GREG JENNETT, HOST: For the first time in almost 30 years, a new and expensive drug has been approved for heavy subsidy for the many thousands of women suffering endometriosis and the pain that comes with that. This was part of an announcement made over the weekend by Health Minister Mark Butler. So to pick up on that and some other cost-of-living pressures in health, the Minister joined us a few moments ago from Port Adelaide. Mark Butler, it's good to have you back with us on Afternoon Briefing, welcome. Now, you made an announcement, a very important one at the weekend, significant for hundreds of thousands of women across the country with endometriosis listing this new daily tablet on the Pharmaceutical Benefits Scheme It does save them money. How quickly will that product be available on prescription?
MINISTER FOR HEALTH AND AGED CARE, MARK BUTLER: It's available as of yesterday, the 1st of December. This is the latest in a series of steps we've been taking to try to give better support for the one in 7 Australian women who suffer from endometriosis. This is, frankly, a condition that has been hidden in the shadows for too long. For too long so many Australian women have been expected to suffer in silence and even from healthcare professionals, I have to say, they’ve been told that the experiences that they're having, the deep, debilitating pain is simply a normal part of being a woman. This latest decision to list Visanne, a highly effective treatment for women with endometriosis, the first new listing on the PBS for 30 years is going to be genuinely life changing for hundreds of thousands of women.
JENNETT: Alright, it has been widely welcomed, I think, among medical groups and it is supplemented by a number of other decisions the government has made in this area, I believe. It's fairly automatic, though, isn't it? You are just making effective the recommendations of the independent panel?
BUTLER: I'm delighted there was a recommendation that we were able to action as the government. As I said, the most common drug currently being used was listed back in the 1980s. the last listing was in 1994, 30 years ago. It’s pretty extraordinary. Frankly, there hasn't been a new treatment listed on the PBS for 30 years, but this treatment Visanne has been available on private script in Australia now for a decade. I've spoken to patients for whom it's been genuinely life changing. Now being able to improve its affordability for hundreds of thousands of Australian women is a wonderful step forward in this condition.
JENNETT: Yeah, can I take you to some interesting data? Striking figures actually, that came out late last week while parliament was perhaps preoccupied with a bunch of other matters here in Canberra, Mark. The APRA has a striking increase in the uptake of private health insurance, particularly by younger Australians, a 5% increase in those aged in their 20s. What do you put that down to?
BUTLER: There's been a pretty steady increase in private health insurance membership now for several quarters, really probably quite a number of quarters since COVID. And so to an extent, it's a continuation of that. I haven't really been able to delve into the numbers in great detail, but my sense from the industry is among young people in particular that reflects a desire for better mental health supports as well as the general range of options that private health insurance gives you.
Private health insurance is still a very important part of the mix of the system. That private hospital system funded by private health insurance delivers, for example, about 70%, 7 out of every 10 procedures for elective surgery is delivered in private hospitals through private health insurance. Having that mixed system in Australia, Medicare, the universal health insurance through Medicare for free, public hospitals for Medicare, billing and general practices and the like, supplemented by this private system, a viable private system is one of the real, enduring characteristics of one the great healthcare systems in the world.
JENNETT: It's a choice that younger people, they're the ones we're talking about today, are making in the midst of a cost of living crisis. Can you say that it may present to them better value for money these days than it may have appeared to them? You know, 5 or 10 years ago?
BUTLER: It really depends on individual assessments. For example, younger couples might want some choice about their maternity services options if they're planning a family, mental health supports, a range of other things will drive a decision to take up private health insurance membership. You'll remember also, Greg, that almost 25 years ago, the Howard Government put in place a range of what you might describe as carrots and sticks. Forcing people to think about that, at least at the age of 30, there's carrots in the form of private health insurance rebates that improves the affordability of private health insurance, but also sticks in the sense that there are financial penalties over the age of 30 for not having full cover as well. That obviously factors into the decisions that young households will be making.
JENNETT: Yeah, there is a degree of compulsion almost with some of those stick elements, that is true. Can we move on, Mark Butler, to shortages in supply of medicines? I mean, the saline situation has been pretty well canvassed. In addition, there are more than 400 other medicines, including hormone replacement therapy treatments that appear to be in shortage. It seems, correct me if I'm wrong, that these shortages appear more commonplace of late. Do you understand why?
