ACT Health is bracing for increased demand on the public hospital system if the federal government cuts bulk-billing incentives for CT scans, MRIs, ultrasounds and other diagnostic imaging.
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Concern about patient impacts has gathered steam since the federal government's Mid-Year Economic and Fiscal Outlook (MYEFO) identified $650.4 million of savings over the next four years, from reducing or removing bulk-billing incentive payments for certain pathology and imaging tests.
AMA President Professor Brian Owler publicly criticised the proposal, labelling it "a co-payment by stealth" which would hit the sickest and poorest patients hardest.
While ACT Health Minister Simon Corbell held back from direct criticism of the plan he said it would affect wait times in the territory.
He called on the Commonwealth to continue the incentive payments introduced in 2009-10 where the diagnostic imaging subsidy was 10 per cent of the set Medicare fee for each service, with the exception of MRI procedures at 15 per cent.
"If the incentive payment is cut by the federal government, removal of bulk billing in the private system will increase the number of patients being referred to diagnostic services in our public hospitals," he said.
"This will inevitably put pressure on our waiting lists."
ACT Health confirmed it was "already looking at capacity and planning in this area to ensure we can meet any further demand."
Federal Health Minister Sussan Ley said the government would scrap the bulk billing incentives from July.
Ms Ley said the incentive payment had cost $1.3 billion over five years and failed to improve rates of bulk-billing.
"The Turnbull government wants to redirect these funds within the health budget to improve the health outcomes of Australians," she said.
"It is disappointing the Labor Party is taking the side of multinational pathology companies, which are threatening to charge patients as much as $30 and $40 for tests (and more) based on the loss of a small and inefficient payment worth just $1.40 to $3.40," she said.
However bulk-billing incentives, according to Australian Diagnostic Imaging Association's figures, range from $6 for X-rays to $62 for MRIs.
National Capital Diagnostic Imaging's three private clinics, in Tuggeranong, Woden and Deakin, conduct 75,000 image procedures each year, equivalent to 43 per of the total number of imaging procedures undertaken by ACT Health.
NCDI general manager Jason Martinez said 45 per cent of patients were bulk-billed and while the government committed to continue incentives for concessional patients, pensioners and children, the cuts would impact 33,000 procedures each year in the ACT alone.
He said the changes were tantamount to a co-payment and would "drive patients to emergency departments where they know they are covered and scans will be bulk-billed."
"Our upfront costs for patients can be up to $1000 or $2000 for something like MRI so it's likely people won't have funds for that, even though the out of pocket may only be $100 or $150."
"This will put absolute pressure on a public health system that is already cracking," he said.
"My greatest fear is that upfront cost will get in the way of services that are absolutely essential to early diagnosis and treatment.
"Creating a system that makes it harder for people to get properly assessed will be more costly and harmful in the long run."
