Time to tinker over; now for the tough work on Medicare

Health Minister Mark Butler. Picture: NCA NewsWire / David Mariuz

How good would it be if you could claim the $40 gap you have to pay every time you see your GP for a standard appointment on your health fund? What about that $8000 you had to fork out in out-of-pocket costs just to be able to use your insurance to have your baby delivered by an obstetrician in a private hospital?

This would surely be welcome to anyone paying up to $5000 a year for private health insurance and yet never makes a claim.

While there are strong arguments for insurers to be able to play a greater role in funding primary healthcare to keep their members well, and thus out of hospital, private health funds covering gap fees and diagnostic services is not the solution to the crisis facing Medicare.

The reason for that is simple: it risks disadvantaging the most vulnerable. Who covers the gap fees for those without health insurance, some of the poorest in our society? In an ideal world, these people would be bulk-billed; in reality, this is not happening and is not a guarantee.

Labor is moving in the right direction on Medicare, and the stars are aligning for federal Health Minister Mark Butler, who has played clever politics.

Labor made saving Medicare a central plank of its election platform, and immediately moved in office to convene a taskforce. The policy groundwork has already been laid with a 10-year primary health plan agreed and containing the kernels of the ideas that over the next six months will mature into a policy that looks set to transform the primary health system’s interface for everyday Australians.

Mr Butler is blessed to have a sector behind him that broadly agrees with the actions he wishes to take to modernise Medicare.

A new blended funding model will finally bring Australia into line with international best practice in primary care medicine: team-based care that draws on the speciality and expertise of a wide array of practitioners who can efficiently delivery urgent care as well as prevent escalation of chronic conditions.

Anyone who has visited their GP to have a vaccination and been baffled as to why the doctor pops their head in the door seemingly to just say hello should understand why this system was broken. That cursory visit by the GP, who has more important things to do, was a necessary action for the nurse managing the vaccination to get paid.

The critical thing over the next six months is that Mr Butler crafts a truly transformative policy. The time for tinkering around the edges is over. The tough work will be in resisting pressure from doctors to retain complete control of the purse strings while cementing the GP’s place at the apex of primary care. It won’t be easy but the signs are all good.