The high cost of of law reform

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Post by Graham Douglas-Meyer26 Nov 2010

When their partner’s income became assessable in 2009, many HIV positive people around the country lost their Disability Support Pension (DSP).

Initially, they were entitled to use a pensioner concession card for a further 12 months which meant that they and their partner were still able to access Pharmaceutical Benefits Scheme (PBS) medications at the lower pensioner rate of $5.40. Additionally, their combined prescriptions also entitled them to the lower pensioner PBS safety net which, once reached, provided them both with all PBS medications free of charge for the remainder of the calendar year.

Unfortunately, most couples are now required to pay the maximum cost of $30.30 per PBS prescription. But it doesn’t stop there. Losing the concession card has also meant losing concessions on utilities as well as many other state and local government charges. This has the potential to financially devastate many couples.

Research by the National Welfare Rights Network has shown that when people are hard-pressed they often forego medications rather than miss out on food or other essentials. We can’t afford to let this happen to people with HIV, many of whom are on a large number of medications.

MY PERSONAL CASE

I have been living with my partner for nine years. When we first met, I was on two prescriptions per month with the occasional need for antibiotics and other medicines. I was on the DSP and although my HIV was under control, I had other health issues which made it impossible to work; but I was able to pay for my medication and contribute to the costs of running the house. Two years later I started on antiretrovirals. There were a number of side effects from the new drugs and so I was put on another three medications. I was now dealing with a total of eight prescriptions each month, but the co-payment was still manageable.

In 2005 the Health Minister introduced new Medicare measures; and PBS prescription costs began to increase on an annual basis. In May 2006 the Howard Government tightened eligibility for the DSP, restricting the number of hours someone could work from 30 to 15 hours per week. Fortunately, my pension fell within the grandfathered group, which continued to be assessed under the old rules. We were still able to cope with the costs.

On 1 July 2009, our relationship was formally recognised by the commonwealth and we were assessed as a de facto couple. I lost my pension and became dependent on my partner.

At this time I am on 25 different PBS prescriptions as well as a small range of supplements, and the cost for prescription medications alone comes to around $110 per month. For the remainder of the year, my partner is also entitled to his prescriptions at the pensioner rate because my pensioner concession card was still valid for another 12 months.

In January 2010 the new Medicare safety net applied to our newly-recognised family so with our combined medication costs, we reached the PBS safety net in March 2010.

Although I was informed that there was no reason my concession card would not be renewed, it expired recently and I now have to appeal the decision.

Unless this appeal is successful, my personal PBS prescription costs for the month of January 2011 will amount to roughly $630 – an amount I will also have to find to pay in February before we reach the safety net and begin paying the reduced rate per prescription.

I am already paying increased transport costs and, as a couple, we now have to pay full utility costs as well as full local government rates and charges.

Where is all this money to come from?

Any suggestion that PLHIV should have special rights over other sections of the community goes against the whole purpose of calling for equality in the first place. However, the implementation of these important reforms could have provided an opportunity to amend what was already a poor system affecting the general population. This is not the fault of one government, but the cumulative effect of government blindness to the plight of people who deserve better treatment.

So, rather than trying to gain special treatment for a specific group, we now have the opportunity for the GLBTI and PLHIV communities to ally themselves with the disability community in challenging this situation.

While the best possible outcome would be for all people to be granted DSP on the basis of their disability, rather than on their partner’s income, there is another option. What we need is a ‘Chronic Illness Health Care Card’.

The Australian Federation of Disability Organisations (AFDO) has been calling for a ‘Disability Inclusion Allowance’ for some time. Part of their proposal is for just such a concession card that could offset the costs of disability and would not be means tested.

  • Please write to, email or telephone your local federal MP or your senators and let them know this is not an acceptable outcome of the reforms that took so long to achieve.
  • You can also contact the Consumers Health Forum of Australia (www.chf.org.au
  • Centrelink has a list of exceptions, which could allow some to qualify for pension cards. This and other information can be found at www.centrelink.gov.au.