Belinda Neal (Robertson, Australian Labor Party) Share this | Hansard source

I rise to speak on the Health Insurance Amendment (90 Day Pay Doctor Cheque Scheme) Bill 2008, a simply titled bill that just rolls off the tongue! It contains amendments to the Health Insurance Act 1973 which are designed to expand access to the 90 Day Pay Doctor Cheque Scheme. As has already been stated, the scheme was formerly only available to general practitioners, but the amendments before the House today will make the scheme available to all specialists and consultant physicians in cases where the original claim for the Medicare benefit was submitted electronically to Medicare Australia.

The 90 Day Pay Doctor Cheque Scheme was introduced in 2001 to guarantee GPs the payment of the Medicare schedule fee, more commonly known as the Medicare rebate. The original intent of the scheme was to rectify problems that arose when a patient submitted an unpaid claim to Medicare. In these cases, Medicare issued a pay doctor cheque to the account of the GP for the amount of the Medicare rebate. The cheque was given to the patient to forward to the GP who provided the original service along with any copayment required to satisfy the full amount of the account. In effect, this arrangement allowed the patient to use the Medicare rebate towards the payment of their medical bill rather than paying the medical bill in full at the time they were claiming the service.

So, in its original formulation, the 90 Day Pay Doctor Cheque Scheme carried advantage for both parties: it allowed the patient a more flexible payment option and provided a payment mechanism to the doctor of the Medicare schedule fee. But in cases where this cheque was not returned to or presented to the doctor or where there were lengthy delays in its presentation, the doctor sometimes incurred an unmet debt for services that had been provided in good faith. To overcome this problem, the 90 Day Pay Doctor Cheque Scheme provided that, if the doctor had not received and banked the cheque within 90 days of it being issued to the patient, Medicare Australia could cancel the cheque and forward the applicable Medicare rebate direct to the doctor via electronic funds transfer.

Under the legislation as it stands now, this scheme is only available to general practitioners, as I have said and as has been previously stated in the debate. It was noted at the time that the scheme was first proposed in 2001 that such instances of nonpayment of patient accounts were not limited to GPs but were experienced by other medical practitioners as well. However, proposals to make this scheme more widely available to practitioners other than GPs were not taken up by the previous government. The amendments before members today extend this scheme to a wide range of medical practitioners, specifically to specialist and consultant physicians, including pathologists, but only where the original Medicare claim for the service provided was submitted electronically. Other practitioners such as dentists and allied health providers will not be included in the amended scheme and the current arrangements for GPs will remain the same. It will provide an incentive for more practitioners to take up the use of electronic claiming of Medicare benefits.

The bill will also provide benefits to the patients and the families using the amended scheme. This is especially true in rural and remote areas and in regional areas such as my own. When a claim is submitted to Medicare electronically, the patient is not required to visit a Medicare office in person to receive their rebate or pay doctor cheque. This will have great advantage for those in rural and regional areas, where getting to a Medicare office sometimes requires travelling long distances or where public transport systems offer limited access to facilities operating in other towns. So I welcome any measure that eases the burden of people being forced to travel to access such facilities.

In addition, the elderly, the frail and many people with a disability will be able to have their claims automatically generated and lodged immediately after their consultation. They will not have to travel to a Medicare office to receive their rebate or a pay doctor cheque. An increased uptake of electronic lodgement mechanisms for Medicare claims makes for a more streamlined, efficient and flexible system. It brings advantages to patients and medical practitioners, but there will be a beneficial impact on the families.

I have mentioned that the scheme has the potential to reduce the number of families that are required to pay their medical bills up-front at the time of the service. Paying medical bills up-front, often with little warning in an emergency and little time to plan for the event, can have an adverse consequence on a family’s cash flow—in other words, they often cannot afford it. Being able to use their Medicare rebate towards the payment of such bills will materially assist many families right across Australia.

My own electorate of Robertson, centred on Gosford on the Central Coast of New South Wales, is far from being the most remote or rural of regions but it has many areas where access to medical facilities and Medicare offices is still difficult. People living in areas such as Mangrove Mountain and in rural areas further west towards Spencer and Wisemans Ferry, in the lower Hawkesbury Valley, are relatively isolated from Medicare offices. There is a medical clinic in Mangrove Mountain but without regular public transport for many people in the area connections to the Medicare office at Erina Fair and in Gosford are difficult when trying to claim medical expenses. They in particular will take great comfort from a more accessible method to claim Medicare benefits. Even some of the residents of Kariong, a relatively new and affluent suburb adjacent to the F3 freeway, have been vocal in their demands for better access to medical facilities.

The Central Coast is a region in which 19 per cent of the population is aged over 65 years—a proportion that is well above the national average of approximately 13 per cent. Just like the rest of Australia, the ageing of the nation’s population is a challenge that must be met. The amendments to the 90 Day Pay Doctor Cheque Scheme contained in this bill before members is part of the Rudd Labor government’s efforts to meet this challenge.

These amendments will be especially important for the nearly one in five Central Coast residents who are seniors. They are more reliant than the rest of the population on public transport and they face greater obstacles when travelling to complete what is at present a trying and sometimes time-consuming task. This is a task that will be made much easier by the passage of this bill. The Rudd Labor government is investing in many other ways to build a stronger public health system but I will leave the discussion of those to a later time.

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