PDF printable version of Radio Interview on 2GB with Ray Hadley (PDF 405 KB)
2 June 2014
Ray Hadley: In the meantime as I mentioned earlier, it has emerged a co-payment to visit a doctor was part of a reform plan put to - well I guess, the statement I've got in front of me, let me just check and see what it says - Health Care in Australia – Directions for Reform in the '91-'92 Budget - pretty simple.
It came from the Deputy Prime Minister and Minister for Health, the Honourable Brian Howe. Now, The Daily Telegraph via Simon Benson reports this submission by the then minister, contained a proposal for a $3.50 co-payment. That was back in '91, '92. It never happened of course.
As you know the current Coalition Government wants to introduce a $7 co-payment for doctor visits, capped at $70 per concession card holders and children under 16.
The current Labor Opposition has claimed the proposal will kill universality of Medicare, but in their own party in 1991, they said no it won't. We'll find out what the Federal Health Minister Peter Dutton thinks about all this, he's on the line. Minister, good morning.
Peter Dutton: Good morning, Ray.
Ray Hadley: No such thing as anything new, it's just old stuff rehashed.
Peter Dutton: Well, we're happy to give credit where it's due and Bob Hawke came up with the idea of a co-payment and at the time they said Medicare was unsustainable without a co-payment. And the other interesting aspect to it is that the Labor Party has always supported a co-payment in the medicine system - so there's no bulk billing when it comes to the PBS regardless of how sick you are or how poor you are, you pay about $6.10 for the first script and you get up to a safety net once you get up to about 60 scripts.
So the argument there is that we need a co-payment to keep the system sustainable and our argument is, as Bob Hawke's was and as the even the current Labor Shadow Assistant Treasurer, who's written extensively on this says, that Medicare's unsustainable without a co-payment.
Ray Hadley: Can you equate, in simple terms, what $3.50 would mean from 1991? It would be - it would be worth a lot more than $7, I'd imagine, in 2014.
Peter Dutton: It depends on the indexation factor but it's about $6.40, so it rounds out to about $7 and it, again, it's - we've got a population that's aging, we've got new medical technologies, we've got personalised cancer medicines, genomic testing that maps out the DNA within somebody's body. All of these expenses are coming down the line, and my view is that we need to really strengthen Medicare and make it sustainable over the coming decades. And if we want to have a world class health system going forward, then people who can afford to pay the $7 I think should and those that can't we still retain bulk billing so that the doctor can have discretion as to when they bulk bill.
But at the moment too many people are being bulk billed, and this view that you can just borrow money and give everything to everybody for free, which seems to be the Labor way, is just not sustainable.
Ray Hadley: See if I've - if you'd said this was going to consolidated revenue, you'd probably have, you know, more people opposing it, but the reason I supported it was because you're looking at a medical fund, you're looking at a research fund of $20 billion down the track. Now, as someone that's fervently supporting research into motor neuron disease and other people that are equally passionate about cancers and other matters, dementia and the like, we might get an answer to this by spending research dollars and the research dollars will come from this co-payment, won't they?
Peter Dutton: Well, of the $7, $5 effectively goes into the medical research fund and then $2 goes to the doctors, to supplement the income coming from Medicare already. So, we think it provides a good balance and you're dead right, the reason that we've got to put more money into medical research is - particularly the diseases of the brain, the Alzheimer's, the dementia, by 2050, 7500 each week will be diagnosed with one of those diseases and it's just horrific.
Particularly as our population ages, as people live longer, we have to put the money into research to try and find the better care methods, the better outcomes in terms of the ways in which we can provide medicines and support to people who have - and it's not just diseases of the brain, but as you say cancers, leukaemia, so - all of these highly technical solutions that are taking place within medical research and so - we've got some of the best researchers in the world and not only do we get good health outcomes but we also get, I think, really good economic benefits because it's a big exporter and we've got some great institutes here, Ray, and I hope that we can support them through the fund.
Ray Hadley: I got a lot of phone calls after the announcement of the Budget from ladies that work and have worked in medical centres who say that many people simply come in to see the doctor because they're lonely. And, I mean, I'm not suggesting that they're not mildly ill, but many of them - and they said we could just about set the clock on the arrival of quite a number of people at a set time on a set day, because they just got used to coming in and signing a form and because they wanted to talk to someone.
Peter Dutton: Well, and that's what the doctors will tell you as well Ray, and it's not just then the taxpayer paying for the consultation, it's then if there's a referral off to the orthopaedic surgeon or if there's a blood test ordered or an x-ray, for argument's sake.
Now, in most cases all of that is entirely appropriate, but then on the other hand, you've got mums with sick kids who can't get in to see the GP. So the idea is, I suppose, to try and put a value proposition around going to the doctors, the Commission of Audit had recommended $15 which we thought was too high, and the $7 strikes a reasonable balance. And I think particularly given that we're going to retain bulk billing, there's that safety net and as you pointed out in your intro, once people on a concession card or under 16 get to 10 visits within a calendar year, so a maximum of $70, they can go back to bulk billing anyway.
So there's a couple of safety nets in the system and we just can't pretend that we can continue to put money on the credit card and give all these services away for free, because Medicare will just fall over and I think these are sensible changes.
Ray Hadley: Okay, now, in relation to getting it through the Senate; the $64 question. Even allowing for your colleague taking Clive out for a Chinese feed on State of Origin night… I mean, will you get it through the Senate? Let's just - don't worry about all the other things you're trying to get through the Senate - in isolation, will this pass muster, or not? And if it doesn't pass muster, what do you do next?
Peter Dutton: Well I always think if you're putting forward a sensible proposition that you'll carry the argument at the end of the day, even if things are popular or not popular in the first instance. So, I think if you seriously believe that with a population of 23 million people, that we can give 263 million free services a year through Medicare, and 10 years ago we were spending $8 billion a year on Medicare, today we're spending $20 billion a year. If people think that they want a good system going forward, and they want a sustainable, strong Medicare, well, sensible changes have to be made. And I think on that basis, you can have the argument, but there'll be political posturing that goes on, they'll fox and have all of the public comments, but I think in the end common sense has to prevail on these issues, and that's the argument that we have to push.
Ray Hadley: And how do you deal with this - or how does the Prime Minister deal with it, and the Treasurer. With all these different things being battled, can we part… pass part of it through the Upper House, and are there non-negotiable things as … for instance, can it become a $4.50 part payment, what do you do in relation to that, is there any wriggle room, so to speak?
Peter Dutton: Well a couple of points. One is that we really are determined to get money into this medical research fund, because we do need to find those cures. Secondly, if you reduce it too much, then doctors will continue bulk billing. And part of the problem that doctors have is, they say well, bulk billing's about providing support to people who can't afford $7, but the competitive doctor on the opposite corner is bulk billing everybody to try and take some of the patients away from the practice across the road. Now, that's not what bulk billing's designed for, it is to help provide support for those without means, and if you reduce it too much, then you remove the incentive for the co-payment to be charged, and then the bulk billing continues and then we're on the same unsustainable path as we are at the moment.
So, in New Zealand, its $17.50, in parts of the US it's over $20, the Commissioner of Audit recommended $15. Its $7, I think we've got a pretty good balance, and all we can do is just to argue common sense, and I hope that that prevails, Ray.
Ray Hadley: Alright, thanks Minister, appreciate your time.
Peter Dutton: Thanks very much mate, cheers.
Ray Hadley: Federal Health Minister, Peter Dutton, talking about a very important issue in relation to our future wealth.
PDF printable version of Radio Interview on 2GB with Ray Hadley (PDF 405 KB)