Dr Andrew Pesce: Medicareless petition will get the government to react

Dr Andrew Pesce, former head of the Australian Medical Association (AMA) and Jillian Spears, a surrogacy patient, were interviewed by 4BC radio in Brisbane on Monday, 15th April. In the interview, Dr. Pesce agreed that the Medicareless petition to change Medicare laws would get the government to react. The aim of the petition it to provide equal treatment under the law for all IVF patients, including surrogacy.

“The AMA’s position has always been where a procedure is lawful, and it is clinically necessary, the AMA believes that the whole principle of Medicare is to make sure that clinically necessary and lawful services are made available to people that need them. So this would certainly fall into that category,” he said.

The AMA represents the interests of more than 27,000 medical practitioners from all specialties and locations across Australia.

andrew-pesce

Listen the entire interview here

Partial transcript below:
Why no rebate?
“I think it’s just a historical fact, there’s probably been a slow evolution of what technology has been available for people and surrogacy only came into clinical use probably some time after the rebates were set. Governments tend to have a policy that until they make a specific decision that until they are refundable through Medicare then they aren’t. That’s why a lot of new treatments often are outside Medicare rebates. And leaves us in what is quite an anomolous situation.

Wouldn’t surrogacy give some women a better option than IVF?

There is no doubt that for some women their only option is surrogacy……Now I have to say I wasn’t available to listen to your discussion with Jillian so I have absolutely no background to her medical illness and story.

Well basically due to illness, her, and her other friends, well, she lost her womb.

Well obviously, she can’t carry a baby so there is no option for her other than there being a surrogate to carry the embryo on her behalf if she was able to donate eggs to be fertilized with her partner’s semen. So for her it is the only option.

For various other people, normally most couples would try very, very hard and exhaust all possibilities of carrying their own babies themselves, and only consider surrogacy if it seems to be the only option left available to them.

It seems really expensive doesn’t it. I mean, the average cost of a legal surrogacy is around $60,000.

In which country are you talking?

Obviously here in Australia.

So, I am not involved in the fertility industry. I guess this is in addition to the normal IVF costs, I guess it is because you need to pay for the time and pain and other things associated with the other things of having another person having a baby on your behalf. Look, I am not sure how those costs have evolved, but it certainly does sound expensive.

As the former AMA president, would you see with this petition, that there’s potential that the government may react at last and that the government may do something about this and provide some kind of rebate?

Oh, yes, I think so. The AMA’s position has always been where a procedure is lawful, and it is clinically necessary, the AMA believes that the whole principle of Medicare is to make sure that clinically necessary and lawful services are made available to people that need them. So this would certainly fall into that category.

There are some other times when surrogacy might be requested where there isn’t a medical necessity for it. Let’s just say for argument’s sake there was a woman who was too busy in her career to take the time off to become pregnant and wanted someone else to carry her baby. I think some people might say there are some examples where we could think that we don’t that taxpayer dollars are necessarily best invested. But I think that most people would agree when it’s the only option available for a couple that are desperate to have children, I think most people would be comfortable with Medicare covering it.

Channel 9 – The Today Show

For those who missed the live show, please click on the link to see us on the Today Show, Wednesday 10th April, 2013 – The Medicare loophole.

We are happy to have had the opportunity to engage with the Australian community through the Today show this morning. We are interested in any other mediums to share our story, to let people know that it is ordinary Australians that are impacted by this discrepancy in the Medicare legislation that forces surrogacy patients to pay double or triple the amount for IVF treatment as compared to other citizens.

Feel free to contact us through this blog or our Facebook page https://www.facebook.com/Medicareless 

Trewy’s Surrogacy Story

In response to our media story on Channel 9 News Tuesday, 9th April, we received words of encouragement from Trewy and his wife, an ordinary couple facing the difficulty of a surrogacy without Medicare. Trewy decided to share his story for us below.

“After, marrying my wife Rach in October 2010. We discovered Rach has fertility problems.

Fertility problems in Australia are not rare with 1 in 8 couples needing treatment. However, Rach has a more rare and costly medical condition which prevents her body from producing eggs. No eggs, is a not a big problem. If you have a family friend you could be lucky. If you wait for donor eggs in Australia, it will take about 5 to 6 years according to the doctors.

[Moderator note – http://www.eggdonationaustralia.com.au is an excellent not for profit site dedicated to egg donation in Australia and recipients can find donors within a few months, so for those needing an egg donor, don’t lose hope and don’t believe the doctors!]

Rach and I have been lucky to find an egg donor and harvest three eggs at a cost of $12500. This was a straight out-of-pocket expense and not covered by our private health or anything. It’s worth noting that in Australia, no money is allowed to be paid to an egg donor.

I thought having three 3day old embryos (3 potential children), our hurdles and dramas would be over. Sadly, it was just the beginning. After months of drugs and money being used to try and get Rach ready to have an embryo transferred,  we have only managed to kill one of our potential children, kill my equity in our beautiful home, beat up our credit card and become ever so saddened by our grim outcome.

