Howard’s Medicare Changes – The Final Nail In The Coffin Of Bulk Billing Stephen Smith - Shadow Minister for Health and Ageing

Media Statement - 1 April 2003

Reports today that the Howard Government will introduce incentives for doctors of up to $5.30 to bulk-bill pensioners and concession card holders spell the end of Australia's universal health system.

In proposing incentives only for those on low incomes, John Howard is turning his back on the majority of Australians who pay for Medicare through the Medicare levy and through their taxes, and who will receive nothing under this proposal.

Medicare has never been means-tested. But, that's what this proposal will do. Unless you have a Pensioner Concession Card or a Health Care Card, you will be paying for your visit to the doctor with a Credit Card.

Doctors' fees will escalate for all those people who are no longer bulk billed.

Medicare is a universal health system under which everyone is entitled to health care; irrespective of their capacity to pay. But under John Howard's plan, Medicare will become a system of welfare only for those who can't afford to pay for their own health care.

Millions of Australians will miss out on bulk billing, and Australian families will have to make decisions about their kids' health on the basis of how much money they have.

Allowing doctors to bill Medicare and charge their patients

The proposal to allow doctors to charge a co-payment and also to receive a rebate directly from Medicare would be the final nail in the coffin of bulk billing.

It will see the destruction of bulk billing and the escalation of doctors' fees.

Many doctors who currently bulk-bill will immediately start to charge their patients co-payments as well.

As a result, few GP services would in the future be provided without charging out-of-pocket expenses to patients who don't have a Pensioner Concession Card or a Health Care Card.

Australian families' health will be determined, not on the basis of the health needs of their children, but on how much money they have and whether they can afford to pay for a visit to the doctor.

It won't be your Medicare card that you'll need, but your Credit Card.

Allowing private health funds to cover the GP "gap"

The proposal for private health insurance funds to insure GP ‘gap' costs will lead to an American-style two-tier system in which access to a GP is based not on health, but on wealth.

Knowing that health funds will be able to cover the gap for those people who have private health insurance, GPs will be free to charge even more for a visit.

This will lead to even greater increases in GP out-of-pocket expenses.

Under the Government's plan, those who could afford GP gap insurance will be able to visit their GP for free, as will patients with Pensioner and Health Care Cards.

But everyone else – millions of Australians in the middle – will be faced with having to pay even more for a visit to the doctor.

The reality is that despite protestations to the contrary, John Howard has never believed in Medicare or in bulk billing.

Throughout the eighties and early nineties John Howard campaigned on a policy to destroy Medicare, threatening to "pull it right apart", describing Medicare as "an unmitigated disaster", and promising to "get rid of the bulk-billing system – it's an absolute rort".

Confronted with the overwhelming popularity of Medicare bulk-billing, John Howard changed his public tune in 1996 to get himself elected.

But if these latest proposals succeed, Medicare will remain in name only. What will be left will be a two-tier health system in which your access to medical services depends on how much money you have.