Medicare 'an article of faith'

The Age

October 12, 2003

Strengthening the current health system is a priority, says Tony Abbott.

As the new federal Health Minister, my job is to ensure that Australians continue to receive high-quality, affordable health care. The initial challenge is tackling the medical indemnity problem but strengthening Medicare so that everyone has reasonable, affordable access to a local doctor is my greatest priority.

Despite current problems, Australia has a good health system compared to other countries. Unlike Britain , we have a vigorous private sector which takes the pressure off public hospitals. Unlike America , access to top-quality health care does not depend upon private health insurance.

After the Japanese and Swiss, Australians have the highest life expectancy in the OECD. After the Japanese, Swiss and Swedish, Australians have the longest healthy lives in the OECD. Even so, governments can never be complacent about the state of our health system because health is important to everyone.

Round the world, health budgets are under pressure. Patients invariably expect more than society can afford. People are living longer and in better health but medical advances don't come free. In Australia , health costs have increased from 8.1 to 9.3 per cent of GDP over the past 10 years despite our comparative success at keeping costs under control.

Significantly, many doctors feel that price discipline has been at their expense. Doctors work long hours in stressful circumstances for their comparatively high incomes and many do honorary work for sports clubs and professional institutions too. They resent being found negligent when operations go wrong, even though they have followed accepted medical procedures, and believe that the ever-present threat of litigation is inhibiting medical advance and forcing them into early retirement.

In the face of these pressures, the Government's key priority is to strengthen Medicare which is an article of faith for this and any future coalition government. The Australian Government's commitment to Medicare is underlined by our record.

Since 1996, spending on Medicare rebates has increased by almost $2 billion - from $6 billion to almost $8 billion a year. Australian Government expenditure on general practice (including Medicare rebates, the Practice Incentive Program and the General Practice Immunisation Incentives) has increased by nearly 30 per cent over the past six years.

The three pillars of Medicare are a universal Medicare rebate for doctors' services, a universal Pharmaceutical Benefits Scheme and universal access to free public hospital care. These must be maintained and strengthened.

In some areas people are finding it difficult to access doctors. Over the past four years, the bulk billing rate has dropped from about 73 to 67 per cent of visits to doctors. Bulk billing rates vary greatly so that access to a bulk billing doctor often depends on where people live.

As part of the $900 million "Fairer Medicare" package, the Government proposed to increase medical student numbers, add 150 places to GP training programmes, pay higher Medicare rebates to doctors who bulk bill health care cardholders, and introduce a safety net for low income families with out-of-pocket expenses from doctor visits of more than $500 a year. The Government is considering further ways to strengthen the safety net and increase affordable access to doctors, especially in outer metropolitan and country areas.

Bulk billing is important but it's not the heart of Medicare. Medicare is universal medical insurance providing high quality, affordable health care, not free trips to the doctor.

The health portfolio faces other challenges such as ensuring continued access to life-saving and life-enhancing drugs at reasonable cost to taxpayers and consumers; ensuring affordable access to aged care facilities; and minimising the squabbling between federal and state governments which is an unedifying but seemingly inevitable feature of Australia 's constitutional arrangements.

None of these issues can be resolved overnight but the Government will do its best to make a difference and will try above all else to avoid playing politics with people's health. 

Copyright 2002 Global Action on Aging
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