Radio interview with Minister Butler, 3AW Weekend Breakfast - 23 February 2025

DARREN JAMES, HOST: The Minister for Health and Aged Care, Mark Butler, joins us. Hey, Mark, thanks for joining us. This means I can go to the doctor and it won't cost me a cent, but it comes at a cost, doesn't it? Good morning to you.
 
MINISTER FOR HEALTH AND AGED CARE, MARK BUTLER: Good morning. This for the first time extends bulk billing support to all Australians. Up until now, it's only been available to pensioners and Australians with a concession card. But we'll now extend that support to all Australians. And for the first time too, we're providing an incentive payment to general practices to become bulk billing practices - so they'll get the additional money if they bulk bill all of their patients. We're confident this will triple the number of bulk billing practices in the country and deliver almost 20 million additional free visits to the doctor every single year.
 
JAMES: Will you? How will you pay for it? Will you increase the Medicare levy?
 
BUTLER: No, we've got no plan to increase the Medicare levy. I can't think of a more important thing to do, frankly, by federal government. I think your listeners know that bulk billing is in freefall. That's the description the College of GPs has given to the situation we face. Out of pocket or gap fees are soaring and more and more Australians are deciding not to go to the doctor because they can't afford it. I mean, that is - particularly for a Labor government - a completely untenable position. The core promise of Medicare was that every Australian could access the world's best health care, no matter what their means. And with the announcements today, we deliver on that promise.
 
HEIDI MURPHY, HOST: By what date do you deliver on that promise, Minister?
 
BUTLER: The funding comes in on the 1st of November this year if we're re-elected. It's not phased in. It's all delivered on the 1st of November. Ultimately, this will be a decision for general practices about how quickly they can remodel their operations. But we want to see this turned around as quickly as possible. We inherited a situation where funding freezes over the past decade had seen bulk billing slide. Some investments we made to triple the bulk billing incentive for pensioners and concession card holders the year before last, that's worked. Bulk billing rates for that group of Australians are comfortably back over 90%.
 
MURPHY: Well, when you say it's ultimately a decision for general practice, they could ultimately decide now we'll keep charging can't they.
 
BUTLER: They won't get the additional money. I mean we've done the modelling-
 
MURPHY: Is it enough?
 
BUTLER: For almost 5,000 practices, which is the very clear majority of practices, this is a good deal for them. This is a better deal than charging patients. We're very confident that doctors will see the sense of this. That's why the AMA, the College of GPs, a range of other doctor’s groups are already out strongly endorsing our policy because they know this is the single largest investment ever in Medicare, and its focus is on making sure people can access a free visit to the doctor when they need it.
 
NICK MCCALLUM, HOST: And, Minister, there's going to be big incentives, $30,000 it's reported, for young doctors to effectively leave the state government system and go into the federal system, which is obviously GPs. Have you spoken to? I mean, the state government is complaining they've got a lack of doctors in our hospitals. So have you spoken to state governments about how they're going to react to that?
 
BUTLER: Absolutely. We all agree we need more GPs. You know, the health ministers from state and territory governments and I meet very regularly, probably more often than any other group of ministers, for obvious reasons. The health system's just so important. And they agree we need more junior doctors taking up general practice. A few decades ago, about one in every two medical graduates chose general practice as their career and the rest became non-GP specialists.
 
MURPHY: But aren't you effectively robbing Peter to pay Paul?
 
MCCALLUM: Isn't that going to be a problem?
 
BUTLER: I tell you, ask any state health minister “do we need more junior doctors in general practice?” They will say a resounding yes.
 
MCCALLUM: But they also say we need it in hospitals as well, because there is a shortage in Victoria of doctors in hospitals.
 
BUTLER: Today's package also increases the supply of doctors. For the first time in a long time, we're increasing the number of medical school places in our major cities. We've added medical school places in rural communities and that's been terrific because we know if they train in rural settings, they're more likely to build a life and take on a career in rural settings. But we're also expanding medical school places for the first time, probably in a decade, in our major cities. We know we need more doctors. We're getting some from overseas. We're fast tracking GPs in from the UK and Ireland and New Zealand systems, where we have a high level of confidence in their training. And over the past couple of years, we've delivered more new doctors than at any time in the past decade.
 
MURPHY: Minister, this is $8.5 billion for four years. After that, what's the ongoing cost of it?
 
