hold a special hatred for healthcare.
(Not that Labour’s neoliberalism is a whole lot better.)
There is fraud. At least one of my doctors has been convicted and was suspended for a year or so. Others may have been spoken too or penalised but not actually suspended so I think there is a lot of it going on. The shear volume of possible frauds suggests a serious review is called for.
I think clock work orange is happening. What have you done Scott?
Here is a funny one. Went into services NSW today. Told them that the local cetrelink has nothing to do with other federal arms including ato and the my gov app as relayed by the local centrelink. The guy frowned and typed something and he said “on the official website it says services NSW is responsible for medicare in this state”. He then said “news to me, we’ve never done medicare issues”.
Hint as to the “rorts”: Multinational “medical group”site calls on existing doctors to sell their practice to us, saying “we can do all the administration work”. “Medical Group” also are calling on new G.P’s in the country to work with us and we can help get you certified…. Why? Profits are the incentive… Profits which come out of the collective country’s Medicare and our autonomy; same blokes as CEO’s also invest in city car parks, etc ,etc.. once public infrastructure carved up for private gain; individual G.P’s are just muddling along;Same with the middlemen in NDIS, aged care and job services; sick profiteers
What I find interesting is that the gigantic Medicare fraud story arrived shortly after medicos made a convincing case for a crisis in general practice There are many reasons but governments freezing rebates have undeniably contributed The question remains is that if the so called loss is as big as claimed-so far it’s seemingly based on the views of a couple of people-how much is due to fraud and how much to poor design and bureaucratic bungling The Channel 9 Entertainment papers are one if the instigators and their papers increasingly resemble the Murdoch media