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Medicare - where to now?

Maurie Mifsud

Health (Medicare) remains the utmost priority of the Combined Pensioners and Superannuant's Association of NSW (CPSA).

There exists a strong opinion abroad that the Federal Coalition government, led by John Howard, has set Medicare up to fail. This is based in the firm belief that the centrepiece of the government's MedicarePlus - i.e. removal of the medical fees cap and the guarantee of 80 per cent reimbursement of whatever medicos decide to charge, is totally unsustainable.

MedicarePlus is unsustainable because it will not be long before certain doctors will see that the bigger the fee they charge the bigger the 80 per cent equivalent they receive from the taxpayer. Surely one does not have to be a financial genius to realise the inflationary pressure this represents!

Indeed we have already seen the undignified rush to higher fees proposed by the Australian Medical Association less than weeks after the re-election of the current government. And all that Tony Abbott, Minister for Health and Ageing, can offer in defence of consumers are some weak willed platitudes directed at doctors and their union.

The CPSA has already expressed deep concern against the federal government's MedicarePlus proposal. It appears to be designed to replace and dismantle our extremely popular universal Medicare for the above stated reasons as well as creating strong pressures for down-trending bulk billing.

It is seen by many commentators that the downward trend in bulk billing in recent years has been caused by a decline in the value of bulk billing payments to doctors. This has created dissatisfaction amongst doctors and a reluctance to bulk bill. The decline in value of such payments has occurred because increases in the payments in line with inflation are said to have been either discontinued or minimised at some stage by the current government. The question is - 'Was this a deliberate act of sabotage?'

Bulk billing is considered to be the centrepiece of, and vital to, a truly universal health care scheme such as existed prior to the Howard government's malevolent tampering with Medicare.

CPSA is mindful of the need to maintain and improve bulk billing as the essence of a universal Medicare. This is by no means guaranteed by the government in its proposals. If anything, given statements by Abbott, bulk billing is under distinct threat under the government's MedicarePlus proposal.

CPSA perceives that the government's aim still remains the undermining and ultimate removal of the universality of Medicare and the creation of a greatly undesirable two-tier system where the most disadvantaged will be further disadvantaged. The government should restore the medical fees cap and renegotiate a fair deal with the doctors.

It is worthwhile to mention here the gaff committed by Deputy Prime Minister, John Anderson, close to the election when he said that his constituents were quite happy with a two tier system - thus he let the cat out of the bag about the government's real intentions regarding Australia's health system. This was further confirmed by the hurried way in which Anderson was gagged on this issue so close to an election. In other words, the Prime Minister and his government knew full well what they intended with MedicarePlus and just how unpopular their intentions were viewed by the voters!

It is a matter of great concern that the intent of the government is to create a two tier health system such as that operating in the United States where the biggest taxpayer generated advantages (in addition to private wealth) go to the well healed at the same time as some 40 million US citizens are left with little or no health cover.

With the re-election of the Howard government the above described attack on our health care system (together with many other humanity and socially related matters) can be expected to be redoubled to the greater detriment of all average Australians particularly those represented by CPSA.

It is a matter of some concern that the Save Medicare Alliance of NSW formed to combat the government's attacks on a universal Medicare scheme has ceased to operate. Given that similar organisations exist in other states or are proposed to recommence their activities, it is heartening to hear that tentative moves are being made to recommence the operations of the Save Medicare Alliance of NSW.


Maurie Mifsud is President of the Combined Pensioners & Superannuants Association of NSW Inc (CPSA), Level 3, 25 Cooper Street, Surry Hills NSW 2010. Phone: 02 9281 3588. Country callers: 1800 451 488. Mobile: 0418 976 961. Fax: 02 9281 9716. Email: Web:


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