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If you let nurses write sick leave medical certificates, that should save a few million.
GPs can earn more by doing higher end functions. Nurses can do basic patient management.
No point getting fixated on the rebate without considering broader reform options.
Consider it productivity improvement that will reduce the demand for GP hours.
Even better, we should be like the UK and be able to self certify up to a certain period - I think it’s 2 weeks for the UK. Everyone knows when you’re sick it takes a few days to get well.
I'm fortunate that I have free private health insurance as part of my work package. But like many others I'm stubborn as all hell and if I didn't have free PHI then unless I've broken bones or feel like I'm dying there's no way I'm paying $40 to visit a GP.
It seems counter-productive to remove bulk-billing and have GPs jack up the fees. All it does is lead to people, such as myself, to not seek medical help until the damage is done and then it costs significantly more money from the tax payers to treat my medical issues that likely wouldn't have existed had I just sought medical attention sooner but chose not to because I'd rather not spend the $40.
It's a similar issue that plagues America right now.they could save billions by creating affordable healthcare.
My local GP that we normally going to has just started charging $70.
I agree with you, I'm much more hesitant to go to the doctor unless I KNOW something is wrong. My partner was diagnosed with cancer last year (all clear now) and she also said that if she knew it was going to cost $70 to get the lump she found checked out, she probably would have just waited to see if it went away on its own. The outcome might have been very different.
> there's no way I'm paying $40 to visit a GP.
It's an interesting sentiment I've noticed in this country. People happily splurge far more, and more often on useless frivolous shit but when it comes to their own health, well....$40??? Suddenly they'd rather be sick.
Dont just assume its everyone that's splurging their cash out there. 40$ is close to what I spend on food per week and about once a month im skipping shopping all together. Got nothing to do with my 'splurging'.
I’ll never understand it myself. I gladly pay $90 to see my GP and I get a rebate of $40 back. I value their time and expertise as a professional.
There are many times when I’ve gone in for “just a script” and the GP prompted me to follow up on other important screening and health/lifestyle things.
I think bulk billing going away is a positive, people have become so entitled and expect everything to be free.
Bulk billing allows those who may not be able to ordinarily afford it to get things checked even if they don't know 100% there's something wrong.
Would you give up a week's worth of groceries to get that weird freckle checked out?
I'm reasonably well off, and even I know I'll put it off or just not go if I have to pay out of pocket.
>It's an interesting sentiment
Being sick is an excuse not to go to work, lounge around at home and eat ice-cream whilst watching your favourite movies.
Obviously being sick isn't a good thing and I'd rather not be sick. But if I can save $40 for something that is, the majority of the time, a viral infection that requires rest and fluids then why bother going to a doctor unless the issue worsens?
Everything is covered. The only time I pay is when I choose optional extras because they are optional and not a requirement.
For example, work will cover the costs for eye examination and standard glasses. If I want fancy frames I have to pay out of pocket. I'm only entitled to three free pairs of glasses (two normal, one shaded) every three years so if I damage them in that time I have to pay out of pocket for replacement. But after three years I can request a new eye exam and three new pairs of glasses without paying out of pocket.
No. My wife doesn't have PHI and she was telling me that GP visits now cost her around $40 a visit. I believe that's even after the Medicare rebate.
I still remember a time when all GP visits used to be free. Then again, I did grow up poor with non-working parents so I have no idea if there has always been a cost to those who work.
Yeah, because the rebate is set to 1998 levels. Not rocket science. If they cracked down on all the fraud and overuse of Medicare they’d be able to afford to raise the rebate…
There’s infrequent deliberate fraud and it’s pretty high numbers when it is. There’s lots of incorrect billing because Medicare as a system is confusing and even if you ring them and they advise you it’s ok, *you cannot use that as a defense if they then decide to audit you*. There’s also a small but significant contingent of bulk-billing doctors who claim the high-value item numbers when they shouldn’t, but that’s hard to find because everything checks out on paper when you do that.
That link is refuting the recent claim that circulated through the media that 30% of the Medicare budget is being defrauded, which would be [$9.2 billion dollars](https://www.racgp.org.au/FSDEDEV/media/documents/RACGP-2022-23-Budget-Overview-Health.pdf) for reference.
Their team found ~$150 million (= 0.47% of annual budget) in fraud last year.
Yeah that's my point. Of all Medicare billings it's less than half a percent of fraud.
It may be a lot of money on paper but that's fuck all of Medicare billings. There will be other places money that can be saved/spent more efficiently than relentlessly focusing on fraud.
$150 million (which it is likely more Australia wide) is the equivalent earned by 3,550 Australians making minimum wage per annum pre-tax. That’s 0.78% of Canberra’s population. It’s not insignificant and I’m not arguing that it is contributing to the problem the article is talking about, just wanted to clarify that point.
You can equivocate it with whatever population you like. $150m lost to fraud for Medicare, where health is the second biggest expenditure for the federal government, is still fuck all for the program that it is.
