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Medicare & PBS |
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Saturday, 13 August 2005 |
Issues of Inequality: MEDICARE & PBS
The issue: Treating all families the same for Medicare and PBS
Australia has a diverse range of families. A lot of these families are two-parent families with a mum and dad, either married or living in a de facto relationship.
However, there are a large number of single parent families and extended families. Increasingly there are also families headed by same-sex couples.
For a fair outcome for all families, Australia's laws should recognise and protect all families fairly under law.
Disappointingly, same-sex couples and families are not treated fairly by the Federal Government when it comes to the Medicare and Pharmaceutical Benefits Scheme (PBS) safety nets.
The current laws: How the Medicare and PBS safety nets work
In 2003-2004, the Howard Government made changes to the way the Medicare and PBS safety nets work to grant greater concessions for couples and families.
There are two Medicare safety nets – one for out-of-pocket medical expenses and one for the gap between the cost of a medical service and the Medicare Schedule fee recouped.
The 2005 Medicare safety net threshold for the out-of-pocket Medicare safety net is $716.10 per year. There is a reduced threshold of $306.90 per year for some concession card holders and families eligible for the Type A Family Tax Benefit. The threshold for the gap between costs and the Medicare benefit paid is $335.50 per year.
The Pharmaceutical Benefits Scheme provides subsidised medicines for all Australians.
The 2005 general PBS safety net is $874.90 per year for individuals, couples and families. Once this amount has been spent on prescription medicines, further prescriptions cost a reduced rate of $4.60 per prescription. The threshold for individuals, couples or families with a concession card is $239.20 per year. If this amount is spent, further medications are provided for free.
How it's unequal: Same-sex couples are left out of the picture
Both the National Health Act 1953 and the Health Insurance Act 1973 defines what makes a couple and a family for the purposes of both the Medicare and PBS safety nets.
A couple is defined as being a married or de facto heterosexual couple only. A family is defined as an individual or a couple with a dependent child.
This means that same-sex couples are not considered a family but as two individuals for any of the safety nets.
Similarly, same-sex families are ignored by the safety nets as the children are treated as the family member of only one of the parents. This means same-sex families have the added financial burden of not having everyone included in each safety net.
The price of inequality: Two families and the PBS safety net
Robert and Jane are a de facto heterosexual family with two dependent children. The Federal Government considers them as one family for the Medicare and PBS safety nets.
This family would only need to spend $874.90 to reach the PBS safety net threshold. This is about 31 prescriptions at the standard $28.60 price. All prescriptions for any of the family members after this point would only be $4.60 – a saving of $24 per prescription.
In comparison, Danielle and Louise are a same-sex family with two dependent children. The Federal Government does not consider all four of them together as a family for the safety nets.
Danielle has decided to register herself and the two children as a family. This leaves Louise as an individual. Danielle and the children have one $874.90 threshold, while Louise has her own $874.90 threshold.
As Louise is not recognised as part of the family, she cannot help the family reach one threshold, nor can she take advantage of the reduced price for medicines if her partner and children reach the threshold. She must reach her own threshold, which is about 31 full priced prescriptions.
This inequality to same-sex families and couples is a burden of up to $744 per year – the difference between the full price and concession prices for up to 31 prescriptions.
And this is just for the PBS threshold. Same-sex couples and families face similar burdens from duplicated Medicare safety nets.
Talking points: Speak out about unfair treatment of same-sex families
Same-sex families and couples need equal treatment for Medicare and PBS benefits to:
- treat all families equally, fairly and justly under safety nets
- allow all family members to contribute to the reaching of safety net levels
- recognise all family members for concessions when a safety net is reached
- cease same-sex families having two safety nets to achieve
- stop same-sex families having to choose which parent is not inside the safety net
What you can do: Ask the Federal Government to recognise same-sex couples
Same-sex families and couples face discrimination in many areas due to the lack of Federal recognition of their relationships and families.
There are a number of ways you can help undo this inequality for same-sex families and couples.
You can write letters to newspapers, ask to meet your local Federal MP, and tell friends and family about the issues.
Every individual can make a difference. For more information on what you can do to change Australia's laws to treat same-sex families and couples equally, visit our website at www.coalitionforequality.org.au
More information: About the Australian Coalition for Equality
The Australian Coalition for Equality aims to achieve equality for Australia’s gay, lesbian, bisexual, transgendered and intersex citizens and families – through campaigning, lobbying, networking and public awareness.
Our website at www.coalitionforequality.asn.au contains more fact sheets on various topics involving unequal aspects of Federal law.
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Medicare & PBS