Medicare was born in 1984, a health system built by Labor and designed to give every Australian access to affordable health care. Throughout the 1980s, as Medicare gained strength and became the foundation for an equitable health system, John Howard was Medicare's greatest enemy. Again and again, he declared his opposition to Medicare. When he was leader of the opposition in the 1980s, he said that Medicare was a "miserable, cruel fraud", a "scandal", a "total and complete failure", a "quagmire", a "total disaster", a "financial monster" and a "human nightmare".
He subsequently threatened to "pull Medicare right apart" and to "get rid of the bulk-billing system". And he said bulk billing was an "absolute rort". John Howard's 1987 election commitment stated: "Bulk billing will not be permitted for anyone except the pensioners and the disadvantaged. Doctors will be free to charge whatever fees they choose.'
But John Howard could never win an election while threatening to dismantle Medicare and kill off bulk billing. So something happened between 1987 and 1995. In 1995, John Howard told Australians: "We absolutely guarantee the retention of Medicare. We guarantee the retention of bulk billing." Well, it's no longer 1984, or 1995, but 2003. John Howard is now the prime minister. And now that the government has ordered the words "bulk billing" to be deleted from the government's vocabulary, John Howard's absolute guarantee to retain bulk billing is worth nothing.
"Labor will stand and defend Medicare and bulk billing."
The Liberal Party's policies are full of glaring contradictions that the Australian people are expected to accept and believe. When the prime minister was elected in 1996, his slogan was 'For all of us'. We now know the truth is that, under John Howard, Medicare is for just some of us. The government's so-called 'Fairer Medicare' package is John Howard's plan to achieve his lifelong goal of destroying Medicare. The Howard government even needed to pay a consultant $39,000 to come up with the Orwellian title!
The proposed Medicare changes, Howard tells us, are to protect bulk billing, and make health care more accessible. It is clear, however, that the changes do nothing to halt the collapse in bulk billing, which sees Australian families struggle to access basic health care The Howard government's policies will restrict bulk billing to only those Australians with health care cards, and give doctors the green light to charge whatever they like for everyone else. Any family earning more than $32,300 will no longer be eligible for bulk billing. Doctors groups have told us, over and over again, that their fees will increase, and bulk billing will all but disappear.
The prime minister might think that Australian families are not intelligent enough to notice that they are paying more and more for health care. Rates of bulk billing have fallen by more than 12 percentage points under Howard's government. They were once more than 80 per cent, but in March this year they sank to a new low of 68.5 per cent. In many areas of Australia, it's much worse. In the electorate of Newcastle, the rates have fallen to 62.9 per cent. In Kingston in South Australia, the rates have fallen to 58.1 per cent. In Ballarat in Victoria, the rates have fallen to 43.8 per cent. And while bulk-billing falls, the average co-payment charged for a visit to non-bulk billing GP is on the increase. Since Howard came to government, this has risen more than 55 per cent, to an average $13.05 a visit.
Wherever you look, Australian families are facing increased health care costs under the Howard government - whether it's difficulty in finding a bulk billing doctor, higher co-payments for doctors who don't bulk bill, increased private health insurance premiums, higher "gap" charges when people need to use their insurance, and the threat of a 30 per cent increase in the cost of essential medicines.
Labor is proud to say that we will stand and defend Medicare and bulk billing. That's why we have announced that Labor will save Medicare with a $1.9 billion package to reverse the collapse in bulk billing by lifting the patient rebate for bulk billing for all Australians, no matter where they live, or how much they earn. Labor will begin by immediately lifting the Medicare patient rebate for all bulk billed consultations to 95 per cent of the scheduled fee - an average increase of $3.35 per consultation.
Subsequently, we will lift the rebate to 100 percent of the scheduled fee - an average increase of $5.00 per consultation. At the same time, we will offer doctors powerful financial incentives to meet bulk billing targets, incentives which are realistic and achievable - with a particular focus on rural, regional and outer metropolitan areas, where the collapse in bulk billing is hurting Australian families most.
Doctors in metropolitan areas will receive an additional $7,500 each year for bulk billing 80 percent or more of their patients. Doctors in outer metropolitan areas and major regional centres will receive an additional $15,000 each year for bulk billing 75 percent or more of their patients. Doctors in rural and regional areas will receive an additional $22,500 each year for bulk billing 70 percent or more of their patients. We will also provide for more GPs in the areas that need them and more nurses to assist GPs in their work.
Australian families won't be fooled by this government's pretend commitment to Medicare. Australians know that Medicare is the best health care system in the world. They know only Labor has a plan to save Medicare - and that's what we will do.
Julia Gillard is the Australian Labor Party's Shadow Minister for Health.