Thursday, January 19, 2012

Webber and the Medicare Safety Net

There’s been some sloppy reporting in the press recently regarding criticisms by the former head of Medicare’s Professional Services Review board, Dr Tony Webber, of rorts and abuses in Australia’s public health system. Dr Webber has estimated that $2-3 billion are “spent inappropriately” annually.

A claim given particularly lurid prominence in most media reports is that the Medicare Safety Net had been used “to subsidise cosmetic procedures, including surgery for ‘designer vaginas’ at $5000-$6000 each.”

Really? As in, subsidised directly under the benefits schedule?

Well, no, actually...

Here’s Dr Webber quoted in The Australian:

Denouncing the system he helped oversee, Tony Webber claims Medicare is “riddled with misdirected incentives” for doctors, that payments worth up to $140 to GPs for writing care plans have created “opportunities for a bonanza” and that the safety net has been used to “subsidise cosmetic procedures such as surgery for ‘designer vaginas’ at $5000-$6000 each”.

Now Webber quoted in The Age:

He says he is aware of instances where the Medicare Safety Net had been used “to subsidise cosmetic procedures, including surgery for ‘designer vaginas’ at $5000-$6000 each”.

Now here’s Webber writing in the primary source, his article in the Medical Journal of Australia:

During my time as Director of Professional Services Review, the Safety Net was used in effect to subsidise cosmetic procedures such as surgery for “designer vaginas” at $5000–$6000 each.

Attentive readers will notice both The Australian and The Age omitted to quote two rather important words; i.e., those cosmetic procedures were “in effect” subsidised under the Medicare Safety Net.

The import, I believe, of what Dr Webber actually wrote is that the “open-ended nature of the Safety Net” permitted opaque arrangements under which such cosmetic procedures could be effectively, albeit indirectly, subsidised without administrative detection. (See paragraph 9 here.)

But the sloppy quoting, by both the above papers, promotes the impression that such cosmetic procedures have been somehow directly subsidised, as if under the MBS.

Note, however, that The Australian at least made reference to Webber’s “open-ended” criticism of the Safety Net, albeit several paragraphs down from the ‘designer vaginas’ quote; whereas The Age omitted that “open-ended” bit entirely.

Webber’s article is worth the read. Note also, he doesn’t “denounce the system he helped oversee,” as hysterically reported in The Australian; he actually quite seems to like it but wants it fixed.

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