Pro bono surgery program helps hundreds who can’t afford to use their private health insurance

THOUSANDS of Australians with private health insurance can’t afford to use it because they face massive medical gap fees. But a new pro bono surgery program aims to disrupt ‘greedy’ doctors.

EXCLUSIVE

DOCTORS irate at their industry’s own greed are offering heavily discounted surgeries and saving patients up to $70,000.

The quasi-pro bono service highlights how ridiculously high some surgeons’ fees have become and how inadequate health fund rebates are.

Head of Plastic and Reconstructive Surgery at Macquarie University Professor Anand Deva is behind the program which covers post weight loss surgery, breast reduction surgery, breast implant revisions, bariatric surgery and is about to expand into hip and knee replacements.

More than 4000 privately insured low income earners have applied to take part in the program and around 300 patients in Queensland, NSW and Western Australia have so far been treated.

However, Professor Deva says he has had trouble recruiting doctors to take part in the scheme especially in Victoria where there are none.

“If all surgeons did at least one access case a month it would be great, I’m doing four” he said.

Surgeons being urged to conduct one pro bono case per month. Picture: istock

Under the program, doctors accept Medicare and health fund rebates for the surgery and charge patients around $500 in gap payments for plastic surgery and up to $1000 for bariatric surgery.

This is a massive discount as commonly gap payments for plastic surgery can exceed $20,000 per surgery.

IS YOUR DOCTOR CHARGING TOO MUCH?

THE $30 BILLION MEDICAL FEES EATING A HOLE IN YOUR POCKET

Professor Deva says the lure of commerciality and profit motive are undermining medicine and he wants to bring it back to what it used to be, a profession that serves the patient.

Too many people with private health cover can’t afford to use it because they are faced with massive out of pocket expenses when doctors charge too much and health fund rebates are inadequate, Professor Deva said.

“I don’t want everyone dropping their cover because of medical greed.

“Affordability is starting to go down and the system is hurting and people don’t see value in it.

“People are drifting away from private insurance and ultimately that will break the system.”

The ACCESS scheme has been set up with the help of Macquarie University which is providing administrative support.

Patients who have private health cover can apply to take part in the scheme online and if they are found to meet certain criteria are granted access to the program.

To access the program go to www.accessprogram.org.au

They must be earning less than $120,000 a year, undergo a pre-surgical assessment and be prepared to quit smoking or lose weight.

Professor Anand Deva is taking on doctors who charge too much. Picture: Supplied

Currently there is a waiting time of around six months for patients to see a surgeon, if patients don’t have health cover they must take it out and wait the 12-month period for pre-existing conditions.

Patients who join the scheme today are facing a two to three wait for surgery and those on the lowest incomes get the highest priority.

Sixty per cent of those taking part have a household income below $40,000 and half had plastic surgery to remove excess skin after achieving massive weight loss.

Jen Sheehan used to weigh 216 kilograms and after shedding 133 kilograms needed major plastic surgery to rid herself of 10 kilos of excess skin but she couldn’t afford it.

Surgeons had told the 28-year-old she would face $50,000 to $70,000 in out of pocket costs for a series of surgeries to make her skin fit her new 80 kilogram body and she couldn’t afford it.

Professor Deva says it was her case that inspired him to set up the pro bono scheme.

The Sydney plastic surgeon had previously treated Ms Sheehan after a horrendous car accident in which she nearly lost her leg.

“She’d had out of pocket quotes of $70,000 or surgery to remove excess skin after losing 100 kilograms,” he said.

Jen Sheehan, 38, before she shed 133kg. She now weighs just 80kg. Picture: Leigh Roberts

She’s transformed! Jen Sheehan as she looks now. Picture: Darren Leigh Roberts

Ms Sheehan says the loose skin from her stomach almost reached her knees, she had six inches of skin hanging off her arms and other parts of her body also had baggy skin.

“I found a new passion for exercise but when you’ve been that big for that long your skin does not bounce back not matter how much you work out,” she said.

She had her first surgery under the access program in January last year and three more followed.

Instead of costing her over $70,000 each surgery cost her between $500 and $1000 out of pocket and doctors accepted health fund rebates to cover the rest of the cost.

“I can’t believe the doctors are doing it,” she said.

“If I wasn’t on the ACCESS program I wouldn’t be able to do it.”

Originally published as Pro bono surgery program helps hundreds who can’t afford to use their private health insurance