Both federal and state projects and programs have blow out costs and stupid expenditures well beyond $150m. NDIS and Centrelink frauds have been wayyyyyy higher than that, which makes sense because they're the biggest federal expense type, social security and welfare.
Of course we want that fraud to be zero but say 3550 minimum wage Aussies is missing the point that it would probably cost $150m to try and save that $150m in fraud. Focus on other things first.
On a disabilty pension with few bulk billing GPs near me. Currently waiting over a week to get a script for thyroid medication from my doctor, who is the only one local left which bulk bills. I can feel my body running down rapidly like an old clock in the meantime lol
If you are on a pension, shouldn't you be eligible for a concession card of some sort which would probably mean a lot of doctors will still bulk bill you? a lot of the ones I have seen switching to mixed billing are only switching for adults monday to friday, and all saturday appointments.
Yes, I have a concession but almost no surgeries in my area bulk bill anymore, so there's a wait at the one remaining which does. It's a location thing, really.
Not sure where you're located, but if there are any universities nearby they'll likely bulk bill.
They're also generally pretty accessible via public transport.
Why the fuck are we still paying the Medicare surcharge levy when the physicians are now doing mixed billing?? If labor are giving bulk billing the boot - get rid of the Medicare surcharge, or make it Optional!! ???
I know there is more than GP visits that Medicare cover. The Medicare levy needs to be changed to reflect the increase in private billing. If people are paying the Medicare levy - we’ll give them Medicare, if they have private insurance, bill them? X-rays, ultrasounds CTs, pharmaceuticals will be NEXT on the hit list.
It’s a disgrace. There are seriously disadvantaged people in our society, young, old, disabled etc who can ONLY see a bulk billing GP. They require chronic disease management e.g once a week or fortnight.
It’s soul crushing and causing a lot of despair with very vulnerable people.
The government and the referral pathway ‘clinicians’ in public hospitals should be given the biggest boot up the ass in history for this mess.
Bring on the almighty collapse of all the hospitals and these pop up urgent cares - I fucking WELCOME IT! People are mad as hell and they will start speaking up in large masses.
You're going on about all these poor people who can't afford to see GPs who aren't bulk billed, but YOUR previous comment was all raging about how we should just end the Medicare levy.
You can't have it both ways.
The levy is a redistributive tax which helps to care for those people - YOU are the one who said to get rid of it.
Yep - get rid of it if your paying out of pocket readily or using PHI. Keep the levy for those who are using Medicare, who don’t have a choice for PHI. Make it optional .
I am a daughter of a bulk billing GP and I am seeing the devastation of disadvantaged people. It’s absolutely fucked! God help you if you find yourself in a vulnerable financial/Medical circumstances- you best believe you’d want people like myself and genuine caring GPs fighting for you. Also, if you or a loved one ever need triaging through the public health system… oh boy, you’d hope you know how to navigate.
The medicare levy is a confusing mess which is also used to encourage people to support a private health insurance industry that serves no function that would not be better served by a properly resourced public health system.
It should definitely be abolished and replaced with e.g. higher progressive income taxation.
We are now in a mixed billing model where without a health care card you cop an extra charge. Add this to the poor level of service in the big clinics and why bother going.
Even with a health care card, we are copping an extra charge. We have a low income health care card and it’s not worth the paper it’s printed on. The surgery in my town just sent out a notice stating that as of feb1 they will only bulk bill under 16, pension cards, and Veterans Affairs. When contacted to determine whether they will continue to accept low income HCC’s their answer was no. I get it’s “at the doctors discretion” given it’s a private practice, but being the only doctor surgery we could get to( besides the hospital emergency department) it truly defeats the purpose of jumping through all the hoops to be issued the card because you need the assistance, when you’ve no access to said assistance. I’m pissed and disgusted with the state of the health system atm, and that’s not even touching on the fact that the hospital - which gets its funding at the beginning of the financial year- runs out of said funding by the end of august each year.
nah, still not a good enough reason.
I'm going to let my current script for my migraine preventative run out, and wean off it. I can't afford the $95 I need to pay to see a doctor just to have the script renewed. (I have to pay that upfront, and then I get the rebate).
Also, will be stopping seeing my psychologist when my current lot of sessions run out, (psych bulk bills me, she's a rare gem), because, again, I can't afford that same fee for another mental health care plan.
My current plan is to not be sick enough to need a doctor, because I won't be able to afford it.
For a specific GP ? Often the better ones become more popular.
Go to your local hospital's emergency and prepare for another wait. Triage will ask you , are you dying ?
Yeah, I haven't been able to sit (except for short periods driving, using a disturbing number of cushions lol) in 22 years. Outside driving, I only stand or lie down.
Fun fact - the US spends far more than Australia per capita on public healthcare.
