The Coalition has vowed to match Labor’s pledge to boost Medicare funding by $8.5 billion “dollar-for-dollar”, as the government moved to set up a federal election contest fought on access to health care.
Labor has promised nine out of 10 GP visits will be free from out-of-pocket expenses by the end of the decade, in what will be a cornerstone of their re-election pitch to voters struggling with the cost of living.
The policy expands the bulk billing incentive to all Australians and includes a bonus for doctors who bulk-bill all patients at a cost of $8.5 billion over four years.
Labor has repeatedly warned that Medicare would be worse off under Opposition Leader Peter Dutton, but the Coalition was quick to announce their own $9 billion funding commitment for GPs as Mr Albanese was detailing his plans at a campaign-style rally in Launceston.
“Australians deserve the quality healthcare that they have been successively denied over the last three years,” shadow health minister Anne Ruston told journalists on Sunday.
“We will not stand in the way of a mess that the Labor government have made that they’re now seeking to try and remedy.”
The Coalition’s $9 billion commitment includes matching Labor’s pledge plus $500 million previously announced for mental health support.
Mr Dutton said the money would go towards training, mental health services and “support to make sure that practices are viable and can provide a mix of services to patients”.
“And it will help build those bulk billing rates back up to what they were under a Coalition government,” he said.
The changes would come into effect in November if the Coalition wins this year’s federal election — which is due on or before May 17 — the same time frame given by Labor.
The announcement came hours after shadow treasurer Angus Taylor flagged that the Coalition would not oppose Labor’s announcement, alleging the government was responsible for falling bulk-billing rates.
Mr Taylor said that bulk-billing rates had dropped from 88 per cent when the Coalition was in government, which was during the height of the pandemic, to 77 per cent under Labor.
But Health Minister Mark Butler dismissed those statistics as “skewed and misleading” in an interview immediately afterwards, and blamed the Coalition for overseeing a freeze on increasing the Medicare rebate.
The Medicare rebate was temporarily frozen under Labor in 2013, but that was continued until 2018 under the Coalition.
“Australia’s doctors hung on for as long as they possibly could after six years of having their income frozen while their costs continued to rise,” Mr Butler said.
“But at some point, the thing broke, and we inherited a situation when we came to government of bulk billing being in free fall.”
Chalmers says investment is ‘substantial and responsible’
The shadow treasurer also questioned where the additional funding for Medicare would come from, adding that the Coalition would work through that “over the next little while”.
“But I tell you what, we’ll continue to oppose bad Labor spending proposals, as we have throughout this term of parliament,” he said, hours before the Coalition announced they would match Labor’s pledge.
Appearing on ABC’s Insiders, his counterpart Treasurer Jim Chalmers described Labor’s Medicare policy as a “substantial” and “responsible” investment that would help reduce pressure on household budgets.
“It’s hard to think of a more appropriate use of public funds than to strengthen Medicare and help with the cost of living,” he told ABC’s Insiders.
He said about $5.4 billion of the $8.5 billion announced had already been provisioned for in the mid-year budget update.
The cost to the taxpayer of the bulk-billing expansion when it begins in November — if Labor is re-elected — starts at $1.1 billion in 2025-26, rising to $2.4 billion in 2028-29. Over the first four years, the total will reach $8.5 billion.
“Let’s not lose sight here of the main objective, strengthening Medicare to help with the cost of living. More doctors and more bulk billing means less pressure on household budgets,” Mr Chalmers added.
Under Labor’s policy, Medicare payments for bulk-billed appointments will be increased depending on location, from $42.85 to $69.56 for a standard consult in a metropolitan area up to as much as $86.91 in a remote area.
Those increased payments include an extra 12.5 per cent that will only be paid to practices that exclusively bulk-bill.
They have also promised 400 nursing scholarships and 2,000 new GP trainees a year by 2028.
The government has cited one ABS estimate that around 8.8 per cent of doctor visits are delayed because of the likely up-front cost, with the number of people in their 20s not going to the doctor tripling due to cost over the past three years.
Doctors say more reform needed
The Australian Medical Association (AMA), which represents GPs around the country, said the increased funding for Medicare was welcome and would provide some short-term relief but that broader reform of the Medicare rebates system was still needed.
Under the proposed changes, AMA president Danielle McMullen said many practices, especially in cities where out-of-pocket costs often exceed $40, would still be taking a fee cut to bulk bill.
New total Medicare payment at a Bulk Billing Practice*
How total Medicare payments for common visits will increase from November 1.
“It is quite difficult to see how it will make a huge increase in some of our central, metropolitan areas,” she said.
“We expect there will be higher uptake in rural and regional Australia, but also areas of socio-economic disadvantage.”
The incentives would give doctors across the board “more flexibility” to provide some bulk-billed consultations when patients can’t afford to pay, Dr McMullen added, but “we need to recognise though that’s still the GP taking a significant cut in their usual fee to be able to support their patients to access care”.
Under Labor’s plan, the cash boost will only be available to doctors who bulk-bill and the rebate for private consultations would remain the same at $42.85 for a standard consultation.
The AMA has been calling for a broader overhaul of the Medicare item system, that would see a new seven-tier rebate structure for different types of GP consultations.
“While bulk billing incentives will now be available for all patients, it is important for the public to understand that general practices will still need to set their fees based on an assessment of the costs they face in running a modern medical practice,” Dr McMullen said.
