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

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.