Restricting abortion

Remember last November when Federal Health Minister Tony Abbott and his parliamentary secretary, Christopher Pyne, claimed there was an "abortion epidemic" (although the Australian Medical Association disputed this at the time)?

Remember everyone calmed down when it was recalled that abortion was a state legislated matter, out of the Federal Government's control?

Guess what: the benignly-named Health Legislation Amendment Bill 2005, will if passed, restrict Medicare funding for some types of surgery, including abortion.

Australians have until this Wednesday, October 12, to make a submission to the Senate's Community Affairs Committee about the proposed changes, which were only made public at the end of last week.

And even now, there are gaps in what we may know about these changes. We know that the amendments will give the Minister a new power to determine that Medicare rebates will not be applied to medical services in "specified circumstances". But those specified circumstances, to be outlined in a new legislative instrument, are not yet clear.

Of perhaps greater concern is a whole new section to the Health Insurance Act 1973 (4BAA) which “will restrict items of medical, diagnostic imaging and pathology services by making those items subject to conditions, limitations or restrictions”, according to Mr Abbott. But how? The Minister isn't saying. Despite research, Section 4BAA cannot be located for perusal.

Last year, our canny Prime Minister saw the political danger of being anti-abortion and declared, "There will be no government-sponsored change at the federal level to the current legal status of abortion". This has left plenty of "wriggle room" for the Health Minister to address the availability and the affordability of abortions in the proposed legislation.

So what's going on?

Under this proposed legislation, it appears that the Minister for Health will have the power to restrict the procedures to be funded by Medicare, and can make these changes merely by tabling them in Parliament.

Here's what to watch for: the two Medicare item numbers used for abortions are also used for a number of other purposes (which is why the figures on abortion are so unreliable). Item 35643 is used by gynaecologists for both abortion and for blighted ova, missed abortions and molar pregnancies. Item 35640 is used for incomplete miscarriages, where there is significant bleeding and passage of some pregnancy tissue but there are retained products of conception requiring curettage.

Under these new powers, we can only speculate how new arrangements might work. Might your doctor have to explain to the Minister that you need a curette for an incomplete miscarriage rather than a termination?

Will your doctor be able to claim for the use of the diagnostic imaging technology to find out whether or not your baby has a condition that is incompatible with life?