Medicare Plus - a positive 'second best' option
AMA President, Dr Bill Glasson, said today there are many positives in the Government's Medicare Plus package but questioned whether the big increase in funding could have been better directed at an across the board increase in the Medicare patient rebate.
Dr Glasson said the AMA has for years - especially since the release of the Relative Value Study (RVS) - campaigned for a significant increase in the Medicare patient rebate.
"An across the board increase in the rebate would have been our preference to strengthen Medicare," Dr Glasson said.
"By strengthening Medicare with a higher patient rebate across the board for all patients, fewer people would be in need of the safety net initiatives.
"In the absence of a higher Medicare patient rebate, we have to judge the package as a 'second best' option - but there are very significant positives in Medicare Plus.
"While the safety net improvements are a move in the right direction, a combined MBS/PBS safety net would provide better overall protection for the disadvantaged.
"We welcome the removal of the compulsory bulk billing of concession card holders that was a key feature of the original Fairer Medicare package. This means that bulk billing remains as it should be - an arrangement between the Government and the patient.
"The proposal to increase the patient rebate by $5 for bulk billing concession card holders and children under 16 will be attractive to GPs who choose to bulk bill these patients. However, it is doubtful it will slow the inevitable and continuing decline in the rate of bulk billing overall.
"The practice nurse grants to all urban areas of workforce shortage are welcome, and should be extended to all practices to help lessen the impact of doctor shortages.
"The streamlining of processes for registration of overseas trained doctors is a good decision. Reducing the bureaucratic red tape that was preventing or delaying doctors who met the necessary standards from practicing in Australia is long overdue.
"As we have said before, the HIC Online initiatives - when they eventually become available - will benefit both doctors and patients.
"While the AMA still has serious concerns about the cost and timing of the implementation of these initiatives across the country, we see time savings for patients, less red tape for doctors, and savings for taxpayers through more efficient systems.
"Allowing the rebate to go directly into the patient's account is a more effective use of resources.
"The AMA is encouraged by measures for non-Vocationally Registered (non-VR) GPs.
"But the restriction of this measure to non-VRs who choose to practice in areas of need fails to recognise that this section of the GP workforce is disadvantaged and disappearing and their patients are also disadvantaged.
"Patients of non-VR GPs who do not choose to relocate will continue to experience the discrimination of lower Medicare rebates.
"Non-VR GPs will continue to be lost from the medical workforce.
"We are disappointed that the unfunded bonding of medical students remains a feature of the Government's package
"Overseas evidence supports the AMA's long held view that conscripting doctors does not work.
"Schemes that contain incentives such as scholarships or loans to new medical graduates are proven to be more effective at attracting and retaining doctors in areas of need.
"We welcome the new Medicare item for aged care.
"There is very little in this package for specialists and their patients, and I will be taking that up with the Minister.
"Medicare Plus is a collection of initiatives addressing medical workforce, safety net and electronic billing issues that would have been eminently more satisfying with an important central plank - a higher across-the-board Medicare patient rebate.
"Nevertheless, the AMA welcomes the Government's renewed commitment to health policy and we will continue to advise on how Medicare can be further improved.
"We will take the Medicare Plus package to our members and our patients for the final verdict when tested against the access and affordability benchmarks," Dr Glasson said.
CONTACT: John Flannery (02) 6270 5477 / (0419) 494 761
Judith Tokley (02) 6270 5471 / (0408) 824 306