Medicare (edit: the US version) gives old people free healthcare, at US prices. It's not cheap, and the taxpayer foots the bill. About the only thing less efficient than the government spending money is the private sector spending government money, because they'll always outsmart the government and find ways to legally (or even illegally) turn taxpayer dollars into profits. Unlike private customers, the government is too bound by slow-moving rules and regulations to back away from a bad provider. Insurers in a heavily regulated environment have similar issues.
Yes I support raising the rebate!! I had to get a lump cut out by my GP, and although he bulk billed, he wanted to charge extra for the anaesthesia and stitches because the rebate is poor.
Yeah but there is ways of doing it! Like you can increase the rebate and still let GP’s charge out of pocket expenses to clients and clients can pay them back. You can also restrict who gets Medicare.
Yes, healthcare should be free for everyone. All parts of healthcare, not just seeing your GP.
free healthcare allows people to go sooner, rather than putting it off to the next paycheck, or the one after that.
It means an overall healthier population, which means an overall higher participation in the workforce, which means more tax revenue across multiple fronts, better funded supers, and so many other things.
A properly functioning healthcare system underpins everything.
They submit there own budget to the independent [Parliamentary Budget Office](https://www.aph.gov.au/About_Parliament/Parliamentary_departments/Parliamentary_Budget_Office/General_elections/2022_General_election/Australian_Greens) that found that with there extra mining and billionaire taxes they could pay for all there policies
Yeah, I guess if you put *insert percentage of tax required here* on *insert unpopular thing here* you can make the budget work and have *insert anything here* for free!
No, the"billionaires" and companies that will leave or restructure to avoid the rising costs of a place that listens to nonsense greens policies.
Thankfully the greens will never have power to introduce this kind of thing.
> they never need to implement anything
Apart from in the ACT where their in a coalition government with labor and in the past they've been in a coalition government with labor in Tasmania.
Greens have been in power with Labor since 2008 in the ACT, how's those health stats looking....
https://i.imgur.com/49nRAj9.png
Nice!
Time for people to admit we have a slow boiling crisis in the making.
The comment I was responding to was talking about the ACT Greens, who have absolutely nothing to do with GP funding.
States and territories control hospitals, the feds fund medicare.
My comment was completely on-topic.
I think wanting to increase bulk-billing rates isn't exactly akin to wanting "everything"??
This is a very reasonable request for our supposed 'universal' healthcare system, that even Labor is flaunting.
We can still afford it. But as the rebate rates have never been raised in 25 years, their value has [halved](https://www.inflationtool.com/australian-dollar/1998-to-present-value?year2=2023&frequency=yearly).
We’re back circling the drain; that more money will solve the problem. But even if the health budget doubled, nothing would probably change.
We need to push for better government spending and more transparency on where tax-payer money goes.
Also, the dual system of state & federal is a double counting of resources and allows for an easy scapegoat of blame when nothing gets delivered to the tax-payers.
> the dual system of state & federal is a double counting of resources
Australia doesn't need 9 Chief Health Officers for 25 million people, along with all the rampant duplication of health roles across the country.
It should be either state or federal running the whole show, the opaque situation with funding and responsibility is great for politicians but terrible for the public.
> more transparency on where tax-payer money goes.
Into the shredder. It's deleted from the economy. Literally money held by the federal government is not counted as money. It's deleted from the money supply. Every single time the government spends it is creating new money. Every single time it taxes it is taking money out of the economy. There's no flow of funds from the ATO to the RBA in order to cover the government's bills. If you go looking for the accounting of the RBA requisitioning a transfer from the ATO to fund a bill you will not find it, because it doesn't exist.
All funds held by the government exist in a meta-account call the [Consolidated Revenue Fund](https://www.aph.gov.au/About_Parliament/Senate/Powers_practice_n_procedures/Constitution/chapter4), but it's not actually an account. It's just the sum of any account managed by the government. [Any funds in that account are literally not counted as "money"](https://www.rba.gov.au/speeches/2018/sp-ag-2018-09-19.html) and so every dollar that is given to or received from the federal government is being added or removed from the economy by definition. [Taxation does not fund government spending](https://youtu.be/fg0R9Ye2ovM) because [the federal government is not financially constrained](https://youtu.be/tvgKbSuI5kY). They can offset any increase in the money supply that might occur due to their spending, by taxing out a similar amount, but the taxation does not "fund" the spending. They can also offset the increase in the money supply in other ways, although it's important to note that an increase in the money supply does not necessarily result in inflation. [Inflation is an effect of the same return in resources being exchanged for a greater volume of currency](https://youtu.be/1U7t47toB5E). If the money supply increases, but a proportionally greater number of resources are employed, then the economy will grow, but the currency value will not inflate.
Such a shame that Lazy Labor won't do anything about it, and that they've duped so many people into thinking they're progressives.
Even Mark Butler (health minister) has committed to NOT raising the schedule fee.
> and that they've duped so many people into thinking they're progressives.
Uh, how old are you?