BUTLER: Before COVID, there were always shortages of medicines that ran to, you know, a couple of hundred, maybe 300 at any one time. That's long been a big part of the work of our Therapeutic Goods Administration which oversees our medicines and other therapeutic goods systems to monitor that to plan for it to put in place alternative measures where there is a shortage. There's nothing new in that. There's a bit of, there's a bit of a challenge in terms of scale post-COVID. As your viewers would know, COVID really did put pressure on supply chains that are continuing to be felt throughout the world. As one example, there is a global shortage of hormone replacement therapy, menopause hormone therapy, as it's more commonly described today, that is affecting countries right across the world and is something the Therapeutic Goods Administration has been working really hard on here in Australia. One of those things includes arranging alternative patches, transdermal patches for women to be able to access. Only in the last couple of weeks, we've given pharmacies additional powers to approve alternative supplies without the patient having to go back and get a new prescription from their doctor as well. We're doing everything we can. I know the equivalent authorities around the world are doing everything that they can. Some of those supplies will moderate over the course of the next couple of weeks. But we know some brands of the patches are going to continue in short supply across the world well into next year. We have to be vigilant about all of this.
JENNETT: Right, so just roll with it and it should improve over time. We did discuss cost-of-living pressures in the context of private health insurance, Mark Butler I might just get your thoughts on some other reporting over the weekend. Drawn out of Redbridge consulting surveys, a third of people report delaying their medical treatment due to financial pressures. Does this accord with what the government sees around elective surgery and diagnostics, other non-bulk billing services. Does that seem about right to you?
BUTLER: Yeah, there was nothing new in that research for me. I've been talking about this since before we were elected, that the cuts to Medicare rebate had caused out-of-pocket fees to rise very substantially. It had caused a freefall in bulk billing. That was the language of the College of GPs, not my language. And we know that medicines costs were placing real pressure on households. The Bureau of Statistics told us a couple of years ago that as many as a million Australians were going without, or at least delaying, a medicine that their doctor had said was important for their health, because of affordability questions. And frankly, that is why that has been such a strong focus of our health policy. Cheaper medicines have saved Australians already in 2 years over $1 billion in out-of-pocket costs, and our bulk billing changes have meant more than 5 million additional free visits to the doctor, without a gap fee just in the past 12 months. There is not a higher priority we have than making healthcare more affordable because we know it's not just good for the hip pocket, it also means people can afford to get the health care or access the medicines that they need.
JENNETT: The Redbridge work, though, did seem to break it down into blue-collar workers, sales and clerical. What I might describe as middle Australia that might also have heavy mortgages and of course feeling the pinch there as well. In many cases they're not going to be eligible routinely for bulk billing services, are they? Do you acknowledge that the toll and the difficult decisions might fall more heavily on that cohort?
BUTLER: That's right. I'm not in the business of really choosing one cohort or the other. We're focused on trying to make healthcare more affordable for all Australians. Obviously, we've had a focus on pensioners and concession card holders and parents with young kids. The biggest cut to the price of medicines that have ever been made was made by our government last year, not for concession cardholders, but for general patients for that very reason that we know that people who are a little bit above the threshold to get a concession card are doing it tough right now. Their household budgets are under real pressure, and we don't want them to be going without a medicine their doctor says is important for their health because of those affordability concerns. That's why we delivered them, not pensioners so much as general patients, the biggest cut last year to the price of medicines in the history of the PBS.
JENNETT: Alright, one quick final one, Mark Butler. That same Redbridge survey also found that about half of respondents viewed Peter Dutton as, “ready to govern”. That would have to be a worry for the government. How do you explain that?
BUTLER: I think you've just got to look at his record on Medicare to know what a Peter Dutton government would do to the pressures we've just been talking about. He tried to abolish bulk billing altogether. He tried to cut funds from public hospitals. He tried to make everyone pay an entry fee to get into a free emergency department. And he tried to jack up the price of medicines. That is why doctors voted him the worst health minister in the history of Medicare. We know in an area where people are really feeling the pinch and are challenged after the really dark years of COVID, that a Peter Dutton prime ministership would be terrible for Medicare.
JENNETT: Alright. We've covered a fair bit of ground in the health portfolio today. Mark Butler will wrap it up there thanking you for your availability, not just today but throughout the year. Enjoy the break if you get one.
BUTLER: Merry Christmas, Greg.
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