Copping it Right in the Eye!

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 THOUSANDS of anxious age pensioners who require vital sight-saving cataract surgery have been battered about like political footballs as negotiations between the Federal Government, the Opposition and eye surgeons over the Medicare rebate descended into deadlock.

Even if the dispute is resolved before the end of the year, it has not covered any of the parties involved in glory.

The bickering between the politicians and the medicos over the terms of the rebate caused untold anxiety to the tens of thousands of pensioners who require the procedure and led to accusations that the interests of the patients have been put last.

At one stage during the dispute, it looked as if patients facing cataract surgery could still have had to fork out the full whack of $624 per eye for their operations.

A clearly rattled Federal Health Minister Nicola Roxon, in an about-face caused by parliamentary pressure,  quickly defused this time bomb by promising to restore some of the rebate on the surgery.

Ridiculously enough, Ms Roxon tried to calm the waters by announcing that she’d changed her mind on the rebate and that pensioners would get a saving of $28.13!

The entire issue became an embarrassment to the Rudd Government and according to lobbyists, reeked of political skullduggery.

There was no doubt that after five months of unsavoury negotiations, there will be an extra financial burden placed on cataract sufferers because of the on-going dispute between Canberra and ophthamologists following the slashing of the Medicare rebate in the 2009-2010 Federal Budget.

Once again, it will be the ageing and vulnerable who will suffer as the eye surgeons and the politicians slug it out, both parties reluctant to be first to budge on the issue.

The reduction in the rebate for cataract surgery from $624 to $315 announced in the Budget was due to be introduced in November.

Both the medical lobby and the politicians have been warned that they could face the risk of a  severe backlash from older Australians if the crippling extra cost is passed on to the patients and it could precipitate yet another Medicare crisis.

More than 130,000 people undergo cataract surgery each year in Australia. Of these 80 per cent are over the age of 65 and the vast majority of these are age pensioners. Overall, 90 per cent of people requiring cataract surgery are aged 55 or older.

Michael O’Neill, chief executive of National Seniors Australia (NSA), has been fighting the proposal in Canberra where it was introduced to Federal Parliament, and then rejected by the Opposition in the Senate.

Ironically be rejecting the Government motion, the Opposition move meant that even the initial rebate was eliminated while the political process dragged on. So much for democratic process.

This means that the issue may not be completely resolved until early next year with patients facing the immediate possibility of paying some extra cost for their operations.

“For the past months, it’s been the doctors and the politicians just banging their heads together without one side giving an inch, it was like a showdown with both parties facing each other waiting for the other to blink,” Mr O’Neill told Go55s.

“What we are trying to do is to get them to forget the blink stage and to sit down at the discussion table and try to work through this issue.”

He said cataract patients who were overwhelmingly older Australians were being used as political footballs. He called for the immediate engagement of a mediator to try to resolve the dispute.

Mr O’Neill said NSA appreciated that the Federal Government was involved in a health reform program but the cataract surgery rebate had angered not only the potential patients but also the ophthamologists themselves.

The Government claims the rebate was slashed because the cataract operation has in recent times been streamlined and is no longer as complicated a surgical process sometimes only taking 20 minutes.

As another seniors lobbyist told me: “That’s an appalling excuse to gouge extra money off those who can certainly not afford it.”

 But Ms Roxon and her Cabinet colleagues did not cover themselves in glory over this dispute.

The Minister was quoted as saying soon after the Senate blocked yet another of her compromise moves: “We are not going to stand by and see the Liberal Party use patients as a punching bag.

“We are absolutely determined to ensure that cataract operations are remunerated at an appropriate rate.

“We are getting advice about a range of different options that are available and I will make announcements about those in due course,” Ms Roxon said.

The Minister also rejected an Opposition suggestion to introduce a private members Bill which would have at least restored the proposed rebate to its current level.

Mr O’Neill said: “Sadly, nobody wanted to budge…the Opposition continually opposed the proposal in the Senate but that meant the whole process dragged on.

 “The impact of the rebate changes initially meant that ophthamologists would continue to charge exactly the same amount (for cataract surgery)  while those who can least afford it, older Australians, would had to have put up with the extra cost of $300 extra per eye making the cost $624 for each eye.

“The parties involved are the ones banging their heads together and the vulnerable consumers are getting the headache.