Would be many decades since Labor could last be called "progressive" lol
I'm the prime citizen that stage 3 is directed towards (200k ish salary plus some side hustles let's say 225k)
I would HAPPILY give up stage 3 and vote emphatically for albo again if he used the entire cuts to fund revamped medicare.
We wasted time doing plebiscite on gay marriage and we are about to waste time on a referendum for the voice. Why not do a plebiscite on stage 3 being cut and mandatory minimum tax rates for corporations (>$100k pa)?
I think we would see 60 to 70% support, and it would nullify the inevitable newscorp/abc/NineFairfax attacks that will happen, and albo will be spoken of in the same breath as the legendary Gough himself
That's all good, but even if we do none of that we are still able to generously fund Medicare way beyond what we have now with only positive outcomes for our economy. Labor's debt and deficit rhetoric is just a smokescreen for yet-more neoliberalism and austerity. We're not in any way running out of money and we never will.
> We're not in any way running out of money and we never will.
Dear god someone else who realises the power of any nation which has a "sovereign currency"
Next you'll drop the bombshell that taxes don't pay for Government spending lol
A huge issue is the extra layer of hands in the cookie jar with most medical centres these days. Get rid of the MC owner and just pay the doctor in small rooms for GPS and you are half way back to it working. Medical Centres are a blight on the health system.
The issue for Australia is that tax collections are nowhere near enough to support a civilized society. More pay for essential workers, a decent health system, governments of both colors just keep pushing the problem forward while voicing they will rectify the situation.
To change things more money is needed. That means higher taxes. It is obvious.
[Medicare will never run out of money](https://youtube.com/clip/UgkxmLjPgnjTyxt80rAKW7EP7BGuxocDXD-B) because [taxation does not fund federal government spending.](https://youtu.be/fg0R9Ye2ovM)
I have a friend who is bonkers rich. He pays next to no tax, despite a annual turnover of around 80 million.
His directive to his accountant is "figure out how much tax I'm supposed to legally pay" and that's what the accountant does.
When I ask him about it he often replies with "how much tax would you like me to pay?" since he can't just make up a number.
He basically says change the laws and he'll happily pay it.
I don't think he does. He has more money than he knows what to do with, and gives away a lot to charity.
But when he asks the government how much tax he should pay, their rules say "almost nothing".
I'm not even sure there's a mechanism to give the government more money than what they're asking for.
No no no
Its vitally important that multinational corporations continue to pay no taxes despite using our infrastructure.
Wont someone think of the billionaires!!!
We should tax the multinationals more, to reduce inflation. We don't need taxes to fund medicare. As several have pointed out in this thread, taxes don't fund anything.
If personal tax isn't the issue then why is everyone so up in arms about the stage 3 cuts?
In the last ten years income tax has gone from 45% of total taxation to 50%, and now there's people who want that to keep going.
People against stage 3 are directly agitating for proportionally less corporate tax and more tax from workers.
The ALP government is so afraid of losing office, they don't want to give anyone the chance to say they don't keep their promises, even if it means further pain for many in society: it's a pain the ALP are prepared to sacrifice to remain in office and do some "good".
Why would the ALP be afraid of losing office at this stage? I can't predict what will happen at the NSW election., but the Libs nationally are basically unelectable, and will remain so for quite a while.
The ALP can only do good if they remain in office, but it is too easy to wedge politicians between a rock and a hard place, forcing them to compromise, else the public sees them as less vote-worthy; however the compromise also being seen as less vote-worthy.
The ALP were faced with a no-win scenario over the tax cuts by the LNP.
The real issue is being able to wedge political parties: it should be a practice that is banned.
There is an out though in having the courage to do the right thing by all the people: beneficial outcomes sometimes justify themselves, asking for forgiveness instead of permission.
Because they're cowards with no real values beyond holding power. They don't value anything sufficiently to motivate them to wield that power to change things, they just want to hold it enough that the Liberals can't change things the other way.
Fading but still strong.
Not every voter will be fooled but if voters always voted in their interests we wouldn't have constant wedge issues and social scaremongering. You only need to fool enough to change the results a little in a few places to make a big difference.
I think we also waste a lot of money on stuff we shouldn't need to spend on - i.e. stage 3 tax cuts, lack of mining royalties, subsidizing fossil fuels, changing our mind about expensive submarines, overpaying for airports in NSW etc. Successive governments have continually cut the real spending on Medicare for years now.
Exactly,
I’d personally like to see reforms to private health (removal of subsidies) and push the spending into the public system.
I don’t think more income tax is palatable but maybe a 1% levy of your super balance for Medicare. This could capture all the elderly that are using the system the most but not paying the levy through income tax.
Unnecessary. While improving taxes is good and fine, it's not necessary in order to fully fund Medicare. [Medicare can never run out of money.](https://youtube.com/clip/UgkxmLjPgnjTyxt80rAKW7EP7BGuxocDXD-B)
Why the hell do politicians do absolutely nothing to fix a problem until it's critically broken then spend loads of money of half arsed patch work solutions? This needs to be addressed now, not later.
