Confusion Surrounds Pap Smear Charge

Claims that women could be charged $30 for a pap smear from July 1 have been thrown into doubt by the Health Minister and the peak medical body, but public outrage continues to grow with an online campaign reaching 140,000 signatures.

In the Mid-Year Economic and Fiscal Outlook statement (MYEFO), released in December last year, the government estimated that axing the bulk billing incentive for pathology services, which include pap smears, would save $650 million over four years.

But this week the Australian Associated Press (AAP) reported that the Royal College of Pathologists of Australasia President, Michael Harrison, said that patients would be forced to pay at least $30 for pap smears, as well as urine and blood tests.

"If laboratories decide they have to go to a patient co-payment, people will stop having pap smears, they'll stop having their other tests done and people will present with advanced disease including advanced cancer," Dr Harrison said.

"That's just a statement of fact, that's what happens."

Pro Bono Australia News repeatedly contacted the Royal College of Pathologists of Australasia for comment. A spokesperson for the college said the organisation would not confirm or deny whether the $30 figure was correct.

The claims sparked a social media frenzy, and Brigitte Garozzo launched a change.org campaign on Tuesday evening, which has continued to gain momentum. Rallies are also planned in major cities around Australia on 20 February.  

11yrs ago a free pap smear saved my life. Stop government proposed changes to medicare. #saveourmedicare

— Jacqui Agius (@agius_jacqui) January 5, 2016

“This is yet another attack by a Liberal government on Australia's already cash-starved Medicare system,” the campaign page said.

“Sussan Ley, stop trying to distance yourself from the inevitable outcome – by your cutting subsidies for practitioners and pathology companies, they’re forced to charge a fee to make up for the loss, which will fall unfairly on patients across the country.

“We won't stand for it. We demand the Liberal government scrap this policy and ensure that pap smears and pathology services remain free.”

However, the $30 figure has been rebuked by Health Minister Sussan Ley, who called the claims “misleading” in a statement responding to the public outrage.

Can reassure Aussie women no change 2 access/cost of #papsmears exam or $ value of your Medicare rebate #auspol https://t.co/PHSZ7zweN8

— Sussan Ley (@sussanley) January 6, 2016

“There are no changes proposed in MYEFO regarding the cost of either receiving or delivering a physical pap smear examination undertaken by your GP or specialist, nor their billing practices,” Ley said.  

“Nor is there any reduction in the dollar-value of the Medicare rebate a patient receives to undertake associated pathology tests.  

“Changes in MYEFO relate to an inefficient payment – worth between $1.40 and $3.40 – that is paid direct to pathology corporations separate to the Medicare rebate.

“It is therefore not part of the patient’s Medicare rebate, as some have tried to claim today.

“Alleged claims by pathologists about the potential cost of raising their prices as a result of any changes are also misleading, because they have omitted the value of the Medicare rebate a patient receives from the Government to help cover this very cost.”

But pathology providers, who have had no increase in the Medicare rebate for their services for almost two decades, have warned that many labs would not be able to absorb the cut, which would be passed onto patients.

The Australian Medical Association said that, while the figure might not be as high as $30, women could still face a fee to receive their pap smear from 1 July.

According to the AMA’s calculations, the government’s contribution to the cost of a pap smear would be cut by 12 per cent, or $3.20.  

However, the amount charged to patients is likely to increase above this to account for the additional administrative costs of billing individuals, including processing payments and chasing up amounts owing.

AMA President Professor Brian Owler condemned the bulk billing incentive cuts at the time they were announced, and said they were “a co-payment by stealth”.

“Cutting Medicare patient rebates for important pathology and imaging services is another example of putting the Budget bottom line ahead of good health policy,” Professor Owler said.

“These services are critical to early diagnosis and management of health conditions to allow people to remain productive in their jobs for the good of the economy.”

Owler said the AMA would be working to convince the Senate to prevent changes from coming into effect.

Shadow Minister for Health Catherine King said that cuts to pathology and diagnostic imagining would have a “devastating” impact on women’s health.

Malcolm Turnbull's health cuts – making life-saving preventive health tests like pap smears more expensive. https://t.co/EKveI9lgxJ

— Catherine King MP (@CatherineKingMP) January 6, 2016

“Labor is deeply concerned by reports these cuts could force women to pay more for crucial preventive health checks like pap smears that are essential for detecting life threatening conditions like cervical cancer,” King said in a statement.

“Every year, over 800 Australian women are diagnosed with cervical cancer, and around a third of those women are likely to die from the disease.

“Pap tests have been a major success story of cancer prevention. In just seven years after the initiation of the National Cervical Screening Program the rates of cervical cancer, and the number of women who die from it, dropped by about a third.”