Medicare reform: ‘Never waste a crisis’

4 minute read

Seizing opportunities for reform whenever they appear will be key to the next 40 years.

Despite the crises gripping the now middle-aged Medicare framework, positive opportunities for reform are everywhere, according to experts speaking at the system’s 40th “birthday party” at Deakin University today.

On the politics of health reform, Professor Mark Cormack, head of the Commonwealth’s Scope of Practice Review, said it was important to seize opportunities as they came up, such as the upcoming renewal of the National Health Care Reform agreements.

“There are always new opportunities that arise to shape and direct reform through those formal institutional arrangements,” he said.

“They’ve got money associated with them, they’ve got accountabilities associated with them and that’s the best way to focus people’s attention on reform.

“Look out for the window of opportunity as it arises, and never let it pass by.

“Never waste a crisis.”

On a day dominated by the self-described “jingoistic” opening address from federal Health Minister Mark Butler and the release of the latest bulk-billing numbers, another academic emphasised that all was not sunshine and happiness for Medicare.

Presenting her findings, Deakin University’s Professor Catherine Bennett, who has been studying the public opinion of Medicare, said that while attitudes remained predominantly positive, over 50% of people thought fundamental changes were needed for it to remain functional.

Mr Butler agreed.

According to Mr Butler, “instilling confidence in patients and importantly in GPs and young medical graduates” will be pivotal to maintaining Medicare.

“The public confidence in our healthcare system has been on the slide,” he said.

“People are doing it really tough with the cost of living generally so gap fees and medicines costs and things are felt more sharply right now than I think they would in ordinary circumstances.”

Mr Butler reminded the room that universal healthcare had “never been a given” in Australia.

“It’s been fought for … in the face of sometimes savage assaults from lobby groups and vested interests.”

But, he added, “Medicare and its beating heart, bulk billing, are here to stay”.

While Medicare rose to “remarkable success” almost immediately after its establishment by Bob Hawke in 1984, a “program of calculated neglect” over the years left it in disarray, said Mr Butler.

“The reality was that by 2022, it had never been harder and never more expensive to see your GP,” Mr Butler told the room.

“Bulk billing was in sharp decline and public confidence in our public health system had fallen a full 10 percentage points the signs of distress.”

While he couldn’t “flick a switch” to fix the health systems problems, Mr Butler echoed the four-worded sentiment used by Bob Hawke in his 1983 election to birth Medicare, “Labor will strengthen Medicare”.

“That work has already begun to return our cherished Medicare to its rightful place as one of the world’s most envied public health systems,” said Mr Butler.

“The Prime Minister and others have tried to send a clear message that we have no more important agenda as a government than strengthening Medicare.”

Mr Butler hoped the government’s injections into making Medicare more accessible would do just that.

The recent tripling of bulk billing incentives for children, pensions and concession card holders, part of the $61.1 billion investment into strengthening Medicare, should mean that five million children under 16 and seven million adult concessions and pensioners will find it easier to see a bulk billing doctor, said Mr Butler.

In fact, bulk billing across the country increased by two percentage points since the measures were introduced in November.

“The Strengthening Medicare Taskforce’s recommendations are being speedily implemented,” he noted.

But according to Mr Butler, “we simply can’t strengthen Medicare for the 21st century without also strengthening that second pillar of our healthcare system, the PBS”.

The Labor government has worked to cut max co-payments, lowered safety net threshold and introduced 60-day scripts for chronic conditions, added Mr Butler.

“We’ve also initiated a review to investigate ways to more equitably distribute doctors, nurses and other allied health professionals right around the country because Medicare can’t be universal when it’s hundreds and hundreds of kilometres and many hours of travel away,” he said.

Multidisciplinary teams will be key to servicing the aging population, added Mr Butler.

Continued improvements to My Health Record and the push for MyMedicare were also central to Mr Butler’s reforms.

“We’re going to make MyMedicare the basis upon which we build a stronger and more personalised universal health care system with high quality care from multidisciplinary teams of medical experts that is tailored to the needs of each individual patient, starting first of all with priority groups,” he said.

According to Mr Butler, the push for MyMedicare is working. More than 5500 general practices and over 700,000 patients had registered for MyMedicare as of a fortnight ago, “which is designed to scale up and take on greater functionality over time”.

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