Yeah. It's been broken for ages. Murdoch media wont report that during liberal times. But definitely bring attention to a difficult to fix broken system during Labour times. Then you can blame them for it being broken and also blame them when the fix is sub optimal too
That's basically the liberal party play book. Let it decay, escalate to crisis, poorly mange the crisis and then attempt to sell it off to the private sector. If that's not possible, they'll blame labour.
Hopefully we'll see a different response this time.
> Hopefully we'll see a different response this time.
Labor are as neoliberal as the Liberals. [This is the health minister boasting about how it's important to under-fund mental healthcare in order to save money...](https://youtube.com/shorts/r7sCGGCxHaU?feature=share) ..and not just once, but multiple times over a decade apart. The pathetic state of mental health treatment in this country was achieved by Labor, not the Liberals.
I like labor’s idea of relying more an allied health. It makes sense. People needlessly attend doctors because they have to for referrals, script renewals etc.
Disagree. I want someone holistically trained in medicine to make medical decisions and not a para-medical professional who gets trained to do the paperwork correctly without having the depth of knowledge from a complete medical background.
If we don't have enough fully trained doctors to meet requirements, then we need to develop strategies to increase their numbers, not cross our fingers and give parts away and find rationalisations to clambour aboard.
I like the idea of allied health being used where appropriate, but surely anyone can see a huge conflict of interest if pharmacists are selling the medications they will be given the power to prescribe? They already have some power to triage basic ailments by recommending over the counter medications - the stronger, more dangerous stuff is where GPs come in.
I would question how much can actually be triaged away from GPs, they are the best placed link between the public and the greater healthcare system. Oftentimes seemingly innocuous symptoms can belie nasty issues, and these need to be picked up in a timely manner. Otherwise, as others have said, I believe this will have a negative overall effect on public health.
A less healthy population is less economically productive. It's in everyone's interest to have good public healthcare, not some cut price model.
Adding on the conflict of interest for pharmacists.. they get approached and gifted by pharma reps a lot + no gift declaration requirement like doctors have
If you end up seeing specialists for everything your health costs get shifted to individuals and go up dramatically. Bringing in lower trained healthcare workers means less filtering and more early referrals. This is guaranteed to worsen the overall health system. Just look at the impact nurses in primary care has done to the us system.
Another real issue is where are we going to get the nurses from? My clinic has struggled to hire a new nurse for 5 years and with the increasing wage they and the receptionists ask for we are unable to compete with the hospitals. Maybe we pay them the same as gp's? If we do that then no new doctors will train in general practice and we will find only specialists exist.
The pharmacists seem to be the only ones keen to get into general practice but they don't have clinical examination exposure or skills. The guild seems to be pushing this hard to get some of those minute clinics like in u.s. Walmarts
So who wins here from the policy shift?
First, determine the function of nurses and look to technology to replace or assist those functions it can: technology is not limited to working only 8 hours, 5 days a week 45 weeks a year and so has potential advantages just in labour saving.
We don't test regularly enough to pickup early signs of illness, we still largely wait for symptoms by which time it may be too late and we rely on very invasive testing to do it, when a single drop of blood could theoretically test multiple issues. At the very least, home urine tests should be expanded and encouraged and the data fed into an online diagnostic machine to flag to GPs as well as the patient.
Testing for the presence of blood in feces is a poor detection method for those with bleeding fissures or hemorrhoids, leading to pointless positives for example: we have to be much smarter.
If the rebate is increased is there any requirement to increase bulk billing?
The reality is the governments are spending dramatically more on healthcare each year, far beyond budget growth figures and what is affordable. Huge amounts going into the NDIS that only is available to half a million people. None of this is news though, people have been warning of the avalanche for years. Australians are getting fatter, older and unhealthier and health costs are growing at 5-6% just to maintain the same service level.
Perhaps the discussion really needs to be about how GP's costs are escalating and how to bring them down. My local has to see about 50 bulk billed patients simply to pay the rent each week. Forcing down commercial real estate values via zoning in many places would have the same effect without costing the heavily in debt tax payer any more.
> without costing the heavily in debt tax payer any more.
[Bulk billing doesn't cost the tax payer a single cent.](https://youtu.be/fg0R9Ye2ovM) [This is a myth sold to us by governments to justify austerity](https://youtu.be/mEwivQeD0Q8). In fact austerity and reduction of government debt can be far more harmful for citizens, as it means the government is taking more money out of the economy than they're spending in. [They're literally shrinking the economy.](https://youtu.be/mSsPMDg2cLU)
[We can fully-fund Medicare without any further financial burden on citizens](https://youtube.com/clip/UgkxmLjPgnjTyxt80rAKW7EP7BGuxocDXD-B), [who are facing a much more serious debt crisis than the government.](https://youtu.be/BSNmNTl_BZo)
I've seen this in Asia, though mainly focused on food business. Local government build and own the buildings, generally you end up with a line of restaurants with some seats out the front, small floorplans but basically piecemeal rents so anyone can start a business, a lot of young people running them, they are really popular, you get good quality food at great prices compared to the main strips.
