Improved access to free GP visits for millions of Australians under a generational investment in Medicare in the budget has been widely welcomed.
Treasurer Jim Chalmers announced more than $5.5 billion to overhaul Medicare on Tuesday night, including a tripling of bulk-billing incentives for vulnerable patients and a suite of primary healthcare reforms to help the system better cope with a rise in chronic conditions.
The biggest change, a $3.5 billion boost for bulk-billing, will benefit about 11 million Australians, with GPs to receive more public funds to treat without out-of-pocket costs.
Doctors will receive $20.65 in additional bulk-billing incentives for treating children, pensioners and concession-card holders in cities. That will rise to almost $40 in regional areas.
It will come on top of a 4 per cent increase in Medicare rebates in 2023-24, and is intended to stem a sharp decline in bulk-billing rates that have sparked big concerns among health experts.
Health economist Stephen Duckett, a member of the taskforce that recommended Medicare reforms earlier this year, believes the budget made solid inroads to improving Medicare.
“It’s a fantastic budget for primary care,” Dr Duckett told The New Daily.
“I don’t think they could have gone any further. They exceeded my expectations of what they’d be able to achieve.”
Angela Jackson, lead economist at Impact Economics, welcomed the boost for bulk-billing and primary health care in the budget, but said questions remain about whether the current system is capable of delivering a truly free and universal health care for all Australians.
She said that the budget’s focus on bulk-billing for lower-income patients is commendable, but indicated the government thinks improving the system for everyone is unaffordable.
“We want to ensure that we’re not going down a path whereby Medicare loses its universal aspects,” Dr Jackson said.
“What last night did was shore up the existing system and made it, potentially, more fit for purpose, but there are still real questions about whether or not a fee-for-service model for primary health care can deliver that cost-effective universal health care.”
Focus on primary health care
Dr Duckett said that about $2 billion in new funding for primary health care will be key to evolving Medicare into a system that can better manage rising rates of chronic disease.
Under measures outlined in the budget, investments will be made in connecting GP clinics with other allied health professionals and community pharmacies to provide wholistic care.
That’s essential, Dr Duckett said, because under current arrangements Medicare can be quite cumbersome for patients who have more complex and ongoing medical conditions.
“In the good old days, you’d go and see the doctor just because you had an infection or something, your interactions were entirely episodic,” he said.
“Nowadays, more of us have chronic diseases, we want to have continuous care.
“We’re moving to a situation where you’ll be able to identify a preferred GP and the practice will have some funding to look after you between visits.
“If you’ve got lower back pain you can ring up your practice and they can slot you in for a visit with a physio without having to see the GP.”
The budget also began the work of creating blended funding models for GP clinics beyond the existing fee-for-service system, a new model for patient registration and extra payments for doctors that treat patients who regularly attend hospitals.
Dr Duckett said mental health remains one area future budgets will need to focus on, with about $500 million in new funding being a starting point, not a finish line.
“Mental health hasn’t been fully addressed in this budget.”
