What is the difference between Labor and Liberal on Medicare?

For more than thirty years, Medicare has been there when Australians need it. A sick child in the night, a pensioner with a persistent headache, a middle or working class family, we’ve all known we could get a doctor’s appointment and medicines when we need it.

But what exactly is the difference between Mr Turnbull’s plan and Bill Shorten’s plan for Medicare?

There are three big Medicare issues at stake this election. We break it down here:
– Who should pay for local doctors to see patients, and how much?
– Who should pay for medicines, and how much?
– And the big one: who should own Medicare — the Australian people, or big business?

The choice could not be clearer.

Paying for doctors’ visits

Bill Shorten and Labor believe people who go to the doctor shouldn’t have to pay at the time.

Mr Turnbull’s plan is for people who go to the doctor to pay more. Medicare would pay your doctor less over time, and you’d have to make up the $20 difference.

Labor says people pay tax to support Medicare, including the Medicare Levy, so there can be ‘bulk-billing’. That’s where Medicare pays your doctor directly and patients pay $0 for the visit. That means people go to the doctor when they need to, not just when they can afford to. It also controls health care costs, because doctor visits cost less than hospital visits, and help prevent disease.

The Liberals first wanted to make people pay directly, by making patients pay $7 at every doctor visit. That was called the ‘GP tax’. But the danger with that is people don’t go to the doctor when they should, making it more expensive for the taxpayer in the long run. Labor stopped that by voting against it in Parliament. (The Liberals tried again with a $5 payment and then with a cut to what doctors are paid for so-called ‘short consultations’ by $20 — both cuts Labor also defeated.)

So this time Malcolm Turnbull’s plan is a bit trickier. He will stop increasing how much Medicare pays doctors to keep up with inflation. That way, doctors will have to charge people more money to keep their practice running. We call it a ‘GP tax by stealth’ — but it’s even worse for patients. The doctors say it will end up costing $20 every time you go to the doctor.

Paying for medicines

Bill Shorten and Labor believe people who need medicine should get it regardless of whether they can afford it.

In Australia, we pay taxes to fund buying medicines for most of us. The Government decides how much to pay for medicines and bargains with the big companies that sell them. If they don’t agree to the price, the Government won’t pay, and that means companies have a reason to do a better deal. Medicines cost less overall, and when you need them, you can get them, even if it’s the day before payday, or you’re a pensioner. This is called the Pharmaceutical Benefits Scheme.

Mr Turnbull’s plan is to increase the price of medicines by up to $5 for each prescription — the letter the doctor gives you saying what medicine to get from the pharmacist — so that medicine costs more. He also wants to increase how much patients have to spend on medicines before they can receive extra support with their costs — by putting up the thresholds for the safety net.

Labor says the current system works. The Liberals say families have to pay more for health care.

With their plan to charge more for GP visits and for medicines, an average Australian family with two healthy kids would pay more than $400 extra every year in essential healthcare costs. A typical pensioner couple would pay $500 more.

Who owns Medicare

Bill Shorten and Labor believe Medicare should be owned by the Australian people. Always.

Mr Turnbull’s plan is to privatise Medicare. Medicare would be owned and run like a bank or a private health insurer, where the ultimate goal is profit.

Labor says the current system works. Doctors get paid the right amount and on time, patients get paid back when they have a bill, and all the sensitive patient information is safe and in Australia. We can all rely on our Medicare card when we need it.

The Liberals think that Medicare should be privatised. The part of Medicare that manages things like how the doctor sends bills to the Government and how the Government pays money back to patients is a bit like a credit card company. So since 2014, the Liberals have had a team in the Health Department getting ready to privatise that.

We could lose the confidentiality of personal patient records , and put the jobs of 1,400 workers at risk. Contracted providers would be motivated by profit, not the needs of patients. Worst of all, it is the first step towards privatising the whole Medicare system.

So what does it all mean?

Medicare has made us healthier and given us better lives. Medicare has also been a really smart economic policy. Australia has one of the most efficient health systems in the world. We invest around 9 per cent of Gross Domestic Product in health care.

We do not want to replicate the American system. The US, one of the only industrialised countries not to provide universal health, spends around 18 per cent of its GDP on health care. Despite spending almost double what Australia spends, the US is flagging dramatically when it comes to life expectancy and overall wellness.

The Liberals and the Nationals always opposed Medicare. They always try to wreck Medicare and now they want to sell Medicare.

Labor will never privatise Medicare. Labor created Medicare, Labor stands up for Medicare — under Labor, Medicare will always stay in public hands.

About Michael Cooney

Michael Cooney

Michael is a former Executive Director of the Chifley Research Centre. He was previously Speechwriter to Prime Minister the Hon Julia Gillard MP, Senior Adviser at the HR Coombs Policy Forum, Crawford School of Public Policy at the Australian National University, and was Principal Policy Advisor to Federal Labor Leaders Kim Beazley and Mark Latham.

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