Goverment's Medicare package:
rotten to the core

by Anna Pha

The Howard Government's latest Medicare package is a death 
sentence for Medicare. Presented as helping the chronically ill 
and a means to increase bulk-billing, it does neither. It is yet 
another lie, another dishonest drive towards the destruction of 
Medicare and the privatisation of health care in Australia. The 
package is aimed at winning the Democrats over, and if possible 
the Labor Party. Urgent action is required to make sure it is not 
supported by the ALP, Democrats or Independents in the 
Senate.

Even the names given to the proposal, first "Fairer Medicare" and 
now "Medicare Plus" are misleading. It would be more accurate to 
call it the "Medicare Minus" or the "Medicare Destruction" 
package.

Under a genuine Medicare, with universal access and full bulk-
billing, no one needs to hand over a single cent, whereas under 
the Government's plan, people holding concession cards and those 
on family tax benefits will be refunded just 80 percent of 
medical expenses over and above a total of $500 a year. Everyone 
else, including singles, will get the 80 percent after having to 
pay $1000 during the year.

"John Howard's plan to reimburse patients for 80% of out-of-
pockets costs is an unsustainable licence for doctors to print 
money", said Dr Tim Woodruff, President of the Doctors' Reform 
Society.

"GPs are already charging ever increasing copayments averaging 
$13.64 but sometimes up to $100", said Dr Woodruff. "Specialists 
and Xrays can cost $100-$200 a visit. When they know that 80% of 
that copayment is covered by the Government, prices will rocket, 
and the Government's Medicare will become unsustainable and will 
be abandoned."

The Government is setting it up to fail, so that it has the 
excuse to make further cuts at a later date.

The main question, however, is not how much people pay, but the 
fact that they will pay. There is a fundamental principle at 
stake. A principle which goes to the essence of Medicare: 
universal access to bulk-billing and the public health system at 
no out-of-pocket cost.

Abbott claims bulk-billing is "not the essence of Medicare". He 
is wrong. He does not believe in Medicare. He only retains the 
name to hide the Government's real intentions which are to 
destroy Medicare.

Bulk-billing was meant for everyone. Bulk-billing should be for 
everyone. That is what the overwhelming majority of Australians 
want.

The genuine Medicare is not based on a user-pays philosophy. Once 
it becomes user-pays it is no longer Medicare. The abandonment of 
that principle lays the way open to further erosion of the 
system, including the dismantling of its universality.

Once certain groups are denied access to bulk-billing on the 
basis of some economic or social criteria, then it becomes a two-
class system on a slippery path towards the US for-profit system 
where millions of people have no health care cover.

As for the $500 or $1000 "safety net", that is only the thin edge 
of the wedge which will be used to get the user-pays system 
through the Senate while trying to avoid too much flack from the 
public.

The user-pays principle can now be seen at work in our public 
universities. When university fees were introduced less than 20 
years ago the fee was $256 per annum. Now, if the Howard 
Government gets its higher education legislation through 
Parliament, students could be facing bills and debts of $100,000.

Likewise with the Pharmaceutical Benefits Scheme (PBS): when 
there was a big hike in prices for prescription medicines, a 
safety net was introduced which meant nobody was out of pocket by 
more than a few dollars a week. Once the safety net was reached, 
scripts were at no cost for the remainder of the year. Now, the 
safety net for a single person is over $600 after which there is 
a payment of $3.70 or more per script.

Medicare, like the PBS, is funded centrally through the taxation 
system. Patients are treated according to need without having to 
make any further payment.

The Government is bit by bit eroding access and hitting patients 
with upfront payments. It has not only discouraged doctors from 
bulk-billing but made it virtually impossible for many of them to 
do so by refusing to increase the rebate doctors receive for 
seeing patients. The latest package gives doctors an extra $5 
when they bulk-bill concession card holders and children under 
16. This would change little.

Pathology and X-ray departments have also introduced fees for 
many patients who were previously bulk-billed. In addition, many 
optometrists have also stopped bulk-billing.

As a result bulk-billing has fallen even further, to 67.4 per 
cent.

The media is also pushing the Government's destructive package as 
benefiting people and retaining Medicare. For example, the Sydney 
Morning Herald ran with the headline, "Trip to doctor cheaper for 
millions". This is not true.

Act now

It is imperative that the public, who value their universal 
health care system, let the Democrats, Independents, the ALP and 
Government know that this latest attempt to destroy Medicare is 
not acceptable. And get behind the Greens who have opposed the 
Government's moves.

Write, fax, phone or e-mail your local Member, the Health 
Minister Tony Abbott at Parliament House, your Senators and 
contact the Save Medicare committees in your State to give your 
support.

The Democrats and independents, in particular, must be convinced 
that the package is rotten to the core.