Doc­tors’ fees cut to slice cae­sars

The Sunday Telegraph (Sydney) - - NEWS - LINDA SILMALIS CHIEF RE­PORTER

AS the number of cae­sarean births con­tin­ues to rise the stan­dard med­i­cal fee for the pro­ce­dure has been cut by the fed­eral govern­ment to en­sure it isn’t be­ing per­formed just to make more money.

The $180 re­duc­tion was or­dered af­ter a fed­eral govern­ment task force warned there was a fi­nan­cial “in­cen­tive” to per­form cae­sare­ans.

At the same time the med­i­cal fee for a com­plex vagi­nal birth has been in­creased by the same amount. The stan­dard med­i­cal fee for both pro­ce­dures is now $630.85.

Medi­care Ben­e­fits Sched­ule re­view task­force chair Bruce Hop­kin­son said med­i­cal ex­perts agreed the fees for cae­sare­ans and nat­u­ral de­liv­er­ies should be aligned.

“The changes were adopted be­cause it was felt that there had been an in­cen­tive for peo­ple to do cae­sare­ans,” he said.

“While we don’t have any ev­i­dence, we want to re­move any fi­nan­cial in­cen­tives so the de­ci­sion re­lies solely on clin­i­cal judg­ment.”

The task force was con­cerned that dur­ing a com­plex birth the higher fees for a quick cae­sarean made it a more at­trac­tive op­tion for a prac­ti­tioner than con­tin­u­ing to over­see a pro­tracted and dif­fi­cult vagi­nal birth. It rec­om­mended, and the govern­ment ac­cepted, that the fee for vagi­nal births when an ob­ste­tri­cian takes over from a mid­wife or an­other doc­tor dur­ing labour be in­creased to $630.85 — up from $450.65. For cae­sare­ans, the fee has de­creased from $811.05 to $630.85.

With de­liv­ery fees cov­ered by pri­vate health in­sur­ers, women whose de­liv­ery fits this de­scrip­tion will con­tinue to have no out-of-pocket costs if their fund cov­ers ob­stet­rics.

The changes made last year do not af­fect ob­stet­ric de­liv­ery ser­vices for pub­lic patients.

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