Anthony Albanese was a big fan of holding up a Medicare card during the federal election campaign. But are governments willing to work together to get the system back on track? Photo: Instagram/Anthony Albanese.
The advent of Medicare in 1984 was supposed to enable free healthcare for every Australian and make it easier to have a healthier, longer life.
But today’s reality is that many Canberrans struggle to find an appointment with a GP who will bulk bill, a problem shared across the country. While many practices will bulk bill patients under 16 or over 65 years, there are almost no GP clinics in Canberra which will bulk bill everyone.
That means too many of us put off routine appointments – vaccinations, annual health checks, cancer screening, getting small problems checked out before they become big problems.
Nobody wants to be in hospital, but that’s where we end up when it’s just too expensive to see our regular doctor.
And it has big impacts on the ACT Budget, as we’ve now seen.
The pressure on our health system is only going to get worse without action. As we live longer and with more long-term conditions to be managed, primary care becomes more complex.
It’s not something a GP can adequately provide in a 15-minute appointment. GPs report that they’re spending an average of eight hours a week in extra work to coordinate care.
GPs don’t just want to be a referral agency for specialists. They want to help their patients achieve their long-term wellbeing goals. They want to use their skills in management of mental health, women’s health, diabetes, heart conditions, arthritis and other special interests.
Medicare Benefits Schedule (MBS) fees no longer cover the real cost of providing quality primary care, especially for people with complex or long-term health conditions. Increasing the MBS fee is a quick fix – no cost to the person needing health care and the clinic remains viable.
But it doesn’t change an outdated funding model that incentivises frequent short visits and doesn’t adequately fund multidisciplinary team care.
Paying each Medicare-subsidised health worker an individual fee per visit does not incentivise shared care with a long-term plan, especially when MBS fees for many allied health services (like physio or counselling) are very limited and only available after a chronic condition diagnosis.
Topping up funding for hospitals also gives only temporary relief and doesn’t resolve the pressures on the system. Hospitals and walk-in clinics are great for urgent care, but they can’t replace the long-term wellbeing planning that the primary care system should provide.
The people who most need a robust public health system should never have been expected to pay a one-size-fits-all tax to fix the shortcomings created by the Federal Government and rubber-stamped through health ministers.
There are other ways for the ACT Government to raise revenue that don’t disproportionately tax those on the lowest incomes in our community.
Reform requires health ministers and treasurers from all State and Federal governments to work collaboratively. If they can’t find a way to work together when almost all of them are from the same party, then what is the point of voting for anyone in the Labor political party?
Fee-for-service models like Medicare have been replaced by blended funding models in most countries, including Denmark, France, New Zealand and Singapore.
By providing a mix of funding that enables the time for a GP to manage care with their patient and for shared care across a multidisciplinary team, those countries are seeing people live healthier, longer lives as well as a more sustainable health budget.
After more than 40 years, Medicare is ready for some mid-life changes to get back on track as the core of our universal public health system.
The question is: is Labor capable of delivering if it means playing well with others?
