Radio interview with Minister Butler, ABC Radio Sydney – 20 March 2025

HAMISH MACDONALD, HOST: I promised you the Federal Health Minister would be here this morning. Lots of questions from you on the PBS. Mark Butler is with us. You've had a very busy morning. Good morning to you.
 
MINISTER FOR HEALTH AND AGED CARE, MARK BUTLER: Morning Hamish.
 
MACDONALD: Now, look, I know you heard that chat about the music at the footy. And you're a Port Power fan, aren't you?
 
BUTLER: I am.
 
*PORT ADELAIDE FOOTBALL CLUB THEME SONG*: “We've got the power to win. Power to Rule. Come on, Port Adelaide aggression.”
 
MACDONALD: Does that classify as a club song or ‘doof doof’?
 
BUTLER: It's a bit of both, that's the beauty of it. But we decided years ago to have INXS ‘Never Tear Us Apart’ in the lead up to the first bounce and having 50,000 fans at Adelaide Oval standing up with their scarves singing the song as well does give you a real buzz. But as the Health Minister, I like everything in moderation –
 
MACDONALD: That sounds incredibly sensible of you, Minister.
 
BUTLER: There's just too much music at the footy now.
 
MACDONALD: Now, listen, we've got to talk about some pretty important stuff. You've made an announcement today about reducing the cost of scripts. A lot of people already have questions about this. The price now is $31.60. What are you bringing it down to and how are you paying for that?
 
BUTLER: We’re bringing it down to 25 bucks next year. And if we hadn't done the first cut, which was to get it down to $30 by next year, it would have reached more than 50 bucks. Our measures will have effectively halved the maximum cost of a PBS script. It’s good for people's hip pocket, but also really good for their health. The more that people can afford the scripts that they have been given by their doctor, the better their health is obviously.
 
MACDONALD: How much are people going without? We're hearing a lot of stories about people not getting scripts filled. I mean, you're obviously responding to a problem. I know you're saying this could have been worse, but there's an issue there, right? Given the cost-of-living crisis.
 
BUTLER: Totally. When we came to government, the Bureau of Statistics told us that as many as a million Australians were not filling a script that their doctor had given to them, and that's obviously really critical to their health. Pharmacists tell me of stories of their customers coming in who might be on multiple medicines and asking for advice about which one they can go without. None of this is good for the health of the country, and that flows into the ability to work, the ability to participate meaningfully in society. And that's the beauty of these policies, they're not just good for the household budget, and they are obviously, but they're also good for our health. That's why we've focused so much on bulk billing so people can get to the doctor if they need it, but also making medicines cheaper.
 
MACDONALD: It is going to cost the Federal Budget $690 million, though over the next four years. How on earth are you going to afford that? I mean, we are going into deficit, it would seem?
 
BUTLER: Jim Chalmers, as you know, Hamish will stand up on Tuesday night and deliver our Budget and set out all of our revenue and spending measures. We've delivered two Budget surpluses back-to-back over the last couple of years, the first time that's happened in a very long time. We've been very responsible about choosing which cost-of-living measures are going to have the most impact on Australian households. And we're convinced that it's just a really important investment for the country.
 
MACDONALD: I know you're pleased to be able to make this announcement, but, you know, there is a question of responsibility here, though, because if we're going into deficit, it means debt, right? Can we afford this?
 
BUTLER: I think when you've got a million Australians and it may be more, saying that they are not sure they can fill a script that their doctor has said is important for their health, I'm not sure we can afford not to do this. This is just really critical for the country; the ability to work, the ability to participate meaningfully in society. Because if people aren't going to the doctor, or they're not filling their scripts, they end up having to be cared for somewhere else in the healthcare system, usually in a more expensive way because they end up sicker. This is a really important investment, not just in cost-of-living relief, but in health policy.
 
MACDONALD: Now, it seems that Donald Trump may be willing to go after the PBS. Big Pharma in America is describing our Pharmaceutical Benefits Scheme which is what, you give us cheaper Medicare or the government gives us cheaper medications through, not you personally, describing it as “egregious and discriminatory.” So can you be very blunt with us, is the PBS up for negotiation after as part of a trade war? Because America can exert a lot of influence on us?
 
BUTLER: Under a Labor government, never, ever, ever will we negotiate around the PBS. Of course, it will come as no surprise that Big Pharma in the US want to sell their medicines at top dollar. But we're committed to cheaper medicines. This isn't new Hamish -  
 
MACDONALD: Is it anti-competitive, though? I guess that's what they're saying.
 
BUTLER: Let me go back a bit. When the Howard Government negotiated the US Free Trade Agreement, the US Big Pharma industry tried to go after the PBS at that time as well. And we in the Labor Party insisted on amendments going through the Parliament that would protect the PBS and ensure that was carved out of any negotiations. In the same way we carve out elements of defence policy, health policy should be sacrosanct. It should be for the government of particular countries to determine the character of their healthcare system -  
 
MACDONALD: You say it should be, but what can we do to stop America going after it? I mean, you know, they don't particularly care what you think, or I think, or any of us think, do they?
 
