Taskforce prepares to tackle Medicare failings

Jolyon Attwooll

28/07/2022 4:52:50 PM

Members of a new taskforce are preparing to gather to address one of the biggest issues facing Australia’s health system: fixing Medicare.

Medicare system
The college is seeking major reform to the current system of Medicare rebates.

Health professionals and advocates tasked with solving long-standing issues with Medicare will meet for the first time on Friday.
Federal Minister for Health and Aged Care Mark Butler this week confirmed the 17 members of what he called a ‘diverse’ group making up the Government’s new Strengthening Medicare Taskforce.
They are being asked to collaborate on solutions to make it easier for patients to see GPs, as well as ease pressure on hospitals and reform the Medicare system. The taskforce’s stated aims also include improved patient affordability and better management of chronic conditions.
RACGP President Adjunct Professor Karen Price is the college’s representative on the taskforce, which will be chaired by Minister Butler.
Professor Price says she is relishing the opportunity to be involved and advocate for substantial reforms to help GPs meet the challenges in providing patient-centred care.
‘The structural changes that are needed are vital to get right,’ she told newsGP.  ‘We can’t go on fragmenting care.’
Greater co-ordination between Federal and State Governments will be key, Professor Price says.
Speaking to News Corp earlier this week, she referenced the example of a Launceston urgent care clinic receiving State Government funding to help keep people out of the hospital system.
‘We need to look at integrated systems so that we don’t have a State versus Federal health divide,’ she said.
‘We can keep people out of hospitals, we can do lots of acute care, and we can also do preventive care.’
While there was no political commitment to increasing Medicare rebates prior to the election, Professor Price is unequivocal that improved resourcing is at the heart of the problem after years of stalled Medicare rebates.
‘The bottom line is the funding directed towards general practice must increase commensurate with the level of care, expertise and volume of care that we deliver for the Australian health system,’ she said.
‘We have a crisis of workforce, which can’t be ignored. We think there’s a link between what’s happened to the funding and resourcing of general practice, and what’s happened to the workforce.
‘We need to fix those two at the same time, that all comes down to the physician experience of delivering high-quality healthcare.
‘We can’t go on with GPs being devalued and disrespected because we will run out of GPs – and the whole health system will be the worse for it.’
Professor Price says that the current design of Medicare funding is not appropriate for the way GPs work today.
‘We need to address fundamental paradigm issues. Medicare was designed for a hospital biological disease model, and general practice is very different,’ she said.
‘It’s not fit for holistic patient care because it keeps deconstructing care into little tasks, which is not how general practice works.’
Establishing a simpler system is an essential outcome for the taskforce, Professor Price believes.
‘Reform without reinvestment is just red tape,’ she said. ‘We don’t want to have an onerous system. We know Medicare is ridiculously complicated.’
Refining the use of telehealth, which has been subject to multiple changes since its wide-scale introduction at the beginning of the pandemic, and providing funding for longer consultations, are two other issues on Professor Price’s agenda.
The RACGP President also warns there will be no quick solution.
‘It’s not going to be done overnight, much as we’d like to snap our fingers and have it all fixed. These things are going to take time,’ she said.
Groups represented on the taskforce include a wide variety of healthcare organisations, including the Australian Medical Association, Australian Nursing and Midwifery Association, and the Consumers Health Forum of Australia.
The formation of the group was one of the central health policy election promises of the Labor Party prior to the election.
The Federal Government has committed to spending $750 million to strengthen Medicare over three years, as well as to providing $220 million in practice infrastructure grants.
In a statement announcing the details of the taskforce, Minister Butler noted the average out-of-pocket cost for general practice services had increased by 60% over the past decade.
‘The Federal Government is committed to restoring affordable and accessible healthcare,’ he said.
‘Our health system is under pressure, our doctors need support, and we need to reduce pressure on hospitals.’
The taskforce is expected to present its recommendations by the end of the year.
The taskforce in full

