Friday July 20, 2018

Howard Announces Changes To Medicare

November 18, 2003

The Federal Government has rebadged Medicare as MedicarePlus and committed an extra $2.4 billion to the health insurance scheme over the next 3 years. Under the changes doctors will be paid an extra $5 for each child under 16 and concession-card holder they bulk bill, a move designed to increase bulk billing rates from the current record-low of 67.4%. The Government also aims to provide 1500 new doctors and 1600 nurses to work in busy general practices within four years.

This is the text of the announcement of the Medicare changes from the Prime Minsiter, John Howard.


MedicarePlus will ensure that we protect Medicare as one of the best health systems in the world and strengthen it for future generations.

Through MedicarePlus we have acknowledged the concerns people have expressed about our health system.

Under MedicarePlus the Government has responded to these concerns by investing a total of $2.4 billion from now to 2006-07 and about $1 billion more each year thereafter. This adds some $1.5 billion to the $917 million funding commitment under A Fairer Medicare.

The three pillars of Medicare will remain:

  • Free treatment as a public patient in a public hospital;

  • Payment of a Medicare rebate at 85% of the scheduled fee for a visit to a doctor outside hospital; and

  • Affordable pharmaceuticals through the Pharmaceutical Benefits Scheme.
MedicarePlus strengthens and builds on these pillars that have protected us for over 20 years.

The Government remains committed to a high level of bulk billing as a key element of the Medicare system. Levels of bulk billing vary throughout Australia. The greatest influence on these levels is the supply and availability of doctors. No government can compel a particular level of bulk billing. But it can take measures to increase the supply of doctors and other health professionals and provide additional incentives for doctors to bulk bill.

Such approaches are reflected in the measures that I announce today. Key features of this package include:

  • an additional payment for GPs when they bulk bill a concession card holder or a child under 16;

  • more convenient Medicare claiming;

  • a new MedicarePlus Safety Net for all Australians covering the out of pocket costs of medical services provided outside hospital; and

  • more doctors and practice nurses in the areas that need them most.
The Government will provide an additional unconditional incentive for GPs to bulk bill visits by concession card holders and children.

Under MedicarePlus the Government will provide GPs with an additional $5 payment for every bulk billed visit by a child under 16 or by one of the 7 million Australians covered by a Commonwealth Concession Card. This will provide greater peace of mind to many Australians and their families about the cost of going to a doctor.

Children and concession card holders currently account for about 60 per cent of all the services that GPs provide. Eighty one per cent of those services are bulk billed or carry a co-payment of $5 or less. The new MedicarePlus payment will be made automatically to all GPs around Australia whenever they bulk bill children or concession card holders. This initiative replaces the previously announced graduated incentives for bulk billing.

As has been the case since the beginning of Medicare, doctors can choose to bulk bill any patient.

Under MedicarePlus, patients who aren't bulk billed can choose to have their Medicare claim lodged electronically at a doctor's surgery and their rebate paid to their bank account within a few days. This provides more convenience for those who do not want to line up at a Medicare office.

Since the inception of Medicare, health care has changed dramatically. GPs and specialists are diagnosing and treating more and more patients outside hospital. The range of medical services provided outside hospital, such as blood tests, x-rays, tissue biopsy and radiotherapy, is increasing.

MedicarePlus will strengthen Medicare by providing a comprehensive national Medicare safety net for all Australians. Adding to the Medicare rebate, the MedicarePlus Safety Net will cover out-of-pocket costs for medical services provided outside hospital.

The MedicarePlus Safety Net will provide a new level of protection against unexpected medical costs that may arise. The MedicarePlus Safety Net will cover 80 per cent of the out-of-pocket costs for medical services outside hospital for:

  • concession card holders and families receiving Family Tax Benefit (A) once a $500 threshold per individual or family per year is reached - covering 12 million Australians, including about 4 out of every 5 families with a child.

  • all other Australians, once a $1,000 threshold per individual or family per year is reached - covering a further 8 million people.

The MedicarePlus Safety Net builds on our previously announced safety net for concession card holders and extends it to cover all Australians.

One of the biggest health care concerns for many people is being able to find a doctor when they need to see one. This is particularly important because the biggest single driver of affordable health care is the supply of doctors.

The Senate Select Committee on Medicare recently acknowledged that "declining doctor numbers have critical implications for current and future access to primary care, both from outright shortages and the increasing pressure on prices caused by short supply and high demand".

I am proud to announce that MedicarePlus will support Australia's most extensive effort ever to attract and retain our medical workforce. MedicarePlus will ensure immediate and sustained growth in the number of doctors and nurses in the places that need them most, such as outer metropolitan areas and in regional and rural Australia.

MedicarePlus will support the equivalent of about 1,500 more doctors and 1,600 practice nurses by 2006-07 by:

  • significantly increasing the number of doctors, including overseas trained doctors and supervised junior doctors, working in rural, regional and outer metropolitan areas of workforce shortage;

  • paying a rebate for practice nurses working in general practices who provide immunisations and wound management;

  • retraining doctors who want to return to work after a break; and

  • providing payments and support to GPs who are delivering essential medical services in country areas.

We will be progressively rolling out these initiatives over the next four years. By the middle of next year there will be an additional 540 doctors and nurses and further significant increases in subsequent years to ensure that access to doctors, particularly in areas of workforce shortage, improves quickly.

This unprecedented commitment to increase our medical workforce will particularly assist people in outer metropolitan, regional and rural areas to access a doctor when they need one.

MedicarePlus will provide another very important new initiative to improve access to doctors for older Australians. MedicarePlus will fund more regular GP services and comprehensive medical assessments for residents of aged care homes. This new initiative will enhance the health care of older Australians and provide reassurance to their families.

The previously announced additional support for GPs treating veterans holding Gold or White Cards will continue, recognising veterans' special health care needs and ensuring that they are treated at no cost. I am pleased to note that there are currently 14,200 doctors who are participating in these new arrangements.

Today's announcement builds on the Government's significant investment in Australia's health system. This $2.4 billion investment in MedicarePlus demonstrates the Government's strong commitment to the health of all Australians. It is tangible proof of our commitment to protect Medicare as a universal public health insurance scheme.

Free public hospital treatment will be available for all Australians. The Pharmaceutical Benefits Scheme will continue to provide affordable medicines for all Australians. The Medicare rebate for a visit to a GP or specialist will be available for all Australians. In addition, MedicarePlus provides a major new incentive for GPs to bulk bill; more convenient rebate claiming; a national safety net protecting all Australians; more doctors and nurses in areas of need; and more services and support for older Australians in aged care.

Our intention is to introduce a ministerial determination as soon as possible to enable the new $5 payment for bulk billed concession card holders and children to commence early next year. In addition, when Parliament resumes, we intend to immediately amend the bill currently before the Senate to remove those elements of our previous package which we are not pursuing and to enable the new national MedicarePlus Safety Net to be implemented. I ask the opposition parties in the Senate to join the Government in securing the passage of the amended legislation before the parliament rises for the Christmas recess. In this way, the benefits of the new safety net will become available to all Australians as soon as possible.

MedicarePlus preserves the things we value about Medicare and builds on them. It ensures that Medicare is here to stay.



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