Just how universal is Australia’s healthcare? With poor access to specialist services and a deficit of GPs in rural and remote areas, Medicare is becoming a sticking point this election, with debates ranging from mental health to dental appearing in political campaigns.
Labor Leader Anthony Albanese has accused the Coalition of “want[ing] to take the universal out of universal healthcare”, citing previous remarks made by incoming health minister Anne Ruston. In 2015, Ruston said the government needed “to seek some alternatives” for making Medicare sustainable, though has since said her position has changed.
But the pandemic has exposed gaping holes in the healthcare system, with a massive shortage of GP and emergency care in rural and regional areas. With mental health, long COVID-19 and affordability still a key concern, here’s what the parties are doing about it.
How bad is it?
Australia’s healthcare system is one of the best in the world: we are the third top-performing country behind Norway and the Netherlands when assessing overall access to care, the care process, administrative efficiency, equity, and health care outcomes.
But things are slipping: in terms of affordability and timeliness, Australia has fallen to eighth place — below average — thanks to people not having a regular GP, the lack of dental care, and difficulty in getting after-hours care.
The country’s mix of public and private healthcare is also an issue, with private health insurance rebates costing Australian taxpayers nearly $7 billion per year. People have been slow to take up private healthcare and it hasn’t done much to reduce the burden on public hospitals.
And people in rural and remote areas of Australia lack access to specialist care. A higher proportion of Aboriginal and Torres Strait Islander peoples live in these regions, where mortality rates are 1.4 times higher than those living in major cities.
What needs to be done?
As COVID-19 has shown, access to equitable and high-quality healthcare is crucial to protect every Australian. Preventative care is incredibly important: across the pandemic, many people put off seeing a doctor or seeking regular treatments, burdening the system once the country opened back up and costing more money as illnesses had to be treated in later stages.
One-third of medical practitioners working in Australia received their initial qualification overseas, with tough border policies impacting the workforce. There’s set to be a deficit of 123,000 nurses and 5000 doctors by 2030.
The Rural Doctors Association of Australia has called for an inquiry into rural GP services, while the Australian Medical Association has requested a strong GP-led primary healthcare system, better investment in public hospitals, and the filling of service gaps for Aboriginal and Torres Strait Islander peoples and other at-risk groups.
What the parties are offering
Cheaper medicines: At its campaign launch, Labor vowed to slash the maximum co-payment for scripts by $12.50. The Coalition has promised to slash copayments by $10 and will raise the income thresholds for the seniors’ health cards to $90,000 to allow more people to access cheaper medications and services.
Medicare urgent care clinics: To ease emergency department pressure, Labor will invest $135 million over four years to deliver 50 medicare urgent clinics based in existing GP clinics and community health centres to deal with sprains, broken bones, abrasions and minor issues.
Rural workforce: Labor plans to change the rules to allow communities to recruit more doctors of their choosing and will restore Telehealth psychiatric consultations in regional areas after it was cut late last year.
The Coalition’s latest budget provides $224.4 million across four years to improve access to health services in rural and remote areas. The Coalition is also funding two new university departments of rural health in WA, along with $14.9 million for medical workforce scholarships.
Dental: In the latest budget, the Coalition allocated extra cash so that more concession card holders can access dental care. The Greens have pledged to provide free dental care to everyone eligible under Medicare, and Labor has no dental plans.
Aboriginal and Torres Strait Islander peoples’ health: All major parties have put forward plans to improve the overall health of First Nations peoples, with the Coalition pledging $4.6 billion over four years in the latest budget. Labor has promised to implement the Uluru Statement from the Heart in full, while the Greens have offered $371 million to Aboriginal Community Controlled Health services and $1.07 billion to build First Nations-owned healing places.
I think there would be better outcomes if that $7b for the private health care rebate was spent on Medicare. It would be an increase of 25% or more of the Medicare budget!
GPs also charge too much (unless you are lucky enough to get bulk-billed). My out-of-pcoket expense for the GP is more than some of my specialists.
And we should take away the requirement to go back to GPs to get refills for prescriptions for chronic conditions.
Agree.
The same applies to subsidies for private and/or religious schools – spend it on PUBLIC SCHOOLS!
