MedicarePlus
Protecting Medicare?
The federal government has been trying to edge us closer to private health care for many years. It continues to subsidise private health in the form of the Private Health Insurance Rebate. Kay Patterson’s health package ‘A Fairer Medicare’ planned to allow people to take out insurance to cover the gap between doctors’ fees and the Medicare rebate. Private health care costs governments substantially less than public health care. It looks better on the bottom line. So why is ‘cuddly Abbott’ (as Labor Health spokesperson, Julia Guillard, called him) now spending $2.4 billion on public health?
One answer is that it’s election countdown time. Australians expect free or highly subsidised health care.
When Howard said in 1987 that Medicare was ‘one of the great disasters of the Hawke government’ he could not have known how much the concept of free and universal health care would become part of the Australian psyche. How it would be one of the biggest obstacles the bulldozer of Liberal Party economic reform would have to face. So much so that in 2004, Howard would need to be seen to embrace Medicare. Announcing ‘MedicarePlus’ he vowed to protect ‘one of the best health systems in the world’.
But the Medicare that Howard claims to protect is a system in decline. In 1987 the amount a doctor received for bulk billing was adequate as full payment. Now with a payment of $25.70, bulk billing is almost untenable.
‘MedicarePlus’ offers a complex series of reforms including a $5 incentive to bulk bill children, pensioners and concession card holders; a safety net to protect people from rising costs and money to recruit more doctors and nurses. At a cost of $2.4 billion it is certainly more generous than Kay Patterson’s $900 million ‘A Fairer Medicare’.
No doubt the additional expenditure helps. More patients will benefit. Out-of-pocket expenses will be reduced. Doctors will be better off and will be able, for a while, to continue to bulk bill targeted patients. But ‘MedicarePlus’ is still a two-tier system. The rich will be able to afford to go to doctors who charge more; the poor will not. And Medicare will exist as a safety net rather than a universal system of health care. Those who must rely on the safety net will be the least empowered in our society. What will happen when the value of subsidies like the extra $5 for bulk billing