The RACGP’s big-ticket item this pre-budget season would cost a cool $64 million over four years, and its success is already in question.
The RACGP has revealed that one of its big asks ahead of the May budget will be an independent pricing authority for Medicare, to ensure indexing keeps pace with inflation forevermore. The Health Minister has already softly knocked it back.
This is not the first time that such a mechanism has been proposed.
Establishing an independent body to advise on pricing and payment levels was a recommendation in the scope of practice report, while establishing an independent primary care pricing authority to provide advice on design and pricing of Commonwealth general practice payments appeared in the review of general practice incentives.
The iteration outlined in the RACGP pre-budget submission, which has been sighted by The Medical Republic, would provide independent, evidence-based advice to “appropriately set and index general practice funding”.
“The problem that we’ve seen for decades now is that Medicare rebates haven’t been set according to need or evidence, they’ve been set according to the political cycle,” RACGP president Dr Michael Wright told TMR.
“That’s meant that rebates haven’t kept pace with rising inflation, let alone the costs of increasing care.
“Really, what this is trying to do is move beyond that politicisation of patient rebates, because that doesn’t help patients and certainly doesn’t help practices to plan for the future.”
An independent pricing body for Medicare is somewhat of a gamble for governments; if it were to recommend lowering rebates, the government saves money. But in the more likely event that it recommends higher rebates, the Commonwealth would be met with little recourse but to raise rebates and spend more money.
The RACGP is pitching the idea as a way to future-proof the current administration’s investments into healthcare.
“This government’s made the commitment to increasing Medicare funding, but we don’t know what the next government might do,” Dr Wright said.
“Even just having a commitment to increase [Medicare rebates] with CPI would be a step to giving GPs more certainty and getting some trust back in the system, which I think is a problem for many GPs.
“We’ve seen rebates frozen by both sides of parliament at different times. Moving this to an independent authority will give GPs and practices some certainty about the future.”
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It appears the college will face an uphill battle, though. When asked this morning whether the government would “butt out” of Medicare funding, though, federal health minister Mark Butler answered in the negative.
“There’s no more important social program for Australia and certainly not for the Labor Party than Medicare,” he told Nine News.
“I can’t see a situation in the foreseeable future where a Labor government would butt out of health policy because it’s one of the most important things for our population.
“We have been working so hard over the last four years to strengthen Medicare, to turn around bulk billing, to make medicines cheaper, to get more doctors into the system.
“… I sort of get where the doctors are coming from here, but a Labor government sees this as utterly core to our job as a federal government.”
By the RACGP’s calculations, introducing an independent primary care pricing authority would cost between $54 and $62 million over four years, along with an extra $10 million in non-recurrent contingency and establishment funding.
The college’s proposal is that initial operations focus on evidence-based pricing recommendations for general practice, with a view to expanding its remit to cover pricing across other aspects of primary care in the future.
