Saving Medicare: universal health care is vital in a fair society

February 13, 2015

This joint statement was issued by unions and campaign organisations on February 10.


Australia’s universal health insurance scheme, Medicare, has ensured world-leading public health care is accessible for all, for over 30 years. The availability of bulk-billing has delivered a health system that is more cost-effective and equitable than in many comparable OECD countries.

General practice is at the cornerstone of a healthy society. Access to quality general practice is essential both for effective health outcomes and for reducing the flow-on costs of illness across the rest of the health system. Public health care must be valued and funded accordingly.

In 2014, The Liberal-National Government’s proposed $7 Medicare GP co-payment was roundly rejected by the Australian community. Yet the government’s ‘Plan B’ optional co-payment proposal, unveiled last December, will be more detrimental to Medicare than the original plan. Both versions share the same objective: to erode bulk-billing rates and push the costs of public health care onto individual patients.

Health industry groups, health professionals, academics and trade unions reject the notion that forcing costs onto patients will “strengthen Medicare”. The argument that Medicare bulk-billing should only be accessible to concession-card holders, children under 16 years and those in aged-care facilities is also widely opposed. If bulk-billing is reduced to a residual ‘safety-net’ rather than a universal right, the quality of health care for those unable to pay will inevitably decline. As advocates for the delivery of a robust and equitable health system, we vigorously oppose any measures that would lead to the creation of a two-tiered, Americanised health care system.

Paying for health care through the taxation system is the most equitable, efficient and cost-effective way to fund the system. Those who can afford to are required to contribute more. Those on lower incomes are not excluded from accessing quality health care.

Contrary to the Liberal-National Government’s claims, the current Medicare funding model is sustainable. It is in fact the Government’s own policy proposals which threaten the viability of Australia’s universal health system.

By introducing a policy to firstly cut and then freeze the Medicare rebate, the government’s ‘Plan B’ optional co-payment would force increasing numbers of GPs to abandon bulk-billing and charge individual patients up-front fees. This would drive up medical costs and generate deeply unfair social outcomes. Aboriginal Community Controlled Health Services will bear the costs of the co-payment and indexation freezes for clients. In doing so, they put at risk the sustainability and viability of the service delivery model which has contributed to some of the biggest gains in Closing the Gap.

Under a system of fewer GPs offering bulk-billing, people on low incomes, those with chronic medical conditions, as well as those from socially disadvantaged communities would find it increasingly difficult to access affordable, quality health care. Aboriginal people fare much worse than other Australians against all health indicators, with complex medical needs including high levels of multiple chronic illnesses and lower life expectancy. Experiencing disproportionately lower incomes than the rest of the population, Aboriginal people who do not fit the proposed exemption categories in the revised policy are increasingly unlikely to seek the health care they need.

We call on the Federal Government and the Minister for Health to immediately abandon all plans to increase co-payments and “price signals” in Australia’s health care system.

Today, Australians already pay the second-highest level of out-of-pocket health costs in the OECD. Rather than increase the financial burden borne by some of the most unwell in our society – those who are predominantly also the poorest – we ask the government to develop policies to secure the future of universal health care in Australia.

The principles of universal, well-funded public health care need to be extended and secured, not undermined.

Signed by:
NSW Nurses and Midwives’ Association
Australian Nursing and Midwifery Federation
Save Medicare Sydney
Doctors Reform Society
Community & Public Sector Union
Australian Services Union
Combined Pensioners and Superannuants Association
National Aboriginal Community Controlled Health Organisation
Welfare Rights Centre (NSW)
Health Services Union
Unions NSW
Australian Men’s Health Forum
Health Consumers NSW
Public Health Association of Australia

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