See the IVF train is a slow and expensive train. Suddenly, your life goes from a newly married couple to counting down days till the next cycle of drugs, and loads and loads of tests with more and more delays.

Financial stress plus emotional stress can start to beat you up. I would be lying if I said “I have never considered divorce’’. I would even give up my house, even body swap with a terminally ill person, if only I could have a son who could catch a ball with me. A son to share his first beer. Sadly, if I bear no children, then there will be no grandchildren either. All I can look forward to is a lonely retirement.

This is where you can help. IVF is a kind of high risk investment. Except IVF investment is a rule breaker as it is investment with emotion. I don’t want to be father of the year, just a father.

This year we are switching from IVF to surrogacy. Sadly, life makes Rach a poor microwave. Rach has found a surrogate. A person, who will not receive money for their priceless gift, to us. Sadly, the costs of surrogacy are about $60000 to $80000. This is lawyer costs to create the legal surrogacy agreement (2 lawyers $15000 each). The costs of counseling, insurance to be able to obtain a parentage order under the surrogacy agreement. Then all the medical costs that are not covered by Medicare or our useless private health which follows the laws set out by Medicare.

Morally, I feel obliged to continue with this course of action, because those two embryos are technically alive and just frozen. Even after this process we may not have a child. I’m sure the cost would double if we are lucky to use both embryos.

I have begged the banks for a low interest loan, and even contacted my superannuation to help cover the $60000 for surrogacy. I have not been very successful. So, goodbye dream home and boat. Sadly, the dream of having a family is killing my dream of financial security. However, you never know…..I could win lotto.

How can two tax paying government employees with private health cover and a small mortgage be forgotten? We’ve never received a government handout, and we’ve paid all of our HECs debts. We have been described by our friends as the ‘unlucky couple in the lucky country’.

How can you help? I have no idea. Bring attention to this situation, government assistance, I remember former Prime Minister Kevin Rudd, giving a speech containing the word family. Family first and family this. Well, after I’ve written letters to Labor, Liberal governments both state and Federal, I’m sad to say that no replies have been received.

If I do make it through this nightmare. I really wanted to take the egg donor, surrogate and wife –  hopefully with a child or children-  on a holiday. To thank them for their commitment to my family. However, with the cost of things coming, I may have to wait a while. A long while. Perhaps a lifetime.

Thank you for taking the time to read my story.

Trewy”

Of course, we know how you can help people like Trewy. Sign our petition for change, and send an email to Tanya Plibersek and other members for parliament. Choose from any of our ready- made email formats from the Resources tab.

Together, we can make this change, and help ordinary working couples become families. As you know we are starting to receive replies and are receiving media attention, so as a group we are making an impact – where before we were solo travelers, losing hope on our own voyages. Too many have been silent for too long!

The murky waters of Medicare – Why we should update the law

The Medicare legislation is not clear in relation to rebates for medically necessary IVF. It states that if you are in an agreement to do surrogacy, you are not eligible for surrogacy. (Clause 2.37.7)

However, what if you are NOT in an agreement – say, you haven’t found a surrogate yet? Or you have just had a hysterectomy or you have just survived cancer and now you want to preserve your eggs so you have a chance of having a family?

If you are not in an agreement, and are not subject to an agreement – technically, you should be able to do an IVF cycle and be treated just like any other couple.

Unfortunately, NO.

Medicare recently replied to one of our campaigners and stated that ‘because a birth would require an ‘intended’ surrogacy’ they could not provide a rebate. However, this is clearly an interpretation of the law, and is not what the law expresses in the legislation.

Medicare state that they are committed to health services and ‘are currently looking into changes but they are NOT expected in the short term.’

This is why we are here campaigning. Now the law is being interpreted rather than expressly clarified – and it is open to interpretation at the clinic too.

Clinics are left to interpret the law, and as we have seen in the ICSI debate in an earlier posting, it means that even when surrogacy candidates are allowed to have a Medicare rebate, clinics will err on the side of NOT giving them.

We would like to clear up this mess. We would like to see IVF rebates provided equally to women who have a uterus or those who do not. Equal treatment under the law is a basic tenant of our society and we want to change the Medicare laws to reflect that.

We hope to have your support by either downloading the Petition in the files section and/or writing to your local member of parliarment and Tanya Plibersek.

Response from Department of Health & Ageing

Today we received a promising response from the Department of Health and Ageing.

Firstly they “commended” us for the work we are doing to create awareness about the Medicare laws as they relate to surrogacy.

Secondly they reiterated that they are committed to medically necessary services to the public and are therefore actively considering the issues raised in the surrogacy paper. They have advised that I am welcome to contact them to see how this work is progressing and provided the contact Ms Mary Warner, Director of Medical Services.

I am so proud of this response and hope that they are sincere in their response.

Please continue the great work you are all doing in creating awareness about this issue, great joint effort.

