Despite spouting largely similar policies, federal health minister Mark Butler and shadow health spokesperson Senator Anne Ruston insist that a vote for the other party is a vote against Medicare.
The sitting health minister went head-to-head with his opposition counterpart at the National Press Club today, ahead of an election that is being cast as a “referendum on Medicare”.
The debate opened with both sides arguing that the other had a poor record on health.
Liberal Party health spokesman Senator Anne Ruston alleged that it had “never been harder or more expensive to see a doctor” than under the current government, citing the post-covid fall in bulk-billing rates, while promising that her party had a “really good story to tell on health”.
She categorically denied that there will be any cuts to Medicare or hospital funding, or that a Coalition government would move toward a US-style managed healthcare system.
“We will invest in a future-focused health system,” she said. “One that sets the right priorities, where everybody works together.
“We need coordination, not cheap political potshots, whether that be the public or the private sector, whether it be the states and the territories or the Commonwealth, whether that be doctors, nurses, or allied health … whether you live in the bush [or] in the city, these are not separate challenges.
“They are interconnected, and so too must be our solutions.”
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Incumbent health minister Mark Butler pointed out that, ahead of the 2013 federal election, Opposition leader Peter Dutton had also stood on the National Press Club stage and ruled out a funding cut to health.
Less than one year later, a Coalition government attempted to introduced GP co-payments and cut hospital funding.
“Peter Dutton does have form on health, and he has to wear that track record now at this election,” Mr Butler said.
“He expects Australians to believe that same promise that there’ll be no cuts to health.
“Well, Australians aren’t mugs.
“[They] know that Peter Dutton needs to find $600 billion to fund his nuclear power plant … Australians will only find out after the election where that axe is going to fall.”
Ms Ruston disputed that narrative, arguing that bulk-billing rates had gone up under the Coalition’s watch, and instead accused Mr Butler of avoiding questions on whether Medicare Urgent Care Clinics are operating at advertised hours.
In response, Mr Butler acknowledged that some clinics were not currently operating at the promised 8am to 10pm opening hours.
It is worth noting that both sides of politics are relatively aligned on health; both parties have committed to $8.5 billion in funding to extend the tripled bulk-billing rebate to all Australians and improve general practice training pathways.
While each has smaller promises related to health, this has been the big-ticket item.
It left little room for debate as to which had the better plan going forward.
When questioned on the detail of the policy, specifically given the GP pushback to tripled bulk-billing incentives, Mr Butler’s and Ms Ruston’s lines did diverge slightly.
“What we have wanted to do is make it very clearly in the interest of general practices to move to this bulk-billing model,” Mr Butler said.
“Not every GP [or] general practice will do it. We’ve been honest about that.
“We think that about three quarters of practices, based on what they are currently doing, would be better off if they shift to our fully bulk-billing model … but at the end of the day, I can’t force GPs to do it.
“I’m just making the argument it’s in their interest to do it.”
Senator Ruston’s answer focused more on how a Coalition government would improve the small business landscape more broadly.
“Most GP clinics are actually small businesses, and like every other small business in this country – 30,000 of them have gone to the wall in the last three years – [they are facing] the highest insolvency rates that we have ever seen,” she said.
“We need to remember that they’re paying higher energy costs.
“They’re paying higher insurance, their mortgages or their rents are higher.
“They are being impacted by the cost and the inflationary impacts of the cost of doing business in Australia, just the same way as every other small business, and we need to recognise that and work together to make sure that we’re resolving this so Australians can get access to affordable health care.”
When asked whether the axe would swing on public servants in health and aged care, Ms Ruston said that frontline services would be exempt from the Coalition’s “natural attrition” policy.
“We want to see an efficient investment in frontline services, so we’ve got the doctors trained, we’ve got the nurses, we’ve got the allied health workers, we’ve got the carers, we’ve got the aged care workers, we’ve got people working in the NDIS and disability,” she said.
“We need to make sure that we are focused on delivering services to Australians, not public servants sitting behind desks in Canberra.”
Mr Butler, meanwhile, said that large-scale cuts to the Department of Health and Aged Care public servant workforce would devastate Australia’s ability to deliver public health programs.
The 2025 Australian federal election will be held on Saturday 3 May.
