Medicare gender audit ‘misses the big picture’

Procedures, imaging and long-acting reversable contraception will be subject to a newly announced Medicare gender audit, the Federal Government has confirmed.
 
The audit is part of a $160 million spend in the 2024–25 Budget that will go towards ‘a tailored women’s health package to tackle gender bias in the health system’.
 
The audit focus is purely on rebates for insertion and removal of long-acting reversible contraceptives, diagnostic imaging and ultrasounds – with internal pelvic ultrasounds currently receiving lower rebates than scrotal scans.
 
Assistant Minister for Health and Aged Care Ged Kearney said there are ‘many ways that gender bias creeps throughout our healthcare system’.
 
‘Women deserve to have choice when it comes to their bodies, they deserve to have access to their preferred contraception,’ she said.
 
‘We want to see more women have a better understanding for contraception as well as better access to long-acting reversible contraception.’
 
With uptakes of IUDs low in Australia compared to other countries, the National Women’s Health Strategy made increasing the use of long-acting reversible contraceptives one of its key goals.
 
But RACGP Vice President Associate Professor Michael Clements told newsGP the audit’s narrow focus ‘misses the big picture’, especially as it overlooks the fact that GPs are the main providers of women’s healthcare.
 
‘This is long overdue reform and we’re very pleased to see that the Government is going to take an active look at this Medicare reform through the gender lens,’ he said.
 
‘But the largest amount of healthcare occurring to women occurs in the relationship between the female patient and their GP.
 
‘This is overlooking things like women’s mental health, menopause counselling and support, chronic pain and endometriosis, which don’t involve procedures and have a very low loading under the Medicare system for rebating.’
 
Associate Professor Clements said GPs spend more time with women with chronic and complex issues than other healthcare professionals but are faced with a ‘system that rewards short, sharp and procedural-based Medicare items’.
 
‘I wouldn’t like to see the loading of any reform in this area to go to the non-GP specialist space,’ he said.
 
‘Because we have to respect that most women are seeking care and get most of their care from their relationship with their GP.’
 
RACGP President Dr Nicole Higgins previously told newsGP patients are not alone in being disadvantaged by Australia’s healthcare system, with female GPs also worse off.
 
‘The majority of people who are providing those longer consultations are women and that gender pay gap is very real, so we need to make sure that Medicare recognises and remunerates the care that’s given,’ she said.
 
‘We need to actually have a look at the structures that we’ve got in place around the regulatory mechanisms, such as the MBS, around how we can ensure that we have equity.
 
‘For women in general practice, we need to ensure that we have equity and that we have a system that allows us to practice medicine in the way that we choose and are expected to.’
 
Within the $160 million announcement are a raft of other changes.
 
The Government says it will change the legislation around ultrasound referral so that nurse practitioners can refer women for ultrasounds in relation to medical abortions, while temporary MBS telehealth items for blood-borne viruses and sexual reproductive health will be made permanent.
 
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