16 January 2004

Change of mind

Senator Jan McLucas, chairwoman of the Senate select committee inquiry into Medicare which is due to report when Parliament resumes this year, says she has had submissions from several allied health professions seeking access to the Medicare Benefits Schedule.

'The [psychologist's] submission was compelling ... but it was the view of the committee that it was extremely difficult to identify which service could be included [in Medicare], in the knowledge that all couldn't, due to funding restraints,' McLucas told the Herald. 'The difficulty ... is trying to pick where you apply scarce health dollars.'

Also in the 'no' camp is the Australian Medical Association, which in November last year decided to maintain its position of not supporting the extension of Medicare to any 'non-medical' group such as psychologists.

The two big gaps in Medicare coverage are dentists and clinical psychologists.

Oral health, as we know from recent research, is critical to general health, especially to preventing cardiovascular disease. The Senate committee argues that the health of the nation is crucial to economic performance and that this is the underlying principle of Medicare. It should follow that it is better to cover dental and clinical psychological services, if only for their preventive value. Australia is unusual in the pattern of psychological services because expensive psychiatrists can bill Medicare, but cheaper clinical psychologists cannot.

I am chasing down some information about exercise therapists and I'll add that when I can. The ADA put in a submission arguing for at least concessional coverage. The APA asked for clinical psychs to be given access to the Medicare billing system. The AMA put in its customary closed shop submission.

The Senate committee could do worse than going with the ADA/APA position.

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