Aussie woman's gripe over $650 medical bill highlights growing problem
The cost of a simple procedure has left a patient 'disgraced' with Australia's medical system.
A woman's frustration with having to pay $650 for an MRI scan for her "peace of mind" has highlighted a growing problem with out-of-pocket expenses for medical care. A few months ago, Melbourne local Alexandra Duffin, 29, noticed redness and inflammation on her left breast the size of a "mosquito bite". However almost a week later it grew to "the size of an orange", which was "quite scary" for the woman, prompting her to book an appointment with her GP.
"Breast cancer is in my family history — my grandmother passed away from it — and I've had a few people in my family including a male relative have breast cancer," Ms Duffin told Yahoo News Australia.
After being referred for a breast screening (mammogram), she thankfully received the result it was a benign cyst. But when communicating she was still anxious about the cyst to her GP, they referred her for a breast MRI, which can detect cancer that mammograms and ultrasounds can't catch.
Her doctor warned her the appointment "might cost a bit of money", but when she found out it would be a hefty $650 out-of-pocket expense, she was completely shocked, begrudgingly paying it for her own "peace of mind".
Ms Duffin thought it was "a disgrace" that certain Medicare requirements wouldn't allow certain people to qualify for a rebate. "I can't tell you how much stress and anxiety I had just having to fork out all that money," she said. "There are so many women out there who have a lump and potentially can't afford [an MRI]. To know that you can't just easily get it checked is really sad."
Breast MRIs are around $700 and in order to obtain a rebate, patients need to be high risk, have a referral from a specialist — which Ms Duffin didn't have — and have the MRI conducted by a Medicare-eligible unit or provider, according to the Breast Cancer Network Australia.
Less bulk billing means increasing out-of-pocket costs
Diagnostic imaging is the most expensive out-of-pocket health expense — outside of hospital care — with the gap increasing from $84 to $120 in 10 years, according to a Department of Health analysis published in 2021.
Associate Professor Sanjay Jeganathan, President of The Royal Australian and New Zealand College of Radiologists (RANZCR) confirmed to Yahoo News Australia that the "the bulk bill percentage is only decreasing overtime".
With medicare indexation — which was frozen for diagnostic imaging for 20 years until 2020 — not keeping up with inflation, patients are forced to fork out increasing out-of-pocket costs.
"When all those increases from inflation occur for things like staff salaries, rent and equipment costs, something has to give way," Professor Jeganathan explained. "So that is what makes it really difficult for patients, because the costs have continued to go up. We will have to really closely look at how the government could step in and look at how they can fund radiology services better."
'Duplication of services' makes medical appointments inaccessible
Under the current system, a patient is only able to get a Medicare rebate for an MRI breast scan if it's requested by a specialist, not a GP. Professor Jeganathan is one of many who believes this is "restrictive for patients to seek access" with the long wait times and associated financial costs.
"Any medical practitioner should be allowed to request for that scan," he said.[Otherwise], it's a duplication of services. To see the specialist you would have to be out of pocket a few hundred dollars... But if it was a GP referring for a scan, they would have an out-of-pocket cost of maybe $30 or $40."
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