BUTLER: They can't go after it. At the end of the day, the PBS is determined by the Australian Parliament. And I can assure people under a Labor government, the PBS will remain in its current form. We created it 75 years ago. We insisted 20 years ago on protections being put through the Parliament, again, against John Howard's opposition at the time, I might say, and we've tried to make medicines cheaper. We've succeeded in making medicines cheaper. Now, the American Administration, may well raise this with us I don't know, I'm not part of those negotiations. That is a matter obviously for other ministers. But as the Health Minister, I can give a solid guarantee that we will never, ever negotiate about the character of the PBS, not just with the US but with any other country. That's a matter for the Australian Parliament to determine. What do you say to anyone in America with ideas about going after it?
 
BUTLER: Good luck. Under a Labor government, you have no chance of changing the PBS. We made that clear 20 years ago when we really tried to put some steel into John Howard's spine and insist that there be a carve out of any negotiation around the PBS. It's just too important for Australians. Minister, are you happy to take a couple of calls? Lots of people feel very strongly about what the US is talking about.
 
BUTLER: Sure.
 
MACDONALD: Simon is listening in Glebe. Good morning to you, Simon. You're on a pretty expensive drug. What do you think of all of this?
 
SIMON, CALLER: I suppose it worries me. The drug that I'm taking according to the box, is $7,520 a month, I pay $30 and I'm very pleased to do it. It's a life-saving drug in my case, a cancer drug. So obviously, I'm a little bit worried about the potential for Americans to influence my life, I guess.
 
MACDONALD: Thanks for your call, Simon.
 
CALLER: And can I say, I'm very. very happy that the government is strongly committed to retaining the PBS. It's an excellent scheme.
 
MACDONALD: Thanks for your call, Simon. Minister, a text in, though, says “the Minister seems to think that Big Pharma makes less from the government being the payer. This is incorrect. The Australian government doesn't get medicines any cheaper than if the consumer in Australia paid directly. Big Pharma love guaranteed sales to the Australian government.” Is that correct?
 
BUTLER: That's not entirely correct because when a drug is listed onto the PBS, obviously that's good for the medicines company because it means they suddenly open up to a huge number of patients, but the government then negotiates a lower price with the pharmaceutical company as effectively a quid pro quo for having access to this big market. It's not the same as direct access. If you go through the PBS scheme, whether you're a company or a patient, the price that we negotiate as the government is lower. And frankly, that's really what the Big Pharma overseas would prefer didn't happen.
 
MACDONALD: Can you explain this, though, you know, in terms of what Big Pharma wants a texting from, Bruce says, “what does going after mean, Hamish, please be specific.” So at the moment, Big Pharma has written to the Trump Administration saying that they've got a specific concern about the Australian PBS scheme. What would they then do to sort of pursue that or go after it? Would they say, we're going to impose tariffs on your pharmaceutical exports unless you drop some of this? Is that what we're talking about?
 
BUTLER: I guess that that's what the industry over in the US would want. It's important to say they're not particularly pointing the finger at Australia, it's a range of other medicine systems around the world that do what we do, which is to try to make sure that Australian patients get the best possible price but also access to the world's best possible medicines. Now, the American industry may well want the US administration to try to encourage us to do less of that price reduction. That obviously taps into the profits that, industry, very profitable industry makes. But we're simply not going to do it.
 
MACDONALD: Louise, you have called in. You were a registered nurse for many years, and you lived and worked in America. What do you think of all of this?
 
LOUISE, CALLER: This is more of a plea than a question. That we absolutely must protect our PBS and our healthcare system at all costs. The Americans must not have any involvement at all. They don't understand it. They equate it with communism, and I think that's the cause of the way they think about it. They don't understand it.
 
MACDONALD: Thanks for your call and your observation, Louise. Minister, we've been talking a bit about access to dental. We heard from someone in the Southern Highlands on the show yesterday absolutely desperate. She rang up and cried on, the air. Her local MPs helped her get in and get seen urgently. Is the government open to ever putting dental into Medicare? That's a question we keep getting.
 
BUTLER: As your listeners might know, if they've thought about the history of health policy at all or were around when Bob Hawke introduced Medicare, he decided really, as a matter of pragmatism, not to fight on the dental front as well. You'll remember the Liberal Party was opposed at the time to Medicare, doctors were threatening to go on strike, it was a hard, hard fight. You can argue that pretty logically, that the mouth should be covered by Medicare as every other part of the body, but our focus right now is trying to strengthen Medicare as we currently have it. Unapologetically, I was really concerned when we came to government, particularly at the state of general practice. We want to make sure we're making medicines cheaper as well. But the Labor Party does have, as part of its platform, a commitment over time to try to bring dental more into the sphere of Medicare. We recognise that that's something many people in the community want. I just can't promise it's going to happen next week.
 
MACDONALD: Okay. What about next term if you're elected?
 
BUTLER: We haven't said anything about that right now. I'm still focused very much on that core element of general practice on cheaper medicines, on bringing a whole range of women's health issues, frankly, back up to date after decades of neglect. But over time, we are going to have to come to this issue.
 
MACDONALD: Okay. Was it ‘Never Tear Us Apart, you said, that you like it?
 
BUTLER: Never Tear Us Apart.
 
*NEVER TEAR US APART BY INXS PLAYS*
 
MACDONALD: Minister, thank you very much for coming on and taking some calls this morning.
 
BUTLER: Thanks Hamish.