By Max Watts
SYDNEY — "Whoever expects politicians to be honest?", said one of the participants during a meeting of psychiatric patients, doctors and carers at Strathfield Town Hall on November 28. The meeting was organised by a new group, Mental Illness Network against Discrimination (MIND), to protest against changes to Medicare funding.
From November 1, Medicare patients in psychiatric treatment will be reimbursed for only 50 sessions a year. After this, Medicare will pay only half the scheduled fee.
In practice, many patients have assured me, this means patients will have to stop any long-term intensive treatment, including psychoanalysis, unless they can come up with the difference, around $60 a session — $200 or more for a week's normal treatment.
As patient Pat T wrote health minister Michael Wooldridge six weeks ago, "This is akin to doctors prescribing medication three times a week and the government decreeing that some, the poor, can only have their medicine once". Wooldridge has, so far, not answered Pat T's letter.
Wooldridge has decided that for the poor there is no need of long-term intensive treatment, in particular psychoanalysis. He stated in parliament on November 6 that such treatment has not been proven to be "cost effective".
For those unable to pay $200 or more each week. Whatever their doctors may think. Even if they have been utterly crippled by intensive traumas, such as childhood abuse. People, of whom 20%, when untreated, end up killing themselves. Where the alternative to intensive treatment is full-time hospitalisation (at $600 a day, for months or years) or jumping off the cliff. Of course a funeral is more cost effective!
Dr Wooldridge goes in for some rather original mathematics to explain why poor people, often so crippled by their trauma that they are unable to work, should no longer be allowed long-term psycho-therapeutic treatment.
To make his point, Wooldridge frequently flies a "747 jumbo jet" through parliament or into the press. On September 11 and again on November 6, he told the House of Representatives about a practitioner "affectionately known" — to the minister — as "the 747 jumbo jet". This doctor, said Wooldridge, has "billed 747 75-minute consultations — for one patient — in one 12-month period".
But 747 is not enough to make the point. On October 24, Wooldridge's department released information to the media about "an Adelaide psychiatrist" who saw a patient nearly 900 times in a single year and claimed, according to Wooldridge, $115,000 for this patient.
Terrible figures. Indeed, every doctor and expert I have consulted says they are incredible figures. Wooldridge will not reveal the names of the jumbo jet doctor or the Adelaide psychiatrist. Is someone covering up systematic criminal fraud?
Or perhaps someone is simply fantasising? Even — shades of Amanda Vanstone and the "Wright family" — misleading parliament and/or the public?
Sydney doctor Michael Honnery: "The Medicare code 162 automatically rejects payment for any second claim on a given date. If a GP has twice treated a patient because his stitches came open, the doctor must write a special letter to explain the second claim. Three, four treatments a day, every day? Minister Dr Wooldridge's psychiatrists would spend their lives writing claim letters! And however could they be reimbursed by Medicare?"
Striking in the Strathfield meeting was the fact that most of the 80 people attending, particularly the patients, were at their first ever political meeting.
Georgina, 33: "I've never gone to meetings. I never had to get so angry about anything before."
Donna, 42: "I was a vegetable. Now I work, help look after others, bring up my two children. And I'm here, too, for a fellow patient, too sick to come, but also now in treatment, who they pulled off the cliffs last week."
Frank: "This is the thin end of the wedge. We're the first to be done over. Others on Medicare will be fucked over later."
Helen: "Wooldridge thinks he can kick us easily; we are few, and many of us are down. He figures we can't fight back. He may yet get a surprise."
No-one from Wooldridge's department attended the Strathfield meeting, though they were invited.
[MIND can be contacted at PO Box 523, Maroubra NSW 2035, phone/fax: 9528 2726.]