Abolish Medicare rebate for RIC

[JohnC]

Since 2008 no state public hospital system provides non-therapeutic circumcision. This victory has taken over a decade to achieve, but a side-effect has been the emergence of medical entrepreneurs who provide the "service" in doctors' rooms or private hospitals.

The logical next step is to push for the circumcision of boys aged under 6 months (item 30653) to be removed from the Medicare Benefits Schedule. This has been twice attempted before: by Blewett in the Whitlam government and Wooldridge in the Howard government. On both occasions political pressure by the Jewish lobby scuttled the move.

However, the time may be right for this to succeed.

I propose that people write to the federal health minister, Nicola Roxon, requesting that this item be removed from the schedule. Her email is:

nicola.roxon.mp@aph.gov.au

If people want some tips about what to put in such an email I will be happy to post some bullet points (I don't think form letters work very well).

The scheduled fee has been kept at a very low level by governments of both persuasions, with agreement of the medical profession, because all sensible people recognise the lunacy of RIC. It is currently $42.95. But descheduling this item will send a powerful symbolic message, and it will stop the gap being claimed under the safety net.

[JohnC]

[text removed]

It should be noted that the Australasian Association of Paediatric Surgeons has recommended that if circumcision is to be performed it should be only after 6 months of age "by a surgeon performing circumcisions on children on a regular basis with an anaesthetist using appropriate techniques".

The presence of this item on the Schedule is contrary to existing medical practice guidelines. It should be abolished.

[Mrs Nietzsche]

Shouldn't it remain on the schedule for cases where it's medically needed?

ie like how you can get a rebate for a medically necessary deviated septum repair, but not for a cosmetic nose job.

[JohnC]

Shouldn't it remain on the schedule for cases where it's medically needed?

1. A "medically needed" circumcision on an infant that age is actually unheard of, but ...

2. If such a case were to arise, it is still recommended that surgery not take place until after 6 months of age.

3. The rebate is trivial ($32), and should surgery actually be required it would be fully covered by the public hospital system and/or private health insurance.

[JohnC]

It should be noted that removal of this item from the schedule was also recommended in the most extensive review of Australian circumcision practice in two papers by Katrina Spilsbury, James B Semmens, Z Stan Wisniewski and C D’Arcy J Holman. The authors were from the Centre for Health Services Research, School of Population Health, UWA, and the Safety and Quality of Surgical Care Committee, Royal
Australasian College of Surgeons.

This is not a zany idea, which is why health ministers from both sides of politics have attempted to do it.

[The Fox]

1. A "medically needed" circumcision on an infant that age is actually unheard of, but ...

Actually thats not true, my son needs an operation and as part of that operation the foreskin NEEDS to be removed so um yer it is medically needed

2. If such a case were to arise, it is still recommended that surgery not take place until after 6 months of age.

True, he wont be operated on until he is between 6 and 7 months


3. The rebate is trivial ($32), and should surgery actually be required it would be fully covered by the public hospital system and/or private health insurance.
Yes his surgery is covered by the public hospital system

[Fellow Traveler]

Yes his surgery is covered by the public hospital system

The case you describe would probably be considered medically necessary and be covered. What johnc proposes is removing the rebate for parent whim.

[Mrs Nietzsche]

John C- sorry I didn't read your post properly, that you were referring only to circ under 6 mths.

[Phyllis Stein]

Will write that letter today. Thanks for the idea, JohnC. :)

[DQ]

I'm sure you all know the drill about keeping in nice, friendly and on topic and all that ;)

JohnC is asking for help in this mission, help if you can, if you can't, then don't.

:thumbsup:

[xkwzit]

Some off topic posts have been deleted from this thread. Please keep to the topic. If you would like to discuss the alignment of RIC and right to life - that deserves a thread of it's own.

(oops cross posted with DQ :D be good )

Cheers

[RedPanda]

I'd to it right now JohnC.

[Opinionated]

For those that may read this that are not letter writers, is there a form letter available anywhere that can be modified by anyone wishing to use and send it?

[serendipity22]

For those that may read this that are not letter writers, is there a form letter available anywhere that can be modified by anyone wishing to use and send it?

:yelclap:

[Fellow Traveler]

Actually, what would also be helpful is to provide a list of contacts too. Who should write who ect. I've written Medicaid officials in the my State and have gotten good responses from my letter. If someone wants to PM me for a copy to send to your officials let me know. I'd change somethings around like citing Australian officials such as the RACP and the AFAO as well as others but the format would be largely the same. Oh and you might have to fix the spelling, as some of mine differs from those of you in the Commonwealth. ;)

[Fellow Traveler]

So JohnC do you have a handy set of names and addresses to write to?

[serendipity22]

A while back I wrote to Nicola Roxon and received a standard letter which included the following:


The need to review particular services or groups of services listed in the MBS is considered

by the MediCare Benefits Consultative Committee (MBCC). The MBCC provides a forum for

discussion between the Department of Health and Ageing and the medical profession on existing

items in the MBS (other than items covering diagnostic imaging and pathology items).

Membership of the Committee comprises representatives of the Department of Health and Ageing,

Medicare Australia, the Australian Medical Association (AMA) and relevant craft groups of the

medical profession.

Submissions to the MBCC for review of particular scheduled services listed in the MBS are to

be submitted through appropriate medical craft groups within the AMA. Individual

practitioners seeking changes to the MBS should seek the support of their relevant craft

group or association which can pursue the matter on their behalf. You may wish to discuss

this issue with a medical practitioner or, alternatively, you could contact the Australasian

Association of Paediatric Surgeons or the Royal Australasian College of Physicians, who may

wish to lodge a submission with the MBCC.

So it seems you either need a doctor, the AAPS or the RACP who may lodge a submission on your behalf.

Does this mean the AAPS or the RACP needs to be lobbyied?

http://www.racp.edu.au/page/contact-us