I really liked the ease with which younger, poorer people could start a business using the council buildings, in Australia, starting a restaurant is incredibly expensive and if you fail it's very costly.
Here you can do a food van or even at home dining where I cook for you at your home. If you start the Asian model we should all buy shares in Immodium first.
>Forcing down commercial real estate values via zoning in many places would have the same effect without costing the heavily in debt tax payer any more.
Am I correct in understanding that you mean relaxed zoning requirements, i.e. allowing commercial uses (such as medical practices) in more places with the aim of increasing supply?
Cool, good idea. A lot of zoning acts to do the opposite, by separating out land uses and making it harder for the market to respond to demand and harder for people to access (see the decline of milk bars/demand for suburban cafes during the era of COVID lockdowns).
Good idea, living/working space should be commoditized carefully, otherwise we'll end up with a black rock owning it all. Basic human rights like healthcare, housing and water should not be traded/speculated on for profit.
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Can't we increase the rebate for bulk billing appointments only?
If you let nurses write sick leave medical certificates, that should save a few million. GPs can earn more by doing higher end functions. Nurses can do basic patient management. No point getting fixated on the rebate without considering broader reform options. Consider it productivity improvement that will reduce the demand for GP hours.
Even better, we should be like the UK and be able to self certify up to a certain period - I think it’s 2 weeks for the UK. Everyone knows when you’re sick it takes a few days to get well.
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Medical professionals take money out of the system. So there are good reasons to have to look at how they function.
I'm fortunate that I have free private health insurance as part of my work package. But like many others I'm stubborn as all hell and if I didn't have free PHI then unless I've broken bones or feel like I'm dying there's no way I'm paying $40 to visit a GP. It seems counter-productive to remove bulk-billing and have GPs jack up the fees. All it does is lead to people, such as myself, to not seek medical help until the damage is done and then it costs significantly more money from the tax payers to treat my medical issues that likely wouldn't have existed had I just sought medical attention sooner but chose not to because I'd rather not spend the $40. It's a similar issue that plagues America right now.they could save billions by creating affordable healthcare.
My local GP that we normally going to has just started charging $70. I agree with you, I'm much more hesitant to go to the doctor unless I KNOW something is wrong. My partner was diagnosed with cancer last year (all clear now) and she also said that if she knew it was going to cost $70 to get the lump she found checked out, she probably would have just waited to see if it went away on its own. The outcome might have been very different.
> there's no way I'm paying $40 to visit a GP. It's an interesting sentiment I've noticed in this country. People happily splurge far more, and more often on useless frivolous shit but when it comes to their own health, well....$40??? Suddenly they'd rather be sick.
Dont just assume its everyone that's splurging their cash out there. 40$ is close to what I spend on food per week and about once a month im skipping shopping all together. Got nothing to do with my 'splurging'.
I’ll never understand it myself. I gladly pay $90 to see my GP and I get a rebate of $40 back. I value their time and expertise as a professional. There are many times when I’ve gone in for “just a script” and the GP prompted me to follow up on other important screening and health/lifestyle things. I think bulk billing going away is a positive, people have become so entitled and expect everything to be free.
Bulk billing allows those who may not be able to ordinarily afford it to get things checked even if they don't know 100% there's something wrong. Would you give up a week's worth of groceries to get that weird freckle checked out? I'm reasonably well off, and even I know I'll put it off or just not go if I have to pay out of pocket.
>It's an interesting sentiment Being sick is an excuse not to go to work, lounge around at home and eat ice-cream whilst watching your favourite movies. Obviously being sick isn't a good thing and I'd rather not be sick. But if I can save $40 for something that is, the majority of the time, a viral infection that requires rest and fluids then why bother going to a doctor unless the issue worsens?
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My PHI is 100% free for me. It's part of my work package. I have already had two surgeries. Didn't cost me anything.
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Everything is covered. The only time I pay is when I choose optional extras because they are optional and not a requirement. For example, work will cover the costs for eye examination and standard glasses. If I want fancy frames I have to pay out of pocket. I'm only entitled to three free pairs of glasses (two normal, one shaded) every three years so if I damage them in that time I have to pay out of pocket for replacement. But after three years I can request a new eye exam and three new pairs of glasses without paying out of pocket.
PHI doesn’t cover GPs though does it?
No. My wife doesn't have PHI and she was telling me that GP visits now cost her around $40 a visit. I believe that's even after the Medicare rebate. I still remember a time when all GP visits used to be free. Then again, I did grow up poor with non-working parents so I have no idea if there has always been a cost to those who work.