Why are tax payers funding the child abuse of religious indoctrination?
Agree entirely with spending the $7 billion on Medicare and public hospitals rather than PHI. The GP out of pocket gap is due to the LNP freezing the Medicare rebate for years while practice costs for GPs keep on increasing. I think when Medicare was introduced, the rebate was 85% of the scheduled fee however it is now somewhere down in the 70% range and frozen. Its another sneaky, long game way of destroying Medicare by degrees and more importantly from the LNP/IPA point of view, destroying the public’s faith in Medicare.
The under funding of public hospitals is also deliberate and aimed at achieving the same thing. Under resourcing results in very long waiting times for what are supposedly elective procedures thus nudging people into private insurance in order to “jump the queue”, especially if the “elective” procedure is to relieve something chronically painful and absolutely debilitating like degeneration of the hip or knee joints. Despite their protestations to the contrary, this government do not like or want Medicare and obviously would prefer a privately funded system, as evidenced by the hugely subsidised PHI monster that Howard imposed on us.
The Liberal/Nationals are killing Medicare by a 1000+ cuts. And now they’ve started on the NDIS. If they can afford to spend $billions on submarines we won’t get, warplanes that don’t fly, and tanks we can’t use, then they can surely maintain the healthcare and disability support structures. They just don’t want to.
Yes.
Agree with Wayne. Co payment for doctors and specialists are causing me to think twice about going to doctors now. And I have private medical cover at rediculous prices that I have paid all my life. I will never get a fraction of it back even I get sick as a dog and last another 50 years. In the light of the co payments my advice to anyone thinking about private health insurance is forget it. Go 100% public.
If yunlive in regional or gawd help you cause the LNP won’t, rural Australia this is rubbish. I live just out of a small regional town 30km from a largish regional city, Dubbo c.38 000. The base hospital is the last one from here to Broken Hill where a bay can be born. If you live in the mining town of Cobar, you need to come to Dubbo, 300km away for a week before the birth, otherwise you run the risk od giving birt at the side of the road, or having to get the RFDS to come to the rescue. My local hospital is pleasant and the food is good, but there are no doctors, despite a town GP clinic with several good GPs. My wife recently had thyroid surgery in Orange and developed a possible complication. A quick look from a doctor was all that was needed. The surgeon said
Go to casualty in Narromine. Telehealth only? Oh dear go to Dubbo…..only 35 minutes away, but 7 hours, time off work for me as she could not yet drive and inconvenience to the Dubbo staff for something that would have been able to be sorted in the home town when I was younger. What crap!! We have no paediatrics short of a 6 month wait. Child psychologist, speech therapist or OT both desparatey needed at my school, no hope.
One wonders who/why people are slow , “taking up private health insurance”?
There are I’m certain thousands, like myself ,who did have Private health insurance (in my case Top cover in Hospital and extras for over 30 yrs) – only to discover that Surgeons/specialists deemed (me) them High Risk of death/severe complications in a Private Hospital setting, and refused to perform even basic surgery unless in a Public Hospital with adequate facilities (thereby negating the outrageous costs of paying Private insurance….and causing me to drop out of it).
I now require all types of surgeries but because of where we are living, cannot even see a specialist or surgeon for well over six months at a time – and/or am refused to be seen by a specialist or surgeon unless I’m in a private health fund. That situation was in place long before Covid began, but has been exacerbated by the latter.
In addition, the nearest public hospital is a 45-minute drive away and services a ridiculously large number of towns and villages.
Yet, our local MP who’s also the Regional Health Minister, David Gillespie (himself a former GP) appears to spend as much time on photo-ops (much like ScoLo) at local sporting clubs, than concerning himself with an electorate known as, “God’s waiting room” due to its large population of over-65s, and almost as large indigenous community.
It’s one of the reasons we’ve now decided to move back to Sydney after only a few short years of retirement – though friends have said that it’s not much better down there either.
The medical system in my view, requires a complete shake-up from top to bottom….and neither the LNP or Labor will do anything to alleviate the problems they’ve all caused while governing at state and federal levels.
Only the greens offer dental care as part of the national health plan. They’re also the only ones serious about affordable housing and the environment. Anyone seriously wanting real change why vote for a party you know won’t deliver…