Medicare funds MRIs for prostate cancer but not breast cancer
IN the latest skirmish in the battle of the sexes, women are being denied a Medicare rebate for their $1500 breast cancer MRIs while men get subsidies for prostate cancer.
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MEDICARE is at the centre of a gender war and is being accused of sexism for subsidising MRI scans for men with prostate cancer but not for women with breast cancer.
Breast MRI’s needed by thousands of women a year can cost between $450 and $1,500 and News Corp has spoken to women who’ve spent $8,000 on the tests they need to make sure their cancer has not returned.
“I think it’s a very sexist policy, it’s like taxing women’s products with the GST,” said Amber Cuthbert whose $460 breast MRI picked up an extra cancer not detected by a mammogram or ultrasound.
A small number of high risk younger women who have two or more close relatives with breast cancer do qualify for a Medicare rebate for a breast screening MRI but bizarrely their sisters, aunts and mother who actually have cancer don’t get a Medicare rebate.
Hobart mum Miranda Bahr who was diagnosed with breast cancer five years ago can’t get a rebate for a breast MRI but her sister can.
“My sister gets her yearly MRI covered even though she’s not had breast cancer because myself and my mother have cancer,” she said.
“I just don’t think that is fair, that people who have been through cancer don’t get it covered,” she said.
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Today News Corp begins a campaign to get a Medicare rebate for thousands of women with a breast cancer who doctors say need an MRI to diagnose their cancer, decide on the best treatment and then ensure the cancer does not return.
More than 17,000 women a year are diagnosed with breast cancer and doctors say one in five need an MRI.
The Breast Cancer Network of Australia said it was inequitable that in Australia only women who can afford to pay for MRIs are being offered the scans but those who can’t are missing out.
In the May budget the government funded MRI scans for men with prostate cancer.
However, in 2016, the Government committee that decides which treatments receive Medicare funding, the Medicare Services Advisory Committee (MSAC) recommended just two out of six categories of breast cancer patient should be funded for MRI.
It said there was not enough evidence to support a rebate in other women and rejected the application on the grounds of “uncertain clinical effectiveness, cost effectiveness and financial impact”.
Oncologist and breast cancer expert Fran Boyle, who supports a Medicare rebate for breast MRI in some women, said she did not think it was right to start a disease Olympics.
“Men are getting a rebate for MRI because they are about to put a beam between the bladder and the rectum and that has massive implications for function, putting a beam across the chest is a whole lot different to the pelvis,” she said.
Professor Christobel Saunders, the doctor sponsoring the latest application for a Medicare rebate for breast MRI’s, was told in July it her application was again likely to be rejected and more research was needed to provide evidence MRI’s were effective.
She noted that when the government copped bad publicity for putting women’s cancers in higher cost silver and gold bands of health fund policy while men’s cancers were to be treated under cheaper bronze policies it was quickly changed.
Surgeons need information from a breast MRI to gauge the full extent of the cancer in some women, it can help determine whether a lumpectomy will clear the cancer or if a mastectomy is needed.
If the cancer is large women may need to have chemotherapy before surgery to shrink the tumour and an MRI shows whether the chemotherapy is working to reduce the tumour size.
Women who have a rare lobular subtype of breast cancer often don’t have their cancer picked up on mammogram or ultrasound and need regular monitoring.
Women aged under 50 newly diagnosed with breast cancer and women with dense breasts need MRI’s because other scans are not effective and may need monitoring using MRI after surgery.
After paying for four MRI’s Sydney mum Sally Govey was unable to afford the biannual test recommended by her doctor when she was diagnosed with lobular carcinoma in 2004 and treated with a lumpectomy.
Fourteen years later it was found her cancer had spread so widely she needed extensive surgery she likened to being “butchered”.
“If I’d carried on having MRI’s every two years it may have shown up something and I could have got treatment earlier,” she said.
Andrea Bolte, a mother from Glenelg in Victoria, has been spending $800 every year for ten years out of her own pocket on an annual MRI and mammogram test to ensure her large cancer does not return and her family has had to go without to afford it.
“My surgeon said if you could afford it you should do it. It struck me, why should it be only if I can afford it,” she said.
Tanya Simpson form the ACT says her MRI was crucial because it found a hidden lump and dramatically changed her treatment from a lumpectomy to a double mastectomy.
“It’s one of the things that should be rebated, it surprised me it was not rebated,” she said.
Brenda Zizza from Benowa Waters in Queensland said she had to pay $600 for breast MRI after being diagnosed with cancer.
She said it was “mind boggling’ that people who have two relatives with breast cancer can get a Medicare rebate for an MRI but those actually diagnosed with the cancer cannot.
“You need a university degree to work this out,” said Mrs Zizza.