Medicare up for review?

A little while ago, I blogged about the relatively affordable cost of AC in Australia. A policy instituted by the former government means that currently, when your out of pocket medical expenses (those that are covered by our universal healthcare system Medicare) reach about $1100, the government will rebate 80 per cent of the subsequent expenses.

The Australian healthcare system is widely recognised as one of the best and most equitable in the world. It was used as the model for Hillary Clinton’s model of proposed healthcare reform in the USA and is upheld as an example to other nations who attempt health reform.

So it was a great shock when I learned today that the medicare safety net is a possible casualty in budgetary reforms soon to be put forward by the federal government.

Australia is in bad shape. It’s not as bad as many others, including New Zealand and the US, but we are in pretty dire financial straits.

In the last five or so months, a raft of stimulus packages have been proposed and executed by the federal government, mainly to their core base of “working families” (which my partner and I, being childless are not) in order to put some dollars back into the economy – the rationale being that it was going into the hands of those who are most likely to spend. As a result, the nice, solid financial buffer that had been built up has been eroded.

And the current government needs to cut costs, so something that is allegedly coming under review is that safety net, which costs hundreds of millions dollars a year.  It is all speculation at the moment, but speculation starts somewhere. I have private health insurance, but it doesn’t cover AC.

So I have started writing and calling the relevant people. Predictably the profit driven IVF clinics have seized upon this with gusto, and are urging infertile couples to take action. I am very cynical about private clinics and healthcare, but if it is the only way I can get a baby, I’m going to join the fight.

If anyone wants to help, these contacts were given to me by ACCESS, the Australian infertility network, however any communication needs to be received by this Friday. Please email these people and tell them how important it is that the federal government continues to subsidise Assisted Conception.

The Hon. Kevin Rudd MP
Prime Minister
T: 02 6277 7700 F: 02 6273 4100
Email: alister.jordan@pm.gov.au
Email ankit.kumar@pm.gov.au
The Hon. Lindsay Tanner MP
Minister for Finance
T: 02 6277 7400 F: 02 6273 4110
E: anthony.baker@finance.gov.au

The Hon. Nicola Roxon MP
Minister for Health and Ageing
T: 02 6277 7220 F: 02 6273 4146
E: ruth.kearon@health.gov.au
The Hon. Malcolm Turnbull MP
Leader of the Opposition
T: 02 6277 4208 F: 02 6277 4208
E: josh.faulks@aph.gov.au
The Hon. Peter Dutton MP
Shadow Minister for Health& Ageing
T: 02 6277 4884 F: 02 62778572
E: Peter.Dutton.MP@aph.gov.au

How much would you pay?

The cost of a child is something I think about quite a lot – or perhaps more specifically, what I would pay to have a child. I play a little game with myself about what I would give up in order to have a baby.

I tend to not want to give up very much, and as a result, fell like I am less deserving. As I have mentioned in another post, I wouldn’t give up my right arm, my sight or re-mortgage my house to pay for it. But I could live without a finger or two, a couple of toes, the sight in one eye, or a few gastronomic delights like never eating truffles again or no more champagne. But those games are about as reliable as avoiding cracks in the pavement – hypotheticals won’t get me pregnant, but being able to afford ART might.

Which brings me to the financial  cost of assisted conception, and in this respect, Australia certainly is The Lucky Country.

Thanks to a wonderful little legacy of The Howard Years called the Medicare Safety Net, after we have reached our $1111+/- yearly out of pocket medical expenses (Medicare rebateable) we are reimbursed 80% of subsequent applicable fees.
This means that my next cycle of IUI – the first cost AU$1250 (click here to convert, international readers) will cost about $237 according to the current cost sheet at my clinic.

This includes everything – drugs, monitoring, semen preparation, IUI, all ultrasounds, bloods etc. The only thing that it doesn’t include is consultations with the specialist which are around $80 each – but again, this is almost fully claimable at Medicare.

The full cost of an IVF cycle with ICSI is $5110, however after that magical safety net is reached, the out-of-pocket expense is $941. We also need to pay day surgery fees for EPU and anaesthetist, up to $1700, but because I have comprehensive private health insurance, this is covered (I pay about $120 per month in insurance).

There are a while bunch of variables, depending on the treatment you have, but for us – a professional couple with two incomes – the cost is very affordable. In fact I think it is probably affordable for a majority of Australians.

In the US, however, a full ICSI cycle is about US$11 000 (AU$17 200). I don’t know how health insurance works over there (maybe one of my lovely US based readers can enlighten me on how much you end up paying out of pocket), but at those prices, even professional DINKs on very good wages need to think about how many times they can afford to do it.

In Canada an ICSI cycle appears to be about CAD$4500-$5000 (AU$5460-$6070) and again I’m not sure how insurance works, or whether meds are included, so lovely Canadian ladies???

Over the pond in NZ, the government will fund two IVF cycles for women under 40. After that, or if you don’t fit the government screening criteria (under 40, non-smoker, BMI under 32) you need to go private, where costs start at around NZ$6500 (AU$5100) for an IVF cycle.

Going private in the UK will set you back about £4500 (AU$9900) for ICSI or  the NHS will give you up to three cycles if

• you are between 23 and 39 years of age at the time of treatment, and
• one, or both, of you has been diagnosed with a fertility problem, or
• you have been infertile for at least three years. *source

Of course you need to get on that looooooong NHS waiting list if you want to access the treatment!

So how much do you pay? How much can you pay? How do you decide how much a child should cost? For us, I guess we are in the lucky position if living in a country which makes AC so affordable, and are able to pay for it and it will hardly cause a blip on our financial radar.

It’s awful reading the blogs of my American friends whose major concern is how they are going to finance that next cycle of treatment. Even a drug like Clomid, which costs about $25 for three months here, is ridiculously expensive in the States.

Setting up a spreadsheet to calculate how much your conception efforts are costing is a heartbreaking exercise. Just another tick on the list of infertile unfairness.

IVF Cost is a really interesting blog run by Sue who has done some ridiculously extensive research into the costs of IVF across the globe in order to find a clinic to treat her. It has lots of good info, so check it out if you are interested.

* Lovely readers, these prices were found with a few quick Googles, so I would love it if anyone could give me some more comprehensive information to update this post. Merci!