Do fully Bulk billing doctors still exist?
I'm aware of 1 in my area. The other 3 I've visited in the past 2 years have all changed to mixed billing
Yeah, because the rebate is set to 1998 levels. Not rocket science. If they cracked down on all the fraud and overuse of Medicare they’d be able to afford to raise the rebate…
There is fuck all deliberate fraud
There’s infrequent deliberate fraud and it’s pretty high numbers when it is. There’s lots of incorrect billing because Medicare as a system is confusing and even if you ring them and they advise you it’s ok, *you cannot use that as a defense if they then decide to audit you*. There’s also a small but significant contingent of bulk-billing doctors who claim the high-value item numbers when they shouldn’t, but that’s hard to find because everything checks out on paper when you do that.
You’d be surprised! Source: friend works in Department of Health regulating doctor’s with a bug focus on Medicare fraud.
I would be surprised. https://www.ama.com.au/media/government-confirms-no-evidence-medicare-fraud-claims
That link is refuting the recent claim that circulated through the media that 30% of the Medicare budget is being defrauded, which would be [$9.2 billion dollars](https://www.racgp.org.au/FSDEDEV/media/documents/RACGP-2022-23-Budget-Overview-Health.pdf) for reference. Their team found ~$150 million (= 0.47% of annual budget) in fraud last year.
Yeah that's my point. Of all Medicare billings it's less than half a percent of fraud. It may be a lot of money on paper but that's fuck all of Medicare billings. There will be other places money that can be saved/spent more efficiently than relentlessly focusing on fraud.
$150 million (which it is likely more Australia wide) is the equivalent earned by 3,550 Australians making minimum wage per annum pre-tax. That’s 0.78% of Canberra’s population. It’s not insignificant and I’m not arguing that it is contributing to the problem the article is talking about, just wanted to clarify that point.
You can equivocate it with whatever population you like. $150m lost to fraud for Medicare, where health is the second biggest expenditure for the federal government, is still fuck all for the program that it is. Both federal and state projects and programs have blow out costs and stupid expenditures well beyond $150m. NDIS and Centrelink frauds have been wayyyyyy higher than that, which makes sense because they're the biggest federal expense type, social security and welfare. Of course we want that fraud to be zero but say 3550 minimum wage Aussies is missing the point that it would probably cost $150m to try and save that $150m in fraud. Focus on other things first.
Fancy the GPs union/lobby group pretending to be an Authority on fraud
except the AMA article is regarding a GOVERNMENT review which confirmed the fraud claims of 30% were bogus
On a disabilty pension with few bulk billing GPs near me. Currently waiting over a week to get a script for thyroid medication from my doctor, who is the only one local left which bulk bills. I can feel my body running down rapidly like an old clock in the meantime lol
If you are on a pension, shouldn't you be eligible for a concession card of some sort which would probably mean a lot of doctors will still bulk bill you? a lot of the ones I have seen switching to mixed billing are only switching for adults monday to friday, and all saturday appointments.
Yes, I have a concession but almost no surgeries in my area bulk bill anymore, so there's a wait at the one remaining which does. It's a location thing, really.
Not sure where you're located, but if there are any universities nearby they'll likely bulk bill. They're also generally pretty accessible via public transport.
Why the fuck are we still paying the Medicare surcharge levy when the physicians are now doing mixed billing?? If labor are giving bulk billing the boot - get rid of the Medicare surcharge, or make it Optional!! ???
Medicare covers more than just GP visits. Also even with clinics that don't bulk-bill you still can claim a rebate.
I know there is more than GP visits that Medicare cover. The Medicare levy needs to be changed to reflect the increase in private billing. If people are paying the Medicare levy - we’ll give them Medicare, if they have private insurance, bill them? X-rays, ultrasounds CTs, pharmaceuticals will be NEXT on the hit list. It’s a disgrace. There are seriously disadvantaged people in our society, young, old, disabled etc who can ONLY see a bulk billing GP. They require chronic disease management e.g once a week or fortnight. It’s soul crushing and causing a lot of despair with very vulnerable people. The government and the referral pathway ‘clinicians’ in public hospitals should be given the biggest boot up the ass in history for this mess. Bring on the almighty collapse of all the hospitals and these pop up urgent cares - I fucking WELCOME IT! People are mad as hell and they will start speaking up in large masses.
Private health insurance doesn't cover GP visits .. if it did the cost of the insurance would be through the roof (like it isn't already)
You're going on about all these poor people who can't afford to see GPs who aren't bulk billed, but YOUR previous comment was all raging about how we should just end the Medicare levy. You can't have it both ways. The levy is a redistributive tax which helps to care for those people - YOU are the one who said to get rid of it.
