Telehealth

[Tannin]

Federal Health Minister Greg Hunt has announced an extension to the telehealth subsidy to assist with the coronavirus response. According to Hunt, telehealth, despite being forced upon us, has been a revolution, and has provided better-than-ever health care with reduced risk to all involved - patients, doctors, and other staff.

OK, I buy all of that.

(Obviously, there are conditions which require in-person visits. None of this discussion applies to them. It applies to the many other cases where you only need to speak with the doctor.)

The bit I don't get is that he's claiming it costs extra money to deliver a cheaper service. WTF? If I go into the clinic - never mind my own expenses for lost time, travel, and parking - there are costs over and above what it costs to have a phone call with the doctor. More reception staff time, added load on cleaning, more space required for waiting rooms ... it all adds up.

Anyway, either I pay the bill and the government refunds about 60% of that, or the clinic charges me the 40% and the government for the 60%, or they bulk-bill, charging only the 60% and going without the 40%. (I don't know the exact figures, but it's roughly 60-40.) Whichever way you slice it, the government pays around 60% of the full price.

Compare that in-person consultation with a telehealth consultation. I make an appointment using an app on my phone (paid human time required: zero) and the doctor rings me at the appointed time, then bulk-bills for payment. Fast and efficient all the way through. Extra cost: zero. Staff hours required, other than the doctor's own time as per appointment: zero.


So how can it cost extra?

SECOND QUESTION:

If this is really a revolutionary improvement in health care delivery as per Hunt's claim, why are they only extending it for a short time?

It's a better way of delivering health care (as stated by the Minister himself), and I don't see how it can possibly cost more and indeed there is good reason to suppose that it costs less. So why buggerise about with a short-term extension instead of just making it standard practice? WTF?

[K]

What are the details of the extension?

Are GPs still required to bulk-bill? (I take it it's already been changed so you can only get telehealth from a GP you've seen before.)

[Tannin]

I don't know, K. Only what I read in the paper this morning. It was pretty vague and very light on detail. (As journalists tend to be these days. As a profession, they have a poor reputation, which is well-earned.)

[stui magpie]

I've had a few telehealth consultations with my GP. Receptionist is still there, no app involved, you ring up as before to make an appointment and they text you to confirm the time and date. Only difference is instead of showing up in person it's done over the phone and the GP gets less money as they only get the Medicare amount.

I can't see how it's more expensive but expenses are essentially the same or slightly less (utilities, cleaning) but the income can be significantly reduced.

[Pies4shaw]

^ Just a heads up - not all doctors are bulk-billing for 'phone or zoom consultations.

[stui magpie]

^

OK, fair call.

My GP charged a fee above the Medicare rate for all except pensioners, but there's no charge for Telehealth, they just claim it from Medicare.

[K]

[Tannin]

I can't see what the point of making GPs bulk bill is. OK, if you are a Labor government which cares about poor people and health care affordability, sure. But this mob? Not a chance in hell of that, so there must be some other reason. I just can't figure out what it is.

I'd be perfectly happy to pay a bit (insofar as I'm happy to pay at all for what should be and indeed used to be a standard service available to all citizens).

PS: Stui, yup. I made my appointment by app (though I could have rung the office instead if I'd wanted to, however the app is faster and easier), and the doctor works from home. I understand that they have other doctors still going into the clinic but I like this one.

[Bucks5]

GPs only have to bulk bill telehealth provided to concession card holders and those listed as 'vulnerable' to COVID.

[K]

The AMA today said this:

“The decision to allow GPs to apply their usual fee schedule to telehealth services from 1 October is also welcome. GPs have a long history of looking after patients in difficult financial circumstances and this decision will not change that approach."

https://ama.com.au/media/temporary-telehealth-extension-will-help-patients


I guess "concession card holders, children under 16 years old and patients who are more vulnerable to COVID-19" who need a teleconsultation should do it before the end of the month or discuss the fees with the clinic from 1 Oct.

[Tannin]

Ah, that is useful information, Bucks5 and K.

[Morrigu]

Well it is great for public health outpatient and clinic appointments! Don’t know about GPs I stay away as far away from them as I can!

Mum’s last few appointments with her Haematologist at Peter Mac were by video call - so much easier than dragging her out of the house and travelling and parking and sitting in the waiting room. It took a few minutes for her to get the gist ie take the phone away from your ear Mum but much better. Unless you need a physical examination it’s a great way to conduct a consultation!!

[stui magpie]

^
When I had the post op consultation with my surgeon, I took photos of the area and emailed them to him.

I still prefer a face to face consultation personally.

[K]

Up to one in seven medical diagnoses could be wrong, study reveals

https://www.theage.com.au/national/queensland/up-to-one-in-seven-medical-diagnoses-could-be-wrong-study-reveals-20200920-p55xf9.html


* https://onlinelibrary.wiley.com/doi/10.5694/mja2.50771

[stui magpie]

^

So they're improving?