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No cap on funds for medical treatment

A word from the Chief Health Officer and Principal Medical Adviser

Chief Health Officer and Principal Medical Adviser
Department of Veterans' Affairs

A man with his back turned placing his hand on the shoulder of another man who is smiling.

DVA's budget for medical treatment is demand-driven and uncapped. Photo: iStock

During the last month, I received an interesting letter from an old digger in northern Tasmania. Let's call him Jim. Jim's letter to me was based on a previous article that I'd written in Vetaffairs. He was concerned that DVA might be unhappy with him because he’d spent nearly $5000 in the previous year on necessary medical costs billed to his DVA Gold Card.

Immediately on receiving his letter, I phoned him at home. He was absolutely delighted to receive an immediate phone call from DVA's principal medical adviser, and even more delighted when I told him that we would not be concerned about the $5000 spent on necessary medical treatment. I told him that the average spend per Gold Card holder was in fact closer to $25,000 per year. I then asked him specifically whether all of his medical needs were being met by DVA. He said they were.

Many veterans are under the misapprehension that if they spend additional money on their Gold Card for their necessary medical treatment, then other DVA clients may be missing out. Although this is understandable, it's completely untrue.

Our funding for medical treatment is 'demand-driven and uncapped'. What this means is that if in a financial year, DVA needs to spend more money than had initially been budgeted for healthcare support to entitled veterans, then the excess is just 'written off' by government and we start the next year with a clean slate. This ensures that we can always meet the costs of all clinically necessary treatment for entitled veterans.

A second letter received from another veteran was in relation to tinnitus. He had not fully understood my recent article on tinnitus and was very upset that his claim for tinnitus had not been accepted by the DVA decision-maker. In this particular gentleman's case, he'd been discharged from the ADF within one year of joining, had no documented exposures to conditions likely to lead to tinnitus (such as exposures to very loud noises), and he was therefore unable to show a link between his service and this claimed condition. But hopefully, for the majority of veterans, it is relatively easy to demonstrate a link to service and then show how the claimed condition meets one or more of the Statements of Principles established by the Repatriation Medical Authority.

And finally, many veterans will be aware of the large-scale community problems in relation to drugs of addiction. Although the listing of medications on the Pharmaceutical Benefits Scheme and the Repatriation Pharmaceutical Benefits Scheme are controlled by the Commonwealth, prescribing and dispensing are state/territory matters. Certain states are now undertaking 'real time prescription monitoring' which will ensure that doctors and pharmacists check to see whether certain scheduled and addictive medications have recently been prescribed to individual patients.

In time, this will be rolled out nationally, and will also include medications dispensed to DVA clients. But if you have need for special medications (or in larger quantities, higher dosages, or for non-listed indications), your doctor can apply for special authority to prescribe for your medical condition by contacting our Veterans' Affairs Pharmaceutical Advisory Centre group in Brisbane on 1800 552 580.

Until next quarter, stay healthy!

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