Warning: This article discusses topics such as suicide.
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Patients across the Southern Tablelands and Highlands could be left up to $200 out of pocket when accessing telehealth services.
On January 1, 2022 an item of the Medicare Benefits Scheme (MBS) was withdrawn as part of the federal government's attempts to make telehealth services permanent.
MBS Item 288 was designed to give regional and rural people greater access to specialists by financially incentavising them to provide services, often telehealth, specifically in those areas.
"As part of the consolidation, older specialist telehealth items such as item 288 which provided a fee loading have been discontinued," a Department of Health spokesperson said in a statement.
"This item was introduced in 2011 in a different technological time to encourage specialists to take up video and adopt new technologies at a time when they were novel and expensive.
"With the widespread use of video conferencing and very large take up of the COVID-19 telehealth items since March 2020 that rationale no longer holds."
'It makes no sense'
While telehealth services will now be a permanent feature of the primary healthcare system, the abolition of the levy, worth 50 per cent, will leave both specialists and patients paying more.
Goulburn Health Hub Project Manager Sophie Ashton said the change didn't make sense, especially in the midst of a health crisis.
"Telehealth has been so popular over the last two years because of the money assistance it gives patients and to take it away now makes no sense to me at all," she told the Post.
"At the same time they've made the change to this Medicare levy they've made telephone consults for GPs a permanent thing.
"That's a good thing but back in 2011 they had to do something drastic to increase the services to rural areas and this is what they did and it achieved that goal.
"A lot of businesses have actually been created based on that levy. Ours relies on it, not entirely, but quite significantly. It's really bad for the patients in rural areas where there's less money.
"If it reduces demand, and it will because patients are going to have to pay up to $200 more out of pocket, then specialists aren't going to do this work anymore. Suddenly we're back in the same situation, rural areas won't be getting the services."
Whilst mental health has been in the spotlight in recent years, Ms Ashton said other specialists services would also struggle to provide care in the regions.
"It's not just psychiatrists, it's every single specialist," she explained.
"Psychiatry impact is the greatest because they were getting the biggest monetary benefit from the incentive but similarly for our endocrinologist, that's a service for which telehealth works really well.
"Goulburn has a high rate of diabetes so we had a lot of patients who were getting bulk billed services because our endocrinologist could afford it but now she can't.
"She knows that patients will just not pay that gap the government was paying."
'It's life or death'
Young people, especially in rural areas, can often feel extremely isolated when trying to access mental health services.
Eve, a Highlands local, said her ability to obtain counselling quickly and without money as an obstacle was critical.
"Counselling literally stopped me from killing myself," she said.
"I know a lot of people who would just have to stop doing counselling (if they couldn't afford it).
"It's so important, it's life or death. When you are in crisis and you have to wait another three months to even get a diagnosis, that's plenty of time to think, no I'm done."
The quick and cheap access to telehealth was something Ms Ashton said helped prevent hospital visits and she worries people will stop seeking help due to cost.
"There were millions spent on this but it wasn't the billions that you spend when patients get to hospital and theses services prevent that, it was money well spent," she said.
"I'd actually just gotten a fourth psychiatrist, obviously the mental health impact COVID is having is huge, to work and now we don't know whether we can give them business because demand will drop."
Any community members who are concerned about their own or a loved one's mental health are encouraged to speak with trusted support services such as a family GP or call one of the following support lines:
- NSW Mental Health Line: 1800 011 511
- Lifeline: 13 11 14
- Suicide Call Back Service: 1300 659 467
- Kids Helpline: 1800 55 1800
- Beyond Blue 1300 22 4636
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