  • Mark Butler, Federal Minister for Health and Aged Care (Chair)
  • Dr Omar Khorshid, President, AMA
  • Adjunct Professor Karen Price, President, RACGP
  • Dr Sarah Chalmers, President, Australian College of Rural and Remote Medicine
  • Leanne Wells, CEO, Consumers Health Forum of Australia
  • Dr Dawn Casey PSM, Deputy CEO, National Aboriginal Community Controlled Health Organisation
  • Karen Booth, President, Australian Primary Health Care Nurses Association
  • Annie Butler, Federal Secretary, Australian Nursing and Midwifery Federation
  • Amanda Cattermole, CEO, Australian Digital Health Agency
  • Professor Stephen Duckett, Honorary Enterprise Professor, Melbourne School of Population and Global Health, The University of Melbourne
  • Associate Professor Learne Durrington, CEO, WA Primary Health Alliance
  • Professor Adam Elshaug, Director, Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne
  • Dr Steve Hambleton, GP
  • Dr Walid Jammal, GP
  • Dr Nigel Lyons, Deputy Secretary, NSW Health
  • Antony Nicholas, Board Chair, Allied Health Professions Australia
  • Adjunct Professor Ruth Stewart, National Rural Health Commissioner
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Dr MT   29/07/2022 6:59:39 AM

“‘We can’t go on with GPs being devalued and disrespected”. A/P Price should discuss about abolishment of the unrealistic rule 80/20 and “The Professional Review Program”. These issues cause enormous pressure on GPs and prevent GPs from delivering care to patients
Sincerely Yours

Dr Michael Lucas Bailey   29/07/2022 8:27:53 AM

After numerous taskforces and reviews that have done nothing maybe we could try a different approach. A really radical idea.

Take the assumption that medicare isn’t actually broken or failing. Just severely underfunded. Increase the rebates for every item to what they should be - there are have productivity commission studies in the past and the AMA has a recommended table of fees. There is no need to worry about state/federal public hospitals. Stop the public hospitals accessing medicare and muddying the waters. Fund the public hospitals properly and separately to medicare.

Do that first. Most of the “structural” issues will self resolve. Then try and improve the structure if needed.

You can’t make a significantly bigger loaf of bread by messing around with just the yeast and salt. You are going to need a lot more flour.

Dr Allan Phillips   29/07/2022 9:14:28 AM

Not many bag-carrying GP’s in this lineup. Interesting to see consumer groups, nurses and health bureaucrats so strongly represented.

Dr Abdul Ahad Khan   29/07/2022 7:22:51 PM

Leanne Wells, CEO, Consumers Health Forum of Australia is the main Person whose Voice will be heard - her Voice represents the Consumers' Voice ( i.e. the Voice of more than 99% of our Voting Populace - remember that any GP's Voice ( less than 1 % of the Voting Populace ) will only be a Cry in the Wilderness, which no Political Party cares a damn about.
One can only hope that Leanne's Voice will focus on the Pathetic MC Rebates that the Consumers are getting.

Dr David Monash   30/07/2022 11:43:52 AM

When Mr Butler was the Minister for Mental Health in 2012 he presided over the removal of $450M from GP mental health care programs and item numbers to other programs. Be careful of his and the departments agenda in this similar process or the "answers" produced will result in a similar disaster for general practice. This seems to be the theme with every "improvement" or "review" undertaken in the general practice area. Example: The Medicare Review Taskforce 2015 to 2020 only did harm and reduced funding to general practice with every decision they made.

Dr Robert William Micallef   5/08/2022 6:20:32 AM

Karen price sounds like totally the wrong person to represent gp’s. Perhaps we should have found someone from the pharmacy guild as they seem to be very effective at getting gains for their profession. GPs are not concerned about state /federal funding squabbles or more blended care payments. A simplified fee for service with an appropriate Medicare rebate is all I’m interested in. All these health plans and Medicare home innovations are a health bureaucrat’s dream and only appeals to academic GPs. Professionals these days are charging $450 an hour, even plumbers are setting these sorts of hourly rates. That would translate to a standard consult being worth over $100. A Medicare rebate for item 23 of upwards of $80 should be our only bargaining position.