Letter from Dept Health & Aging

Holly’s Story

Holly & Ash

Holly & Ash

At age 14 i was diagnosed with a severe mullerian anomaly with a unicornuate uterus and severe endometriosis. The endometriosis drowned my fallopian tubes and one ovary. What i was left with was half a uterus, one ovary that was not connected, one kidney and no cervix. At 14 years old this was devastating. At 18 I met Ash (23), he was beautifiul, kind and supportive. Like any normal couple our age we had a normal lifestyle, normal paying jobs and a house loan but there was just one thing missing, a child. 6 operations later the news I received was heart breaking ” I’m so sorry Holly, there is nothing more we can do” Surrogacy was our only option. I spent months resaeaching how to go about it and what to do. My gorgeous mum was the first person to offer, it was like a dream come true. Sadly Mum was diagnosed with hormone related cancer and was no longer able to carry our baby. Six months later a wonderful woman offered to carry my baby. The words estatic and overjoyed don’t even come close to what we were feeling! However those feeling didn’t last long when we were told that medicare wouldn’t cover us for IVF. We are looking at around $15,000 – $20,000. As a normal young couple this just seemed out of reach. Medicare cover everyone else for IVF but will not cover us. Not only do we have $15-20,000 for IVF but we also have another $20,000 + for other surrogacy involved costs. It is my understanding that when Medicare made this decision surrogacy was illegal, now that surrogace IS legal here in Australia the outdated laws need to change. So over all i feel discriminated against and think this is greatly unfair. Please change the law so that us and couples like us can be blessed with a family

51 Letters sent to Australian Politicians and other Community Groups

Thanks to our group who is campaigning to change the unfair Medicare laws, we have managed to send 51 letters to politicians and other community groups in a few days. Well done everyone!

But this is not enough!! If we want to be heard its going to take a lot more than 51 letters. I urge you all send letters to your politicians. We have made it easy for you, we have included template letters and contact details for many politicians.

Here is a link where you can see who has sent what letters and the responses we have received so far. Letters sent and Response to date

Busy Weekend for Sending Letters

Well its been a busy weekend sending letters to politicians and other organisations asking for assistance. Thought it would be good to give everyone an update of what letters have been sent over the weekend:

Tanya Plibersek
Laurence Springborg
Tanya Plibersek
Peter Dutton
Laurence Springborg
Jo-ann Miller
Annastacia Palaszczuk
Jackie Trad
Nicola Roxon
Sarah Hansen-Young
Adam Bant
Lee Rhiannon
Kim Carr
Stephen Conroy
Tony Zappia
Jillian​ Skinner
Andrew McDonald
David Davis
Gavin Jennings
Kate Gallagher
Jeremy Hanson
Michelle O’Byrne
David William Tollner
Jeremy Rockliff
Kon Vatskalis
Jack Snelling
Rob Lucas
Kim Hames
Roger Hugh Cook
Queensland Assoication of Independent Legal Services
Caxton Legal Centre Inc
South West Brisbane Community Legal Centre
Women’s Legal Service

Remember if you have sent letters please let us know so we can update our activities sheet. So far I have only been notified by one person of what letters she sent. Thanks Carrie!!

I won’t upload copies of all the above letters, many are the same and they are based on the templates uploaded here. However if you wish for a copy of any of the above please just ask.

Letters sent to Australian Health Care Reform Alliance and Queensland Council of Unions

Today I sent letters to the Australian Health Care Reform Alliance (AHCRA) and the Queensland Council of Unions. Both organisations that friends suggest I write too.

The following is on the AHCRA’s website:

The Australian Health Care Reform Alliance (AHCRA) is a coalition of peak health groups working towards a better health system for Australia’s future.

Australia’s health system was designed more than a generation ago and no longer meets the needs of our community. Many Australians are missing out on the care they need or not receiving the best possible care for their condition. There is a growing gap between the health of the best and worst off in our community which is undermining the fairness of our society.

We need to make major changes to our health system to make it better and fairer for all. With an ageing population and increasing demand for health care, we need to ensure that every dollar we spend on health care delivers maximum value. We also need to make sure that our health system reflects the values of our community.

AHCRA is working to find solutions to the problems with our existing health system, including:

· poor access to care for many Australians
· consumer frustration with problems in navigating an overly complex system
· the health gap between Indigenous and non-Indigenous Australians
· increasing out-of-pocket costs for services
· a severe shortage of doctors, nurses and other health professionals
· an insufficient focus on prevention and primary care
· the inefficient allocation of resources caused by the current State/ Commonwealth funding structure.

The Federal Government has embarked on a major health reform initiative, involving making significant changes to the ways in which health care is funded and delivered. AHCRA supports the overall goals of health reform and is working to ensure that the reform measures deliver a fairer, more efficient and sustainable health system for Australia’s future.

Check out their website for more information; or you may even like to send your own letter to them asking for assistance: http://www.healthreform.org.au..

The Queensland Council of Unions (QCU) is a representative body of Trade union organisations, known as a Labour council, in the State of Queensland, Australia. As of 2011 there are 32 affiliated unions and 13 provincial Trades & Labor Councils (also known as Branches of the QCU) affiliated to the Council, representing some 350,000 workers. It may seen odd to write to the QCU, but having worked in the union movement for almost 7 years, I am aware that they love to get onboard where the average Australian are treated less favourably to others.

You can view the emails I sent here:AHCRA and
QCU