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Historic $8.5b Medicare investment explained
Exactly what do the major parties’ commitments include and how will a promise to make ‘nine out of 10 visits to the GP free’ impact practices?
Prime Minister Anthony Albanese unveiling the Labor Party’s Medicare investment. (Image: AAP/Rob Burnett)
An ‘amazing’ investment for GP training, but a ‘mixed bag’ for general practices financially: that’s how RACGP President Dr Michael Wright views an election funding promise described as the ‘single largest investment’ in Medicare history.
In Launceston on Sunday, Prime Minister Anthony Albanese unveiled a long-anticipated, central plank of the Australian Labor Party re-election campaign, promising a $8.5 billion boost to Medicare funding.
The Prime Minister said investment in a new Bulk Billing Practice Incentive Program, to begin from November this year, will support thousands more general practices to bulk bill every patient, and ensure ‘no one is held back, and no one is left behind’.
If re-elected, the party’s plan will widen the tripled bulk-billing incentive introduced for concession cardholders in November 2023 to the whole population, as well as introducing a 12.5% loading payment on Medicare rebates for clinics that fully bulk bill.
‘Our plan will mean more bulk billing, in every part of our country because our Government wants nine out of 10 visits to the GP to be free,’ the Prime Minister said.
The investment will allow an additional 18 million bulk-billed visits to the GP each year, as well as support the training of 2000 more GPs each year by 2028.
Federal Health and Aged Care Minister Mark Butler says the policy could boost the bulk-billing rate to 90%.
The Government’s newly announced election promise was shortly followed by a pledge by the Coalition to match the commitment ‘dollar for dollar’.
Opposition leader Peter Dutton said he was pleased to announce the Coalition would commit $9 billion extra funding to Medicare including a previous $500 million pledge for more mental health support.
‘It will provide support to training, it will provide support to mental health services, and it will provide support to making sure that practices are viable and can provide a mix of services to patients,’ Mr Dutton said.
Dr Wright welcomed the bipartisan commitment to invest in Medicare.
However, he warned a focus on bulk-billing rates will not suit all general practice business models.
‘The additional investment into general practice is a positive thing but we’ve got to make sure that it’s targeted to the people who need it and the GPs who need that funding as well,’ he told newsGP.
According to the Labor Party, its investment means around 4800 practices will be in a better financial position if they adopt full bulk billing.
Details of the exact difference the Medicare pledge could make to rebates were included in the official announcement (see extract below).
They show a 62% increase for a standard Level B consult in metro areas at a fully bulk-billed general practice, with rebates for non-concession card holding adults rising from $42.85 to $69.56. The rebate for bulk-billed Level B consultations in remote areas will more than double to $86.91.
Meanwhile Level C consultations will increase by 30% in city areas and 59% in the most remote districts, with the lower rise a cause of concern to Dr Wright.
‘We have been asking for increased Medicare rebates, particularly targeting long consultations and mental health consultations, because we know that’s where the chronic disease and the complex care happen,’ he said.
‘We will definitely be highlighting some of the unintended impacts of this because it does increase the remuneration for shorter consultations much higher than it does for long consultations and chronic disease management.
‘Do we have enough GPs to meet the extra demand and what’s going to be the impact on health outcomes if it’s harder for people to get a longer appointment because the incentives are so strong for shorter ones?’
The RACGP President also said GPs may face more pressure to bulk bill and emphasised that an expansion of bulk-billing incentives does not oblige general practices to adopt them.
‘Just because these bulk-billing incentives are available to everyone doesn’t mean everyone’s going to have access to bulk billing, because GPs are still able to set their fees and the college will completely support that going forward,’ he said.
‘The Medicare rebate still may not cover the cost of care and that’s really important for government to make clear and for patients to know.’
However, the RACGP President gave an unequivocal welcome to the commitments to boost support for training GPs, which is one of the college’s key election requests.
The workforce and training funding pledges outlined by the Albanese Government include:
- $265.2 million to expand GP training with 200 additional training places per year from 2026, growing to 400 by 2028
- $204.8 million to fund salary incentives for junior doctors to specialise in general practice
- $43.9 million to provide paid parental leave and study leave for GP trainees
- $44 million for an additional 200 junior doctor rotations in primary health care each year from 2026, increasing to 400 annually by 2028
- $48.4 million for 100 additional Commonwealth Supported Places for medical students annually from 2026, rising to 150 by 2028, with demand-driven places for First Nations students
The announcement confirms Medicare as a key battleground for the forthcoming Federal Election, for which a date is still yet to be confirmed.
In a series of interviews on Monday, Minister Butler set out his belief that the Medicare investment will mean most clinics are better off if they fully bulk bill.
‘We know almost 5000 practices, which is the very clear majority of general practices in the country, would be better off if they bulk billed all of their patients under the funding that we announced yesterday,’ Minister Butler told the ABC.
‘We’re pretty confident this means that we can get to 90% [bulk-billing rate] across the population, not just for pensioners, and we’ll triple the number of practices that become bulk-billing practices, that means they bulk bill everyone who comes through their door.’
However, for Dr Wright the true picture of the investment’s impact is not yet clear.
‘We’ve got over 7000 practices, and we can’t afford to lose any of them due to worsening viability,’ he said.
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