You’ve probably seen this petition pop up in your feed over the past few days - fighting back against proposed changes to the cost of pap smears.



The petition claims changes could see Australians’ medical bills rise - paying up to $30 to receive a pap smear, and up to $173 for an MRI scan from July 1. “It is disgusting that your government is cutting bulk billing incentives for pap smears, MRI's, urine/blood tests, X-rays and ultrasounds,” the petition reads.

And its supporters have grown to over 150,000 and counting, with a string of protests on the issue scheduled around the country next month.

Why now?

Back in December, the Government’s Mid Year Economic Fiscal Outlook AKA MYEFO - essentially a half yearly update of their annual budget - flagged cuts to “inefficient” Medicare payments to pathology services - including pap smears, MRIs, blood tests, X rays and ultra sounds.

The measures intend to cut bonus payments given to pathology - potentially disincentivising bulk billing, and saving, according to the Government, around $650 million over four years.

Keep in mind: these changes will only come in to place from July 1, and they still need to pass the Senate in order to go ahead.

In December, Finance Minister Mathias Cormann insisted the plans wouldn’t affect patients. “I can absolutely guarantee that every patient in Australia who needs these tests will get them.”

For the few weeks over the Christmas break, attention on the issue seemed to cool down.

But on Tuesday, Mammamia posted a link to this article on their Facebook page, bringing the Government’s plans back to the fore, and causing a huge wave backlash online.

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Health Minister responds

As support exploded for the Change.org petition yesterday, Health Minister Sussan Ley denied the claims of patients wearing the extra costs of medical bills, and wanted to “reassure” women there would be no changes to the access or cost of pap smears.

“There are no changes proposed in MYEFO regarding the cost of either receiving or delivering a physical pap smear examination undertaken by your GP or specialist, nor their billing practices.”

On a 'THESE CUTS ARE KILLING US: End Healthcare Austerity' post on Facebook, one woman said she would prefer if Ley could “guarantee” rather than “reassure” Australian women that they wouldn’t see changes to their bills.

In a statement, Ley clarified what exactly came out of the MYEFO plans.

“Changes in MYEFO relate to an inefficient payment – worth between $1.40 and $3.40 – that is paid direct to pathology corporations separate to the Medicare rebate. It is therefore not part of the patient’s Medicare rebate, as some have tried to claim today.”

Put simply: unless pathologists and practitioners cover that cost themselves, they'll have to pass it on to patients.

But the Government isn’t convinced this will have too much of an impact bulk billing. Since 2009, when the incentive was introduced to pathologists, rates of bulk billing only increased by one per cent, according to the Government.

In other words - the payment doesn’t seem to increase bulk billing by that much anyway.

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Where did the $30 figure come from?

25-year-old Brigitte Garozzo, who started the change.org petition, admits she isn’t certain how $30-per-pap-smear figure emerged.

Doctor Michael Harrison, President of the Royal College of Pathologists Australasia, tells Hack the figure isn’t concrete - but it could easily be higher.

“[The $30 figure] is really sort of a punt or stab in the dark,” Doctor Harrison says.

But he breaks down how the “$1.40 - $3.40” cut put forward by the Government could snowball.

“When you have a pathology test we can’t actually raise a bill until we’ve done the test...If we don’t bulk bill it and send straight to Medicare, we have to send an account to the patient,” Harrison explains.

“This is the bit the minister doesn’t understand,” he says, “Once you start sending accounts out - that’s a very costly exercise.”

By accounts he means a manually-processed paper bill in the mail.

“The government is saying it’s only cutting it $3.20, but it costs $15 or $20 to send [out accounts]. So the gap could be more than $30, it could be $50 or $60.”

“What’s being pedalled at the moment [by the government] is completely misleading.”

Can’t pathologists absorb the cost?

Doctor Harrison says the Government’s new measures could be the straw that breaks the camel’s back.

The pathology sector has already suffered budget hits, Doctor Harrison says, and they’re still struggling after reduced fees were introduced to pathology in November 2014.

“Pathology practices are struggling,” Harrison says. And he believes pathologists won’t be able to absorb another cut.

“The feedback that I’m getting from pathologists, is that they will not absorb this cut and it will result in a co-payment.”

Activists remain firm

“I was annoyed that we’re going to have to start paying for these essential services that we previously didn’t have to pay for,” Brigitte Garozzo, the 25-year-old Sydney woman who started the petition tells Hack.

Brigitte doesn’t buy the Minister’s comments from yesterday. She says the Minister incorrectly interprets her cause - they know pap smears will remain on the Medicare rebate; they’re protesting the axing of an incentive for doctors to bulk bill.

“I feel like [the Government is] using that as a decoy - we’re not actually saying that the Medicare rebate is changing at all,” Brigitte explains.

And any increase in costs to pap smears is too much of an increase, Brigitte says.

“I don’t think it matters whether it’s two dollars or thirty dollars - there is going to be money charged for these services if this bulk billing incentive is being cut. We should not have to pay for these things.”

Brigitte’s looking forward to the planned protests next month, and admits the reaction to her petition has been overwhelming.

“I knew people were annoyed about [the measures], I kind of expected it to get some traction but I didn’t expect this much. It’s kind of exploded.”

Sussan Ley: pathology companies are only concerned about shareholders

In yesterday’s statement, Sussan Ley said the priorities of pathology companies weren’t straight - suggesting some practices were more concerned about their shareholders than their patients.

“It is important to acknowledge complaints from stock exchange-listed pathology companies about this MYEFO decision have revolved around impacts on ‘shareholders’ – not patients – exposing what is really motivating these criticisms.”



Doctor Harrison takes offence to Ley’s suggestion.

“It’s actually really insulting for the minister to say that,” he says, “It’s simply not true.” Doctor Harrison said pathology companies need to make a profit and attract investors so they can continue to operate and buy new equipment.

