The new health minister, Tony Abbott, unveiled the package in November. It replaces the ‘Fairer Medicare’ package announced earlier this year, which has been shelved after failing to find Senate support. The Government had hoped legislation enabling its new centrepiece, a safety net scheme for low-income families, would be passed in the last sitting of the Senate for 2003.
But the Senate remains divided over the package’s controversial safety net scheme, and has refused to pass it without further analysis and public consultation. Labor and the Greens oppose the proposed safety net legislation, the Australian Democrats have argued for amendments including a lower, more universal threshold, and key independent senators said they were focused on other areas of legislation, and were not prepared to consider deals on Medicare before Christmas.
The government’s proposals would create a safety net for healthcare concession card holders and low and average income families, so that once they had spent $500 per year on out-of-pocket expenses for non-hospital Medicare services, such as gap fees for doctors’ visits, the family would be eligible for reimbursement of 80 cents in the dollar for further expenses. The safety net scheme replaces a controversial proposal to allow private health insurance for out-of-hospital medical expenses.
The safety net would apply to all out of hospital services covered by the Medicare Benefits Schedule, including GP consultations, specialist services, pathology, X-rays, CT scans and radiotherapy. This is a new protection in addition to the existing PBS safety net.
But the proposal has drawn criticism from some quarters for being linked to the Family Tax Benefit, meaning that many individuals and families without dependent children would have to pay up to $1000 a year on medical expenses before they would be eligible for reimbursement.
Many people with HIV/AIDS who do not hold concession healthcare cards would be among those to miss out on the lower safety net. The HIV Futures III survey of Australians living with HIV/AIDS identified a significant proportion of people with HIV on low incomes, due, for example, to the inability to work full-time and uncertainty about their health.
The Medicare safety net in the proposed legislation is separate from an existing safety net scheme for the cost of co-payments for prescription medicine. Medicines would not count toward the new safety net threshold.
Other aspects of the MedicarePlus package have drawn more support from the opposition and some minority parties and independents. These include a $5 incentive payment each time a doctor bulk-bills a concession patient or child under 16, and a package of measures to improve access to doctors in rural areas. 457 places for GP practice nurses announced in the Fairer Medicare package would now also be made available to urban GPs in areas of workforce shortage.
The National Association of People Living with HIV/AIDS was among many organisations which welcomed the emphasis on workforce development. But NAPWA president David Menadue said that the restriction of the safety net to families would represent an unacceptable burden for many people living with HIV and AIDS on lower incomes.
“People on low incomes who remain in the workforce despite chronic illness look to be the real losers from this package,” Menadue said. “Working people with HIV/AIDS typically spend $150 or more per month on prescription medicines and many do not have access to a doctor who bulk bills.”
Menadue said the MedicarePlus package would do little for these people.
There are doubts, too, about whether the government plan will do anything to stop the decline in bulk billing, now at an all-time low of 67 percent. The Health Policy Officer of the Australian Consumers’ Association has warned that bulk-billing “will go into free-fall” if the government gets its way, but Mr Abbott argues that it is unreasonable for well-off people to demand free doctor visits.
The Senate Select Committee on Medicare will take submissions on the new package before and after Christmas. It will report back when parliament resumes in February.
|_. MedicarePlus| |* Extra $5 payment for doctors who bulk bill concession card holders and under-16s
- $500 ‘safety net’ for most families and concession card holders, $1000 for singles
- Medicare rebate claims submitted electronically by doctors for privately billed patients
- More training places for doctors and nurses
- Improved medical care for aged care home residents
Source: Dept Health & Ageing|
