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The new Medicare package will make access to health care more flexible

By Kay Patterson - posted Friday, 9 May 2003


It is like a game of Simon says. Simon says anything if he thinks it will save his political neck.

The desperation of Simon Crean's perilous hold on Labor's leadership is underscored by his wrong statement today that families earning more than $32,300 a year will be denied access to bulk billing under the Government's $917 million A Fairer Medicare - Better Access, More Affordable package.

This is completely untrue!

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Bulk billing, where doctors choose to provide care at no cost to the patient, will be continue to be available to all Australians. Bulk billing will not be restricted to families with two children who are earning less than $32,000 a year.

As is the case now, doctors will remain in control of their own billing practices and can choose to provide care at no cost to the patient regardless of whether those patients hold a Commonwealth concession card.

We are giving doctors an extra $500 million, which goes to their bottom lines to help them. We are offering them extra resources, such as nurses to help them in their practices. This package will take the pressure off doctors. The vast majority of GPs will be better off if they participate.

There is nothing in the government's Medicare package that would cause doctors to increase the fees they charge their patients. If a doctor chooses not to bulk bill a patient - as happens in some cases now - doctors will be able to offer patients more convenience and significantly reduced up-front costs.

Patients attending participating practices, which choose not to bulk bill people without health-care cards, will only have to pay the gap between the doctor's fee and the Medicare rebate. They can leave the surgery with no more to do and no more to pay.

This will be more convenient because patients will not have to go to a Medicare office to claim their rebate and families will be relieved of the financial burden of paying the full doctor's fee up front when taking sick children to the doctors.

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There has been much wrong comment about the Fairer Medicare package. In putting $917 million over four years into the Medicare system, the Howard government is strengthening Medicare, not creating a "two-tier system" as some claim or setting out to destroy it.

Instead of paying lip service to Medicare, we are actually doing something to make it better. At the very heart of the principle of universality is affordable access to GPs.

A Fairer Medicare - Better Access, More Affordable

One of the myths being created is that going to a GP will become more expensive because of this package. No government has ever controlled the fees that GPs charge, and there is nothing in this package which should cause GPs to put up their fees. Under this package, the Medicare rebate will still be paid for all Australians going to a GP, so the "universal" element of Medicare remains. As is currently the case a doctor may still bulk bill any patient he or she chooses and continue to provide care at no cost to the patient regardless of whether or not they hold a Commonwealth concession card.

Where a GP chooses not to bulk bill, and the patient is permitted to pay the gap at the surgery, it will be very clear to the patient, arguably for the first time, exactly how much their doctor is charging them. This knowledge, and the reduction in up-front costs to the consumer, will benefit patients.

It is true that doctors will be paid incentives to bulk bill Commonwealth concession-card holders. These incentives will, for the first time provide for equity in the bulk billing of card holders - some of whom, in regional and country areas have never been bulk billed. These incentives range from about $3,500 per practice in urban and outer-metropolitan areas (although this figure may increase substantially where there are several doctors in a practice that has a high bulk billing rate), to about $22,050 in other rural and remote areas. The majority of doctors will be better off if they take this package, and so will their patients. This is not a means test. The government is providing a fairer Medicare by moving to protect low-income and chronically ill people and ensure their ongoing access to Medicare.

Some claim that this package will disadvantage people who are not Commonwealth concession-card holders and who find their personal costs rising. This is not the case. First, people without concession cards will still have access to bulk billing. Where doctors choose not to bulk bill people without concession cards, for about $1 a week these people will be able to insure for a $1000 gap for all medical procedures. This package provides protection to people without concession cards against costs above $1000.

As the Prime Minister has said on several occasions, the cost of going to a doctor and the rate of bulk billing are in part ruled by the supply of doctors. On this basis it is entirely appropriate for this package to increase both the number of medical-school places and the number of GP training places. This package will provide incentives of $30,000 for doctors to set up a new practice in an area of need in an outer metropolitan area or $20,000 to move to an existing practice. This increase in the workforce, which is designed to also help with the distribution of doctors to appropriate areas, will have an effect on the fees GPs can charge and bulk-billing rates. The government is making a long-term commitment to improving access to doctors in rural and remote areas. It is naïve to suggest this is not a crucial element in the accessibility and affordability of services.

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Article edited by Sue Cartledge.
If you'd like to be a volunteer editor too, click here.

An edited version of this article was published in The Australian on 6 May 2003.



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About the Author

Senator the Hon Kay Patterson is Minister for Family and Community Services and Minister assisting the Prime Minister on the Staus of Women and a Senator for Victoria. She was Health and Ageing from 2001-2003.

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