POLL: Breast cancer patients left out of pocket

BREAST cancer patients are being left out of pocket almost $10,000 for breast reconstructions and reductions following mastectomies because much of the work is not covered by Medicare.

An investigation by the Newcastle Herald has found women who have mastectomies in the public health system can be left with two different-shaped breasts because of funding arrangements.

Under the current scheme, public mastectomy patients are eligible for a breast reconstruction for free, but will have to wait up to 18 months in the Hunter for the operation.

If they need breast reduction or uplift surgery on their healthy breast, so that the pair match, public treatment is unavailable and they can be up to $7200 out of pocket if they opt for private treatment – less, if they buy private health insurance.

Private patients are looking at $4600 out-of-pocket for the breast reconstruction following mastectomy and $4700 for the matching healthy breast reduction.

That includes refunds from insurers and Medicare.

Many older women who have mastectomies have had children and their breasts are enlarged, and often have started to sag.

If they have a reconstruction on the cancerous breast, they often need breast reduction surgery on their healthy breast to match the newly reconstructed breast.

Breast cancer survivors told  the Herald  the situation was unfair.

Katrina Richardson, of Cessnock, who had a double mastectomy and reconstruction six years ago, said while the procedures were cosmetic, the government needed to consider the psychological and financial impact of breast cancer.

‘‘I also had to give up my job, and a two-income family became a one-income family,’’ she said.

‘‘Then, sometimes your husband has to work less to care for you.’’

Dr Nick Moncrieff is the only plastic surgeon who performs public system breast reconstructions in the Hunter.

He said only a minority of patients needed a reduction or uplift on their healthy breast to match the 

reconstructed breast.

‘‘This additional procedure  currently is only subsidised by taxpayers, rather than fully paid for,’’ he said.

“While I understand this is frustrating, most of the women I treat wouldn’t want another woman to miss out on a reconstruction, given that there are only finite public health dollars to go around.

‘‘A number of these patients go on to have a reduction or uplift through the private system after taking out health insurance.”

A Health and Ageing Department spokeswoman said the difference in rebates was related to the nature of the operations, rather than cosmetic factors.

She said breast reconstruction surgery is a more complex and lengthy procedure and therefore attracts a higher Medicare rebate. 

Anger over rebates limit

Breast cancer survivor Di Hurt has been outraged by a decision to limit Medicare rebates for a particular breast scan to women under 50.

The 67-year-old was 60 when she was diagnosed with  cancer in her right breast, but only after a magnetic resonance imaging (MRI) scan.

Ms Hurt is among the 15per cent of people whose breast cancer will not show up on mammogram or ultrasound.

She said the federal government’s decision to subsidise the scans was great but they were discriminating by arbitrarily  covering women only under 50.

Ms Hurt, of Toronto, has spent more than $3000 over the past seven years paying in full for MRIs on her healthy breast in case her cancer returns.

‘‘Once they get over 60 most people are coming out of the workforce, they have less income,’’ she said.

‘‘For me it’s worth the money; I want to know I haven’t got cancer.

‘‘When I hear about footballers going to MRIs the next day and women over 50 can’t get an MRI on Medicare I get angry.’’ 

Ms Hurt had a mastectomy  and  to date  has been in the clear.

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