Medical groups and the Australian Medical Association are claiming patients face hundreds of dollars in up front costs, as the fallout grows from the government's pre-Christmas announcement it would cut payments to pathology and imaging services.
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But the government has hit back, saying the bulk billing incentive payments - introduced by Labor in 2009 - had directed taxpayer money to private companies, with negligible results.
In its December budget update, the federal government announced plans to cut bulk-billing incentive payments for pathology and imaging services from July 1, saving $650 million over four years.
Labor's incentive payments were designed to increase bulk billing rates. The government says bulk billing rates have increased by just one per cent, from 86 per cent to 87 per cent, although data shows the proportion of bulk-billed diagnostic imaging services increased from 66 per cent in 2008-09 to 77 per cent last year.
After Mamamia published a story on Tuesday night claiming pap smears would cost $30 once the changes to pathology incentive payments took effect (a claim that originated with the Royal College of Pathologists of Australasia), outrage swiftly followed.
A change.org petition had gathered more than 152,000 signatures by Thursday afternoon, with thousands taking to social media to brand the changes a retrograde attack on women's health.
A spokesman for Health Minister Sussan Ley said the government was not proposing to cut rebates, but rather wanted to cut "an inefficient payment – worth between $1.40 and $3.40 – that is paid direct to pathology corporations separate to the Medicare rebate".
He said patients should be "rightly suspicious" of providers who claim they will now charge $30 for a test because of the loss of a payment worth just $1.40 to $3.40.
"Paying ASX-listed companies $500 million [over the past five years] to maintain the status quo is not the best investment of health resources," the spokesman said.
"Medicare is not designed to be a guaranteed bankable revenue for corporations, nor is a taxpayer-funded payment like this provided to cross-subsidise other costs of doing business for pathology companies."
But the Australian Medical Association says that once companies can no longer bulk bill patients, patients will be forced to pay their medical costs up front, and then claim the Medicare rebate back.
This, the Australian Diagnostic Imaging Association says, could mean up front costs of hundreds for specialised imaging services for cancers and other serious illnesses.
Chief executive Pattie Beerens said those costs could be prohibitive, and the government could address this by changing the rules so patients only had to pay the gap upfront.
"You have to take into account many patients who are trying to work out what is wrong with them will have more than one [specialist] service to pay for."
Labor vowed to block the changes in the Senate, and health spokeswoman Catherine King suggested that women could die from failing to have pap smears as a result of the changes.
"The minister seems to be taking a very big gamble with patients on this one," Ms King told Sky News on Wednesday.
"She is trying to say: "Oh well there will be no change whatsoever." The pathology groups, the diagnostic imaging groups are all saying 'well bad luck, we think there will be a change'."
