Guest Post. Why our Medicare system needs up-to-date funding. By Karletta Abianac
A Complex patient’s working out on paper (ok, so typed on my laptop)
I was inspired to write this after listening to an episode of The Drum. 07/07.2022 Ellen Fanning, I think, going through reports about kids in prison and saying - what happened between these two?
A GP came on saying Bulk billing doesn't work and the billing schedule needs updating. She suggested an end to bulk billing as the rebate scheme is broken. The idea was to hit patients where it hurts, to drive action.
I don’t know who needs to read this. Are you a journalist demanding answers? A Department Head in our Public Service: Housing, Health, Community Services, Employment, Education? In a local Council Chamber? State? Federal departments?
Yep. I think I’ll address this to you.
What I need from Medicare rebate restructuring is time and attention in medical appointments. This doesn’t exist. Not with how Medicare is now.
What I need from you, is to care.
You’re not alone. I know you can all talk to each other, share data, and put your heads together. It’s a very human trait – to speak and plan. Please do it.
I’ve described Australia’s health and Medicare system as atrophied. You know the Medicare system was bad – even right back when the Medicare Levy was frozen.
What Can atrophy?
From its literal Greek roots, atrophy would mean basically "lack of nourishment". Although the English word doesn't usually imply any lack of food, it always refers to a wasting away.
I’m guessing you have health considerations.
I have more than one. Actually, I have a lot of health problems. To be simple and quick, my medical issues are often described as “Complex”.
Hence, a recent hospital discharge (where I was ramped for 9 hours without seeing a doctor) stated something like: ‘Presented at Emergency Ward – Complex. See General Practitioner’.
Start and end of my discharge summary.
This type of ramping incident isn’t news to you. I know that. You know that.
Would you like a bit more description of a specific problem? In general terms obviously - you just need context, not a sob story right?
I have strong concerns about my brain capacity and functioning. I feel like my mind has degraded these past four+ years.
I suspect I have multiple brain traumas. Can list incidents if asked. The way this Medicare and hence Bulk-Billing system is, there is no time to ask.
Upon taking time with me, you will find I am articulate and a creative and lateral thinker. These things co-exist - a communication “dis-order”, ADHD, traumatic brain injuries and being articulate etc… Thought I’d write that in case you didn’t know.
Because of, well, people and family dynamics - I did not know about my Autism and ADHD. Even though it was discovered in primary school. You might have, too, whether you grew up wealthy, middle class, working-class, in or in poverty.
This is probably not news to you either. Is it? Australia’s medical system swamped with requests for Autism assessments or diagnosis confirmations.
Given my life history - through to the current disgusting rental I live in – chronic health problems are a given. How I live my life (or sometimes just survive) and being very dependent on the disability pension, my medical issues are many and varied.
You can see them all in Australia’s Health Atlas. You should go through it together. The Department Heads. Like, in the same room, reading and discussing this stuff.
Preventable - it’s up to you Karletta!
Yes - to forestall ye Nay Sayer - many are preventable too. I know that. You know that.
I need hope. That things can change. I need to know that things will be ok. I need you decision-makers to do your jobs. To care about the ignored data-sets like me.
Have you just turned in your seat to see who’s also witnessing this moronic ne’r do Weller? Yeah? I don’t want to turn into you.
To quote many non-apologists, “I am sorry if your feelings were hurt.”.
In updating the Medicare scheme – you should know I need time one-on-one. I need to Bulk Bill (or ‘choose to’ if you want to pretend, I have those choices). Six to ten minutes doesn’t cut it. It’s not even enough time to read this article together.
Especially when I can travel and wait around for two hours. It exacerbates my medical conditions.
I need to spend one-on-one time with a person who is showing they care. I need us to know we have all the time we need. Feeling or sensing that what we don’t get done today - that’s ok. We’ll get to it. That sense of security. Like it’s ok, it’s right here in the plan. Like in Project Phases.
Here’s a thought - the project phases of Karletta, Stunning Goddess Returns.
How did that Project name occur to me? Through slow, patient communication. Albeit in written form.
Our Medicare system does not allow this time and thoughtfulness. Especially now that Bulk Billing is all but dead, floating in the water, and now we must deal with the fallout.
I can’t keep turning up to incredibly short and non-nuanced medical specialist appointments. I haven’t been to heaps because they make my health problems worse.
Just do it!
My functional capacity doesn’t allow the Karletta – Stunning Goddess Returns concept to translate into actions. On my own, doing implementation tasks for prevention requires deliberate cognitive dissonance. A ‘just do it’ attitude requires exhausting and painful mental, emotional, and physical gymnastics.
Prevention needs, say, understanding (tick) implementation (not with my current functional capacity) and Reasons/ Purpose (which I don’t have). Imagining the future. Sensing, feeling, nay, possibly hoping that things could get better.
Which I don’t have.
Or I could turn into an emotionless psychopath. To ‘Just do it’.
Which I don’t want to do.
Maslows Hierarchy of Needs describes blah blah stable housing blab la, a sense of security for the future, safety in my environment blah blah blah – which I don’t have.
Well, what are you bringing to the table Karletta? Hmm?
What I do have - is my intelligence, self-awareness, knowledge, and an ability to be articulate. Articulate when given time to do so.
Hence were some reasons why I need Medicare funding scales to be updated. To allow for calm, patient one-to-one discussions. For it to at least make sense financially for bulk-billed appointments, which I need, to be more than 6-10 minutes.
When I say update Medicare funding - do it properly this time. I’m not going to ask again. Right now, anyway. I must keep fighting. It’s my life
I am sick of begging. Begging is making me sicker.
Post script: Ok, fine. It’s later in the day. Update them properly. Please.
I hear you Karletta. Both of my parents have what can generously be described as complex medical issues. Their GP will regularly spend upwards of 30 mins going through various things with them together. I know because I sit in on these appointments now. (Don't ask *sigh*) Their specilist appointments are another thing entirely. And from what I can tell their experiences are fairly similar to yours. 6-10 mins, unless its something like an assessment. I cannot imagine that *any* of their specilists get much useful information from either of them in 10 mins. And, as a general rule, the specilists almost always have a gap payment so, wtf right? If I'm paying I expect you to take the time needed to diagnose and treat properly. And here's a clue guys..Bulk Billing *IS* paying...Its just not coming out of my pocket directly but via the taxation system. As a person who has been fortunate enough to be able to work full time in a relatively stable situation for most of my working life I can tell you I would be MORE than happy to pay a higher Medicare levy if it meant that people like my parents, and let's be honest here, eventually, people like me, get the treatment they require. All the best with your Karletta - Stunning Goddess Returns project. Sounds like a brilliant goal to have.
You've hit the nail right on the head mate. You sound like a fighter and a winner to me. I've had some injury time to think recently. I reflected a bit on love. I got churched a lot when i was young and what i could never get was why all the different religions thought that they were right and everyone else was wrong. The one thing that got repeated by all denominations constantly was " god is love ". In my mind by extrapolation then " love is God " What if it's that simple?. I'm not talking about sex. I'm talking about loving a cat, dog, person, environment or whatever and the feeling that we get from it. There's no love on a battlefield and maybe the absence of love is evil. Interested to hear your thoughts. Good luck mate