Voters back Medicare fix as bulk-billing rate falls

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Australians have backed the case for tougher controls on Medicare to stop fraud and control costs, with 61 per cent of voters in favour of stricter rules ahead of changes in the May 9 budget to improve services.

An exclusive survey also shows that 40 per cent of voters back the idea of means testing Medicare to scale back the benefits to people on higher incomes, but only 8 per cent are willing to accept a larger “gap” fee when they visit the doctor.

Australians have backed the case for tougher controls on Medicare to stop fraud and control costs.Credit:

In a sign of the pressure on household budgets, only 42 per cent of voters say their general practitioner offers bulk-billing to charge all consultation fees to Medicare, a sharp fall from 47 per cent of respondents on the same question just three months ago.

The findings highlight the impact on millions of Australians as GPs tell their customers to prepare for “mixed billing” or higher “gap fees” so patients pay more themselves.

The trend means a Level C consultation lasting from 20 to 40 minutes is costing many patients $50 to $80 because the Medicare rebate is $76.95, but clinics may charge fees of $130 or $160, depending on what they think customers will accept in their suburb.

Health Minister Mark Butler has cleared the way for budget changes to repair the system after warning that Medicare is in its worst state since it was founded four decades ago, but doctors and pharmacists are at odds over how to cut waste and help pay for the reforms.

The new survey, conducted by Resolve Strategic for this masthead, found that 60 per cent of voters believe they get value for money from Medicare, but that 21 per cent disagree, while the remainder is unsure.

Prime Minister Anthony Albanese is due to meet state and territory leaders on April 28 to negotiate health funding and other issues. Butler said on Tuesday the government would commit more money to Medicare in the budget as part of broader changes to healthcare.

“I’m not going to just put more money into the existing system,” he said on ABC Radio in Tasmania.

“What everyone agrees with, I think, is we’ve got to also reform the system to make sure it provides better wraparound care for the sort of needs people have now.”

State leaders are pressing for more federal help for hospital systems or a funding boost for primary care in the hope this could ease pressure on hospital emergency departments.

A national study of GPs by healthcare director Cleanbill, reported by this masthead last Sunday, found that only 35 per cent offered fully subsidised consultations for adults.

The report found that patients in Level B consultations, which last 20 minutes or less and gain a Medicare rebate of $39.75, were paying average gap fees of $48.74 in the Melbourne bayside electorate of Macnamara and $56.25 in the eastern Sydney electorate of Wentworth.

The Australian Medical Association is seeking a higher rebate for GPs in the May budget while the Pharmacy Guild of Australia is arguing for more scope for chemists to prescribe medicines in order to cut the cost to the government when patients must visit the GP to gain repeat prescriptions.

While the government has promised to act on the Strengthening Medicare Taskforce, which recommends an overhaul of primary care as well as a funding injection, experts believe a full response in the May 9 budget will cost more than the $750 million Labor pledged at the last election.

The Resolve Political Monitor surveyed 1609 eligible voters from Wednesday to Sunday, a period when Prime Minister Anthony Albanese was on leave and Opposition Leader Peter Dutton was focusing on the Indigenous Voice to parliament, with little debate on healthcare or the coming budget. The results have a margin of error of 2.4 percentage points.

When the survey asked voters if their GP offered bulk-billing, 42 said it did but 40 per cent said it did not and the remainder did not know. Asked the same question in the January survey, 47 per cent said it did and 40 per cent said it did not.

The rate of bulk-billing can be reported in several ways, such as by the number of consultations, the number of patients or the number of clinics. A government report issued in February said that 65.8 per cent of patient consultations were always bulk-billed, but this included COVID-19 vaccinations.

Butler received an expert report on the cost of fraud in the Medicare system earlier this month, after a series of reports on the problem by this masthead, leading to potential reforms such as notifying patients by text message every time the government is charged in their name.

The Resolve Political Monitor asked voters about several options to make Medicare more sustainable and allowed them to choose more than one, leading to 61 per cent supporting more regulation and oversight and 40 per cent backing a means test for benefits.

Only 8 per cent supported paying a larger gap fee, but 14 per cent favoured the idea of increasing taxes, and 25 per cent backed an increase in the Medicare levy.

Cut through the noise of federal politics with news, views and expert analysis from Jacqueline Maley. Subscribers can sign up to our weekly Inside Politics newsletter here.

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