Medicare rhetoric but parties are silent on major health reforms
Albanese promised on Monday to negotiate with prime ministers over hospital funding while warning Labor would be aware of the budget implications.
Questioning the future of universal healthcare as part of the coalition was a tactic employed by Labor during the 2016 election campaign after reports emerged that the Turnbull government was considering privatizing the payment system Medicare. The Coalition also made itself vulnerable on the issue in 2014 when then-Prime Minister Tony Abbott unsuccessfully tried to impose a $7 co-payment for a doctor’s visit.
Liberal MP Anne Ruston, chosen last month to replace outgoing Health Minister Greg Hunt, was forced to defend comments from 2014 on Abbott’s co-payment plan that Medicare was unsustainable and “unfortunately the credit card is maxed out”.
After initially refusing to rule out future cuts after being announced as the Coalition’s choice, Ruston said, “Our government has been absolutely clear that we are not cutting Medicare.”
For his part, Morrison points to the fact that as treasurer in 2017 he introduced the Medicare Guarantee Bill, although the bill does not guarantee the existence of insurance. -disease itself, but tax receipts reserved for health expenses.
Australian Medical Association president Dr Omar Khorshid said none of the major parties came out stronger on health in this election, adding that “if Labor is to be taken seriously in About Medicare, they actually have to come up with different policies than the Coalition.”
“Both parties want to lower taxes. Neither party wants to be the best party when it comes to health,” Khorshid said.
The policies announced by both sides were those that “made headlines,” but were cheap and would only benefit a small number of voters.
Morrison followed on Monday by pledging to expand access to the Elderly Health Card to give older Australians cheaper medicines and healthcare, even if their income is over $90,000 a year for singles or $144,000 for couples, work matching the pledge.
Hunt has trumpeted the government’s drug subsidy record through the PBS, approving more than 2,900 new and amended listings worth $16.5 billion since winning government in 2013.
Labor delayed listing several drugs on the PBS in its 2011 budget after they were approved by the independent Pharmaceutical Benefits Advisory Committee, but has since committed to following PBAC recommendations.
The March federal budget provided $525.3 million over four years to lower the PBS backstop threshold, reducing the number of scripts people have to pay before the backstop takes effect, which is expected to save 2.4 million people an average of $80 per year.
Although Morrison is correct that the proportion of GP services billed in bulk increased while the Coalition was in government, the statistics paint a more complicated picture.
The Department of Health’s annual Medicare report shows that 89% of GP services were billed wholesale in 2020-21. The last time Labor was in government it was 82%.
“Political parties should explain how they are going to fix our hospital system, if they win the government.”
WADA President Dr Omar Khorshid
Much of the growth is due to the tendency of GPs to bulk bill patients with chronic conditions – a growing cohort that includes the elderly – who often have low incomes, as well as a temporary increase in COVID-19 Telehealth Bulk Billing. This is counterbalanced by GPs charging variance fees to patients they think they can afford to pay.
According to the Royal Australian College of General Practitioners, only 22% of GPs work in a practice that bills all patients wholesale, while 64% of GPs said they bill most patients wholesale. This roughly matches Health Department data tabled in the Senate showing that 66% of patients had all GP consultations billed wholesale in 2018-19.
Only 35% of specialist visits were billed in bulk in 2020-21, and analysis by the Grattan Institute shows out-of-pocket payments for all Medicare-funded services have increased by 50% over the past decade.
Medicare reimbursements, which increase based on the wage price index, were frozen by Labor in 2013 under a policy pursued by the Coalition until 2017, when the freeze was phased out relaxed.
Doctors say discounts need a substantial increase to keep up with the rising cost of delivering health care.
Labor health spokesman Mark Butler said cutting Medicare ‘is in Liberal DNA’ and the opposition ‘would have more say in our plans to protect and strengthen Medicare during the campaign “.
Albanese promised to create an Australian Center for Disease Control to prepare for “potential future health epidemics”, and the party announced that it would restore higher Medicare rebates for telehealth psychiatry in regional areas, as well as funding for 35 additional melanoma nurses, an Indigenous health package, mental health telephone support for nurses, pediatric hearing services and expanded newborn screening.
A spokesman for Hunt said Australians “cannot be trusted by Labor to run the economy or to run their health care”.
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