BUTLER: We think it will be around $2.5 billion a year ongoing after that. But what it will deliver is a secure Medicare. Things are at a tipping point right now, I have to say. Bulk billing, as I said, for pensioners and concession card holders has been secured by the investments we made the year before last. But free visits to the doctor are really hard to come by, increasingly hard to come by if you don't have a concession card. And more and more Australians, the Bureau of Statistics tells us, and your experience from your listeners will tell you, more and more Australians are choosing not to go to the doctor. And ultimately that ends up being paid for somewhere down the track, when people are sicker and usually end up having to access a more expensive part of the healthcare system, like our hospitals. This is as good an investment I can think of by a federal government.
 
MURPHY: And is this when you say $2.5 billion ongoing, is that on top of what it's already costing or that is total for the Medicare system?
 
BUTLER: No, the healthcare system costs a lot more than that.
 
MURPHY: Sorry, the Medicare part. I meant the Medicare part.
 
BUTLER: The Medicare system is a bit over $30 billion a year, about $35 billion a year, and obviously it's going to grow in the future. You know, we're a growing population. We're getting older. You’ll need more healthcare.
 
MURPHY: Yes that was what I was wanting to get to. It will continue to grow. So realistically you will have to increase the Medicare levy.
 
BUTLER: We find other ways.
 
MURPHY: What other ways are there?
 
BUTLER: The Medicare levy is an important part of funding Medicare, but not the entire part. We all fund our healthcare system through our taxes, whether it's individual taxes, company taxes and the like. But we know we're going to have a growing demand for healthcare in the future with a with an older population with more complex chronic disease, which is why it's so important that we not only do things like this to secure that core promise of Medicare - free healthcare when you need it - but we also ensure we've got a supply of the right doctors, advanced nurses, there's substantial scholarships in today's announcement for new nurse practitioners and endorsed midwives. We all know that we don't have enough midwives in the system. So building that supply of the best trained health workers on the planet is also part of our plan.
 
JAMES: Okay, I'll have another swing at the question then. And the question is it's inevitable that the Medicare levy will have to go up as a result of this.
 
BUTLER: We fund our healthcare system under the existing revenue arrangements. Now Medicare levy is part of that, but other tax arrangements play a much bigger role, whether that's company tax, tax on individuals and all of the rest of the arrangements that are well known to your listeners. We've delivered two Budget surpluses in our time in government. We're responsibly managing the Budget. How we pay for this will become very clear to people at the next Budget Update.
 
JAMES: Are we going to get that soon?
 
MURPHY: Is that before the election or going to be after the election?
 
BUTLER: Sorry, I didn't hear that.
 
MURPHY: Is it going to be before the election or after the election that it becomes apparent to us how it will be funded?
 
BUTLER: Definitely before the election There's either going to be a Budget on March 25th or if there's an election that interrupts that there will be a full disclosure of all of the budget arrangements. So people will go to the ballot box knowing exactly, not just in health, but how we propose to balance all of our revenue and expenditure items. But I do again say that, you know we've delivered two Budget surpluses over the course of this government. That’s the first time that's happened for 15 years. We've applied a very responsible approach to budget management.
 
MURPHY: And will there be a big Mediscare campaign then? You haven't mentioned the opposition at all, Minister.
 
BUTLER: There's a very clear reason why bulk billing is in freefall, and that is that Medicare funding was frozen for six years. And you don't have to be an advanced economist to work out that if you freeze doctors’ incomes while their costs continue to rise, there will be pressure on bulk billing.
 
MCCALLUM: And already sorry and already haven't they the opposition have sort of backed away and said they will on first look they will support this?
 
BUTLER: They've hedged a little bit. Of course we want support across the board. We've got strong support from doctors, you know. But they said last time they came to government there'd be no cuts to health and no cuts to education and within a few months, Peter Dutton, when he was health minister, tried to abolish bulk billing altogether. So you can only take people at their record rather than what they say. What people know from Labor though is that Medicare is our most important social program. We've fought for it for more than 40 years, and we'll continue fighting it for the next 40.
 
MURPHY: Minister, just finally, how far off is the private health insurance premium increase decision. Have you made it yet?
 
BUTLER: Well, I've got some final advice coming to me. I've gone back to insurers now three times I think, and told them I expect them to sharpen their pencil. They came to me with an original claim for private health insurance premium increases that I thought was just not in the interests of their members. So I've gone back to them three times. I've got that response, and I'll be making a decision very shortly on that.
 
MCCALLUM: Before the election?
 
BUTLER: Definitely well before the election.
 
MCCALLUM: Because they start April 1st, I think.
 
JAMES: Mark, thanks for joining us. A busy day for you.
 
BUTLER: My pleasure. Good to talk.