Ophthalmologists again are demonstrating what most people involved in health policy have known for decades: no Health Minister should ever dare stand between a medical specialist and their hard-earned Medicare entitlement.

What is particularly disappointing about the latest campaign from ophthalmologists (here and here) is the way they are using marginalised health consumers as cannon fodder in a public campaign to maintain their substantial tax payer-funded incomes.

The ophthalmologist’s story last night on the 7.30 Report adopted the following script: Take a struggling, older truck driver with limited employment options and limited income. Tell him he is going blind. Tell him the government has cut the rebate for the eye surgery he needs so now it will cost him hundreds of dollars to save his sight. He doesn’t have a spare few hundred dollars. Watch him struggle to hold back tears, this salt-of-the-earth Aussie battler now facing blindness because of the callous and ignorant actions of this government. But all is not lost. An ophthalmologist mounts the white horse of compassion and offers to do the operation for free! Wow, these ophthalmologists are wonderful people, and this government doesn’t seem to understand or care if some older people to go blind!

In my view, exploiting a vulnerable health consumer is unethical behaviour for a professional group campaigning to maintain their high incomes.

Perhaps just as annoying is the lack of factual information about this campaign. No one mentions that the ophthalmologist who performs the miracle cataract surgery will receive a minimum $300 rebate and that the operation will take less than 30 minutes.

And that is not all that goes unsaid.

Make no mistake; this is a campaign about the level of tax-payer contributions to the income of ophthalmologists. It is only reasonable then that their incomes be on the table as part of the discussion. Like most people in the health sector, I want to know why ophthalmologists cannot afford to charge only the new scheduled fee of $300 for cataract surgery? Why do they have to charge above this fee? Is their economic viability now under threat? Does this mean their average income would drop below the level of our PM? Each time an ophthalmologist talks publicly in this campaign, I would like them to be honest about their income, from Medicare and private fees.

As I understand it, the top 10% of ophthalmologists make well over $1 million a year in Medicare rebates alone, more than twice the income of our Prime Minister. Even these high rebates have not prevented ophthalmologists charging substantial gap fees to health consumers, making their services less accessible while increasing their income.

One of the real barriers to health reform is skyrocketing Medicare payments. No government can afford to let costs continue to spiral upwards without seeking to impose some limitation on the amount paid for each procedure. There are very real inequities in the incomes that medical specialists with similar levels of training derive from Medicare for their work.

Governments need to be supported in imposing some measure of work value on Medicare, despite the self-interested campaigns from groups such as pathology companies, obstetricians and ophthalmologists.

Perhaps, more importantly, the media and others need to acknowledge that many of these campaigns against Medicare reform represent exploitative, self-interested attempts to maintain a very substantial tax-payer supported income.

Peter Fray

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