AAPi (Australian Association of Psychologists), the peak body for psychologists in Australia, is calling for the government to correct its two-tiered Medicare system.
Under the existing Medicare Benefits Schedule two-tier system, clients of Australian psychologists are rebated at two significantly different rates depending on the classification of the psychologist, as either clinical or registered.
The two-tier system suggests that 30% of psychologists who have endorsement in clinical psychology should attract a higher level of Medicare funding than the remaining 70%, who are registered psychologists or hold endorsement in another area of practice (for example counselling psychology, education and development psychology or forensic psychology).
Clients of registered psychologists are rebated $96 for a 50-minute session, while clients of clinical psychologists are rebated at $137 – over $40 more for the same kind of service.
Two-tiered system for the same service and treatment outcome
Currently only clinical psychologists can provide their clients with a higher rebate. This has created cost access barriers for the majority of clients who need to see a psychologist under Medicare.
All psychologists in the country have completed at least six years of training and education before qualifying as a registered psychologist. Research1 demonstrates that both registered psychologists and clinical psychologists achieve beneficial outcomes. There is simply no evidence to warrant a difference in funding or endorsement.
All psychologists provide the same service, to the same standards, and to the same population group. The dual Medicare rebate system has caused nothing but divisiveness in the profession and has cost and is continuing to cost taxpayers millions and millions of dollars. Ultimately, it is the community members in need who are missing out.
1 Pirkis, Ftanou, Williamson, Machlin, Spittal & Bassilios (2011a). Australia's Better Access initiative: An evaluation. Australian and New Zealand Journal of Psychiatry, 45:726–739
AAPi is advocating for all psychologists to be able to provide the same higher Medicare rebate to their clients to reduce financial barriers to accessing care the same Medicare Rebate. We need to recognise that all psychologists provide an equal level of service, regardless of the practitioner’s background or qualification. The outcome of the treatment should be the only reason for applying a Medicare rebate, not the endorsement of the practitioner, and the government funding should reflect the reality. The two-tier rebate scheme should be immediately discontinued and replaced with a single rebate higher rebate for the clients of all psychologists.
The government needs to consider the mental health needs of the Australian public during the current crisis but also into the future. All psychologists need to access the same Medicare tier, instead of a system that penalises consumers of Medicare’s Better Access program.
Forcing two thirds of psychologists to offer lower rebates leaves a huge gap in services for the most vulnerable Australians in this time of great need.