The Turnbull government should publish evidence justifying its planned changes to the extended Medicare safety net to hose down fears they will affect vulnerable patients, a government-dominated Senate committee says.
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The changes will lower the spending thresholds required for patients to access benefits for out-of-hospital services but cap the benefits payable for individual services once this has been reached, prompting concerns that critical psychiatric and oncology services could become unaffordable for some patients.
The Senate standing committee on community affairs, controlled by Coalition senators and chaired by Liberal Senator Zed Seselja, recommended that the bill be passed, saying it would resolve inconsistencies in the program, which had been inequitable, inflationary and failed "to deliver affordable access to high quality health care" over more than a decade.
It also said the changes should be reviewed in five years' time "so that any shortcomings can be quickly identified and resolved".
The committee conceded the government had helped stoke the concerns of "various stakeholders" in its report, which was published late on Monday. "To some degree, the lack of publicly available data and modelling on the impact of the measure has caused unnecessary angst and confusion," it said.
While the committee had been provided with some of the details of the government's "evidence base" for the bill on request, it said, "The committee considers that the imminent introduction of a new safety net with fundamental parameter changes warrants explanation as to its anticipated effect and that the [explanatory memorandum] to the bill should be amended accordingly".
The Turnbull government had hoped that the changes, which are expected to save $266.7 million over five years for the Medical Research Future Fund, would take effect from January 1. This means the bill would need to be passed in the next two weeks, the last sitting fortnight of the year.
Labor will oppose the bill, which is expected to be passed in the lower house on Wednesday. The Greens and a number of crossbench senators have not yet decided whether they will support the changes.
Labor Senators Carol Brown and Katy Gallagher called on the government to abandon its bill in a separate dissenting report, saying they were concerned about its potential impact on cancer patients and those accessing psychiatrists and IVF services.
They said the current safety net should instead be reviewed, taking into account recommendations following the government's reviews of the Medicare Benefits Schedule and primary health care.
Health Minister Sussan Ley has said the changes were needed as the current safety net served people living in the wealthiest suburbs.
The Royal Australian and New Zealand College of Radiologists has said that the changes would disadvantage chronically ill patients who would have no trouble reaching the current threshold.
The president of the National Association of Practising Psychiatrists, Dr Shirley Prager, also warned that the changes could lead to more suicides and homicides because the cap would make treatment unaffordable for many patients with complex disorders.
Opposition health spokeswoman Catherine King said, "While Labor is happy to discuss sensible reforms, the Liberals' changes could adversely impact some of the most needy and vulnerable patients and we do not support the legislation in its current form".
Fairfax Media has contacted Ms Ley for comment.
