Government Medicare ads Misleading

June7, 2004

The Socialist Alliance senate candidate, Tom Bertuleit, said today that the current media campaign promoting the new MedicarePlus package is not only blatant government propaganda at taxpayer expense, it is also misleading. "It suggests that the package strengthens Medicare," he said, "whereas in fact it is destroying Medicare."

Bertuleit said that the original Medicare was a universal health insurance system which ensured that everybody in Australia had access to the same level of health care, regardless of the ability to pay. The destruction of Medicare by the Howard government means that now the costs of health care will be so prohibitive for some people that a safety net is required. In an effective and equitable health system such as the one we had before Medicare was destroyed, according to Bertuleit, a safety net is not needed.

One of the problems of this safety-net system is that it relies on the individual to keep records of their costs. They are expected to request a receipt from the provider every time there is an out-of-pocket expense, and to keep these receipts to present to a Medicare office. Bertuleit pointed out that many people who would most benefit from the "safety net" are people, such as those with mental health problems, who have disorganized lives and are unlikely to keep the required documentation.

Another problem with the safety net, he said, is that it is likely to lead to a further erosion in bulk-billing, particularly by specialists, as there will be an understanding that the government will help with the costs of gap payments once a threshold is reached.

The MedicarePlus package includes of an incentive of an extra $5, or $7.50 in some areas, payable to GPs who bulk-bill concession-card-holders and children. The initial evidence is that this has resulted in a slight increase in the rate of bulk-billing, but Bertuleit claims that it is unlikely that this will be sustained. Doctors who have already stopped bulk-billing usually charge a gap of more than $5, so they would lose income if they recommenced bulk-billing even with the $5 incentive. The long-term effect of this initiative may be a slowing down the rate of the decline of bulk-billing, but it is very unlikely to halt or reverse the decline.

Bertuleit?s main objection to the introduction of "incentive" payments for certain population groups and certain geographical areas is that it not only makes Medicare more complex to administer, it also weakens the universality of Medicare.

Another aspect of the new package which Bertuleit discussed was the new item for allied health services and dental health care for people with chronic conditions. He said that the recognition that certain allied health services and dental services are important aspects of comprehensive primary health care, which should be reimbursable under Medicare, is worthy of support. However, he pointed out that this component of the MedicarePlus has significant limitations, particularly related to the fact that the rebate must be paid to the GP rather than the allied health provider. How this will be organized remains unclear. The original announcement implied that GPs will be expected to act as brokers, having to negotiate a fee with the allied health provider, collect the Medicare fee and then pass this on to the allied health provider. GP groups are understandably unhappy about this requirement. It is unlikely that this component of MedicarePlus will be taken up in significant numbers, according to Bertuleit, except perhaps by GPs who work for health-care corporations which can negotiate arrangements with allied health providers.

The other components of the package such as new medical school places and networked electronic medical records are health care innovations which the government was obviously planning to introduce, and which it decided could be included as part of the overall package. None of these components, Bertuleit points out, are directly related to Medicare.

In summarizing, Bertuleit says that the Australian people should not be hoodwinked by taxpayer-funded government advertising - the Howard government is making health care less accessible and more expensive.