Medicare doublespeak: Howard and Abbott call themselves Friends of Medicare : Melbourne Indymedia

It's extraordinary how little understanding John Howard and his Health Minister Tony Abbott have about the health care delivery system in this country. To claim that the government's latest attempts to woo over undecided voters, makes them 'friends' of Medicare is both wrong and misleading. High bulk billing rates have at first glance, two diametrically opposed outcomes. More people utilize the system for a lower overall national cost.

High bulk billing rates increase competitive forces between doctors. The higher the bulk billing rates the lower the cost to access non-bulk billing doctors. Those doctors who don't bulk bill will soon find themselves out of business if the fees they set are too high because patients can readily access a bulk billing doctor. People tend to utilize bulk billing doctors because they do not face out of pocket expenses. Consequently although the number of private doctors visits increase, the total cost to the community in terms of the percentage of G.D.P. utilized for health care, decreases.

The Coalition's decision to increase the rebate for all patients who visit General Practitioners from 85% to 100%, irrespective of whether their doctors bulk bill or not will not, necessarily increase bulk billing rates. The profession will soon absorb the 15% increase in General Practitioner's fees. The 15% across the board increase will maintain, not remove the two-tier system created by their Medicare Plus Package. Doctors who bulk bill will still continue to receive different remuneration for providing the same service to different groups of people. Those patients who can afford up front fees will continue to receive the best health services money can buy, while the rest will have to make do with a second rate system.

The 15% increase, coupled with a 'safety net' that commits Medicare to picking up 80% of any fee a doctor chooses to charge if a patient has reached the safety net, is a recipe for an explosion in individual health care costs as well as the percentage of G.D.P. that is used to meet the nation's health care costs. Labor's package ties the increased rebate to the number of patients a doctor bulk bills. Doctors who bulk bill more than 80% of their patients will receive the increased rebate as well as a yearly cash grant. Those doctors who decide not to take up the package will find it more difficult to raise their fees and the abolition of the safety net will result in a significant reduction in the up front fees charged by many doctors. The resultant increase in bulk billing rates will remove the necessity of a safety net, as fewer patients will have to worry about up front fees when they see a private doctor.

Although Labor's reforms do not resolve many of the problems people have in accessing the health care delivery system, they will significantly decrease patients out of pocket health expenses and they will stop the current rise in the percentage of G.D.P. that is allocated to provide health care services in Australia.