“The Government risks undoing the goodwill it has generated with the increase in the age pension and should certainly expect a backlash from patients.

“Ophthamologists should think long and hard about why their patients will have to pay $300 extra or more because of their unwillingness to find a way forward,” Mr O’Neill said.

Meanwhile, the Australian Society of Ophthamologists admitted that patients requiring the surgery would most likely be inclined to postpone it for the time being.

An ASO spokesman also said private health funds would cut their payments in line with the lower rebate.

“That means many patients are going to be in double jeopardy and out of pocket for their planned operation an extra $800 to $900.”

Opposition spokesman Peter Dutton said Ms Roxon’s attempts at a resolution meant that patients would be just under $300 worse off as opposed to being just over $300 worse off.

A despairing Mr O’Neill at one stage had to appeal to both parties to stop the brinkmanship and find a resolution before older Australians were yet again facing more financial hardship.

“When you get down to the nitty gritty, older Australians facing the extra cost will have blown 10 weeks of their pension on the eye surgery,” he said.

“How can that be right? There’s just too much self interest dominating this debate…it’s time for both the politicians and the doctors to sit down and work out what’s best for the patient.

“I understand the need for health reform but to find out in the Budget that this cataract rebate was being slashed was a major shock to us,” Mr O’Neill said.

“I have been meeting with senior bureaucrats and Ministers to see if the issue can be settled without further distress to pensioners who must be wondering if their pension increase was just a waste of time.”

Cataracts are a major cause of serious eye problems and even blindness if they are not treated and they increasingly affect people as they grow older.

Earlier this year, this newspaper featured an inspiring article on how Gabi Hollows was continuing the work of her late, pioneering eye surgeon husband in bringing much-needed optical treatment to those most in need around the world.

One wonders how Professor Fred Hollows must have been turning in his grave in the hot red dirt outside Bourke as he pondered this disgraceful treatment of Australia’s vulnerable ageing population.

 On another major issue likely to affect pensioners, Mr O’Neill said he had received no response on his plea to stop the NSW Government from implementing its plan to increase public housing rents from September next year.

“We just haven’t heard back from them and we’re appalled that the State Government is willing to grab a quarter of the first substantive pension increase in many decades,” Mr O’Neill said.

At the moment, a full-rate pensioner in public housing pays $71 rent a week. In September next year, following the end of the rent freeze, that figure will rise to $84 a week.

“The latest increase was granted to assist particularly, single full-rate pensioners, widows in their seventies and eighties, to achieve a very basic standard of living.

“Now that will be snatched away and we’re appealing to the State Government to cancel their plans.

 ‘Duping pensioners of the extra money goes against public opinion and a particular request from the Federal Government.

“The Prime Minister Mr Rudd contacted all states and territories earlier this year asking them to ensure public housing authorities passed on the full increase to pensioners. Other states seemed likely to follow the lead of NSW so while I was in Canberra, I asked Federal ministers to put pressure on the stop the rent increases,” he said.

Mr O’Neill did however, have some praise for the Federal Government.

He welcomed Treasurer Wayne Swan’s recognition of population ageing as an issue with society-wide implications that needed to be tackled now.

Mr Swan was speaking at the launch of the Australian Institute for Population Ageing Research and revealed that over the next 40 years, the number of people aged 65-84 would more than double and the number of people aged over 85 would increase four and a half times.

“We welcome Mr Swan’s comments particularly where he sought to put some balance into the debate and to recognise the value of the contribution of older Australians to society whether through working, caring, volunteering and the transfer of skills and knowledge,” he said.

“Faced with a rapidly ageing population and a continuing skills shortage, one of the smartest things we can do as a nation is to create a level playing field for older workers as currently we’re falling behind our neighbours and major trading partners in this regard.”

A special report from the NSA, titled Still Putting In, found that the Australian economy was losing $10.8 billion a year by not utilising the skills and experiences of those aged 55-plus.

“Government, business and unions must take up the challenge to remove age barriers, address discrimination in the workplace and foster opportunities for participation,” Mr O’Neill said.

He said the NSA welcomed the launch of the institute’s new longevity index, which will track the ability of an individual to maintain their living standards over their lifetime.

Photo caption: Michael O’Neill, CEO National Seniors Australia…’Pensioners are being put last in this dispute’

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