Socialist Party Australia - MedicarePlus Deals a Deadly Blow to Bulk-Billing

By Greg Bradshaw, Socialist Party Melbourne
Health Minister Tony Abbott proudly declared the passing of the ‘MedicarePlus’ package as a “watershed moment for Medicare", in reality it is a shift towards an US-style scheme where your wallet is checked before your pulse.

While Medicare has ever provided free universal health-care, public pressure in the past won a government-run insurance system that covered treatment in public hospitals, and 85% of ‘schedule fees’ (Medicare recommended charges) charged by GPs.

The remaining 15% (the gap) was paid for by patients, or by private health insurance. Those doctors and services that ‘bulk-bill’ the government wave the 15%, accepting the 85% fee as payment in full. For those individuals or families whose gap charges exceeded more than $319.70 in a year, Medicare had a safety net that covered all additional gap costs. The problem was, and is, that schedule fees and the actual fees charged are far removed. Nationally, the number of GPs’ bulk-billing has fallen from 80.6% to 65.7% since 1996, mainly because the Government’s bulk-billing schedule fee paid to doctors is frozen at around $25. This fee is just over half the Government’s own Relative Work Study estimate that a 15-minute GP consultation is worth $48.50!

Those doctors who have continued to bulk bill have done so only out of sympathy for their patients. But doctors are being economically forced to abandon this practice. MedicarePlus will raise the schedule fee by a mere of $5 for GPs in major cities, and $7.50 for rural doctors, not coming close to what is required. And even these will only be granted to children under 16 or Health Concession cardholders; that is, those earning less $340 p/w, or less than 25% the minimum wage.

The Financial Review admitted: “MedicarePlus ends the fantasy of unlimited, free universal health care”. MedicarePlus boasts a minimalistic “safety net” that reimburses 80% of these out of pocket expenses for families and individuals after they reach $300 in a year, or $700 for middle-class and high-income earners. However, by the Government’s own figures, this safety net will only aid less than 5% of the population – mostly the elderly and those chronically ill. They will be left with 20% of the bill, which - for these people most in need - will still be huge.

Pressure put on hospitals
As a result, people are avoiding or delaying visits to the doctor, or are turning to overstretched emergency departments in public hospitals. This so called safety net will only exacerbate these trends, by encouraging doctors to give up bulk-billing with the misconception that their patients will be partially protected from massive medical bills. Health economists have predicted that bulk-billing rates will drop below 40%.

On the same day that the MedicarePlus deal was signed, the Howard Government cut its funding to public hospitals by $400 million. This robbing of public hospitals is on top of the $3.7 billion a year that the Howard government already diverts from the public health system to subsidise private health insurance premiums by 30%. Taking advantage of this handout, the private health funds have raised their premiums by around 20% over the past 3 years. Earlier this year, the Government approved fee increases averaging 7.5 percent.

MedicarePlus ends the lie that working people can see a doctor without charge when they need to. Trade unions and community groups must come together to form a new mass workers’ party that represents the interests of all people: free, high quality, health care and education available for all. Only such a party can continue the fight for these basic rights, and defend them against the attacks of privatisation.