On the face of it, it is hard to see the exact motive behind Tony Webber’s spray that was published in the Medical Journal of Australia this week. Sour grapes at the DoHA in their failure to respond to some of his concern? Frustration that despite all that hard work as chair of the Professional Service Review Board he was unable to implement any real improvement in an inherently flawed system? Or just good old fashioned professional jealousy?
Either way, cardiologists were clearly in the firing line.
As others have been quick to point out, the position chairing the committee responsible for dealing with the worst cases of abuse of the Medicare system is perhaps not the best vantage point for taking an objective view of the functionality of the system as a whole. Furthermore, the cost of ‘waste’ quoted at $2-3billion per annum appears to be little more than Webber’s personal estimate based upon a calculation that he doesn’t care to share with the readership.
In fact, Dr Webber’s tilt at cardiologists seems a little misplaced. Whilst mourning the inability of Ms Roxon to arrange to cut the medicare rebate to ophthalmologists for cataract operations by 50% he simply ignores the fact that in the same budget cardiology practices and their patients were forced to absorb a 20% reduction in the rebate for cardiac catheterisation without any discussion, consideration or consultation. Add to that the fact that rebates for cardiac diagnostic imaging services such as echocardiography have not been indexed in the memory of most practising cardiologists (resulting in an effective cut of >40% compared to CPI) and his assertion that once rebates have been set they are never reconsidered seems at best baseless, and at worst a deception.
Whilst Webber goes to some lengths to point out that not all specialists abuse the Medicare system it’s unlikely that this is how his comments will be interpreted. At least not if the first round of associated newspapers headlines are concerned
Sydney Morning Herald – ‘Medicare rorts cost $3bn’
The Age – ‘Don’t let rorters undermine Medicare’
Fortunately, we were able to rely on the journalists from The Australian who weren’t able to see too much past the fact that…
‘…the safety net has been used to “subsidise cosmetic procedures such as surgery for ‘designer vaginas’…
Fundamentally, Webber’s comments are poorly written, randomly directed, lacking detail and unsubstantiated. In many ways it is surprising that the MJA even agreed to publish the article in this form. Perhaps even more disappointing is the total lack of even a suggestion of a solution. Without that it is likely that as Webber slides back into obscurity as a suburban Sydney GP his comments will follow him.