Radio interview with Minister Butler, 3AW Mornings – 3 November 2025

TOM ELLIOTT, HOST: Well, about a year ago, Labor pledged I think it was $8.5 billion to try and convince more GPs to bulk bill. Now, look, the reality about bulk billing is this, effectively, you're saying to a doctor, can you run your medical practice with all the expenses, and everything involved purely on what the government gives you? And the reality is some medical practices do this, but many do not. Our next guest is the Minister for Health, Disability and Ageing, Mark Butler. Good morning.
 
MARK BUTLER, MINISTER FOR HEALTH AND AGEING, MINISTER FOR DISABILITY AND THE NDIS: Morning, Tom.
 
ELLIOTT: Is there any evidence this program has worked? Have we got more doctors bulk billing than what we used to have?
 
BUTLER: Today is the first business day of the new arrangements. I can say in Victoria alone, the number of practices that are bulk billing every single patient that comes through their door has already doubled from Friday to Monday. It was about 20 per cent of practices last week, and it's about 40 per cent of practices today, and that number will increase day on day. I'm very, very confident about that.
 
ELLIOTT: How does it work, though? I mean, is it for all patients? Like, does a practice that used to charge a surcharge, do they now advertise and say, no, now we bulk bill?
 
BUTLER: Yeah, that's right. You'll see them. They'll have signs out the front now as a Medicare Bulk Billing Practice. That means they bulk bill 100 per cent of their patients. Previously, GPs received an incentive to bulk bill pensioners and people with a concession card or kids under 16. We tripled that incentive back in 2023 because we were concerned that the bulk billing rate for those people on low fixed incomes was dropping, and that turned that rate around. Those 11 million or so Australians, their bulk billing rate is today about 92 per cent, so back up where we wanted it.
 
But if you didn't have a concession card, your bulk billing rate has been sliding pretty consistently because the Medicare rebate was frozen for about six years last decade. And unsurprisingly, if you squeeze doctors' incomes, their ability to bulk bill becomes harder and harder. We wanted to turn that bulk billing rate around, which is why, as you said, in February, we announced for the first time we would extend bulk billing support to every single patient. So, doctors will be paid an incentive if they bulk bill everyone coming through their door, so any one episode. And on top of that, if the practice is a 100 per cent bulk billing clinic, they'll get an additional incentive payment of 12.5 per cent on top of their MBS income.
 
ELLIOTT: Right, so just so I've actually got this straight, I'm just trying to get my head around how it works. So, if I run a GP practice and we don't bulk bill, we take the standard Medicare rebate plus we add a surcharge, you just continue to get the standard Medicare rebate. But if I say, no, I am going to bulk bill entirely, effectively, you get the rebate plus an extra amount.
 
BUTLER: That's right, you get two. If you just bulk bill some people in your practice, then you'll get the rebate plus the incentive for those people you bulk bill. If you bulk bill every single person that comes through your door, you get an additional bonus on top of that. So, you get the rebate plus the bulk billing incentive plus an additional incentive for being a 100 per cent bulk billing patient.
 
Now, the problem we're trying to fix here, Tom, is the concession card cuts out pretty early, the Health Care Card, at around $40,000 for a single. If you earn over that, you don't get a Health Care Card, it is $70,000 for a couple. We're not talking wealthy families or households here. And increasingly, those people are being charged gap fees, and they're telling us in record numbers that they're deferring going to the doctor because of cost. Now that's not good for their health as well as being bad for their hip pocket.
 
ELLIOTT: I agree.
 
BUTLER: That's what we're trying to fix.
 
ELLIOTT: Now, is there a limit? So let's just say every GP in the country said, you know what, this is a good program, we're going to get on board. They all ring your office and say, right, we all want to completely bulk bill all patients now. Can the program accommodate that or is there a limit?
 
BUTLER: No, it's what we call demand-driven. If every practice did that, we'll pay for it because that will be good for people's hip pocket but really good for the healthcare system. And I've been going to practice after practice over recent days, and all of the GPs there are giving me a different story about why this is good. One of the doctors yesterday I was at, at a practice in Port Adelaide that's gone 100 per cent bulk billing, he said a lot of his patients who might have come in every month or six weeks, people who have chronic disease, had started coming in every six months or every nine months because they were having trouble meeting the gap. Now, he's going fully bulk billing. He's confident they'll start coming back on a regular basis, which is the best thing for their health.
 
ELLIOTT: And I suppose the other positive impact that we'll see is that at the moment, sadly, a lot of people, if they can't find a bulk billing GP, present themselves to an emergency department, often with things that aren't really relevant for an emergency department, and that clogs up the ED. So doing this might de-clog emergency departments.
 
BUTLER: Absolutely. We're trying to do that through our Urgent Care Clinics, and we'll be opening almost 50 of them over the coming few months to add to the number we've already got. But what state governments are telling us is that because people are deferring going to the doctor, they often end up sicker. They often do need to go to a hospital because they haven't been getting the regular care from their GP that they really need because of costs.
 
Now, this is an investment in the cost of living for households who might not be at the bottom of the income scale, but they're doing it tough still. And if you're in your 50s, you've probably got a couple of chronic diseases, you might be on a number of medicines, but you're not wealthy. You're not wealthy. And so, what we've done with this bulk billing change and what we've done with our cheaper medicines policies is really focus on those middle-income households who don't get the benefit of Health Care Cards or concession payments for their medicines but do need some relief, and we've been focused very much on giving them relief.
 
ELLIOTT: Now, I think it's a good policy, and I hope it works. Just on a separate issue which you and I have discussed before, here in Melbourne, it's reported that one of the biggest importers of illegal tobacco, a man called Kazem Hamad, wants to join forces with a Chinese gang to import millions more illegal vapes. I spoke with Mary Aldred, who's the Federal Member for Monash, earlier on in the program. She says it's time to, at least with tobacco, to cut the excise to try and put the tobacco smugglers out of business. Now, you've said in the past you won't do that, but is it something you would now think about or contemplate?
 
BUTLER: I'm not sure what Mary says we should cut it to to be able to compete with criminals because it would be a very significant cut, which, as I've said to you before, Tom, we’d be concerned would make smoking even more attractive. But Mary's right, you're right, you've been covering this very regularly. We've got a really significant law and order challenge here, as well as a public health challenge. The biggest threat right now, I think, to 50 years of trying to stamp out smoking and all of the death and morbidity it causes, the biggest threat is these criminal gangs who are bringing in shoddy products from overseas and selling them through retailers who frankly should know better.
 
Tony Burke, our Minister for Home Affairs, is working really closely with state police agencies to track these criminal gangs down and to bring them to court to confiscate their profits. But they are resilient gangs. They are making a lot of money through this, which is used to bankroll all of their other criminal activity. I don't accept that a very big cut in the excise- it's going to have to be a massive cut to the price of legal cigarettes to be able to compete with criminals. It might sound attractive at first blush, but it's not practical. The way to deal with criminals is to track them down, bring them to court, confiscate their profits, and put them out of business, and that's what I think all governments are focused on.
 
ELLIOTT: Well, good luck. But I'm pretty sure the kingpin at the centre of it doesn't even live in Australia. So, there you go. Alright, Mark Butler there, Minister for Health, Disability and Ageing.