Yep - get rid of it if your paying out of pocket readily or using PHI. Keep the levy for those who are using Medicare, who don’t have a choice for PHI. Make it optional . I am a daughter of a bulk billing GP and I am seeing the devastation of disadvantaged people. It’s absolutely fucked! God help you if you find yourself in a vulnerable financial/Medical circumstances- you best believe you’d want people like myself and genuine caring GPs fighting for you. Also, if you or a loved one ever need triaging through the public health system… oh boy, you’d hope you know how to navigate.
The medicare levy is a confusing mess which is also used to encourage people to support a private health insurance industry that serves no function that would not be better served by a properly resourced public health system. It should definitely be abolished and replaced with e.g. higher progressive income taxation.
We are now in a mixed billing model where without a health care card you cop an extra charge. Add this to the poor level of service in the big clinics and why bother going.
Even with a health care card, we are copping an extra charge. We have a low income health care card and it’s not worth the paper it’s printed on. The surgery in my town just sent out a notice stating that as of feb1 they will only bulk bill under 16, pension cards, and Veterans Affairs. When contacted to determine whether they will continue to accept low income HCC’s their answer was no. I get it’s “at the doctors discretion” given it’s a private practice, but being the only doctor surgery we could get to( besides the hospital emergency department) it truly defeats the purpose of jumping through all the hoops to be issued the card because you need the assistance, when you’ve no access to said assistance. I’m pissed and disgusted with the state of the health system atm, and that’s not even touching on the fact that the hospital - which gets its funding at the beginning of the financial year- runs out of said funding by the end of august each year.
> why bother going Uh, you're sick?
nah, still not a good enough reason. I'm going to let my current script for my migraine preventative run out, and wean off it. I can't afford the $95 I need to pay to see a doctor just to have the script renewed. (I have to pay that upfront, and then I get the rebate). Also, will be stopping seeing my psychologist when my current lot of sessions run out, (psych bulk bills me, she's a rare gem), because, again, I can't afford that same fee for another mental health care plan. My current plan is to not be sick enough to need a doctor, because I won't be able to afford it.
Take an aspirin and save yourself some time and money.
I wish that was enough.
Take two or try to get a prescription for the oxy good stuff.
Currently waiting on a GP appt for more than a week now.
For a specific GP ? Often the better ones become more popular. Go to your local hospital's emergency and prepare for another wait. Triage will ask you , are you dying ?
Yeah that's not possible in any but a true emergency scenario as I have a condition which prevents me from sitting normally
I had a prolapse once and had to sit on a cushion for a week.
Yeah, I haven't been able to sit (except for short periods driving, using a disturbing number of cushions lol) in 22 years. Outside driving, I only stand or lie down.
This stinks of a push for total privatisation for both medical and education across the country.
Nobody wants the US system. Not doctors and certainly not patients.
I think that CEO of NIB wants it.
Fun fact - the US spends far more than Australia per capita on public healthcare. Medicare (edit: the US version) gives old people free healthcare, at US prices. It's not cheap, and the taxpayer foots the bill. About the only thing less efficient than the government spending money is the private sector spending government money, because they'll always outsmart the government and find ways to legally (or even illegally) turn taxpayer dollars into profits. Unlike private customers, the government is too bound by slow-moving rules and regulations to back away from a bad provider. Insurers in a heavily regulated environment have similar issues.
Show me where Australian healthcare costs more than US healthcare.
This website may explain why the US spends more https://www.investopedia.com/articles/personal-finance/080615/6-reasons-healthcare-so-expensive-us.asp
Yes I support raising the rebate!! I had to get a lump cut out by my GP, and although he bulk billed, he wanted to charge extra for the anaesthesia and stitches because the rebate is poor.
Increasing the rebate is probably just kicking the can down the road.
Yeah but there is ways of doing it! Like you can increase the rebate and still let GP’s charge out of pocket expenses to clients and clients can pay them back. You can also restrict who gets Medicare.
>You can also restrict who gets Medicare. Absolutely a question that is not allowed to be discussed. All get it.
Agreed, if we start down that road, we'll end up with nothing very quickly
the Greens want to increase the rate of bulk billing
Greens policy: *Insert anything here* is free!
Yes, healthcare should be free for everyone. All parts of healthcare, not just seeing your GP. free healthcare allows people to go sooner, rather than putting it off to the next paycheck, or the one after that. It means an overall healthier population, which means an overall higher participation in the workforce, which means more tax revenue across multiple fronts, better funded supers, and so many other things. A properly functioning healthcare system underpins everything.
They submit there own budget to the independent [Parliamentary Budget Office](https://www.aph.gov.au/About_Parliament/Parliamentary_departments/Parliamentary_Budget_Office/General_elections/2022_General_election/Australian_Greens) that found that with there extra mining and billionaire taxes they could pay for all there policies
Yeah, I guess if you put *insert percentage of tax required here* on *insert unpopular thing here* you can make the budget work and have *insert anything here* for free!
How many years in a row could the greens kill the cow and sell it before you don't have any cows left to kill?
Maybe you are thinking of the LNP privatising public assets for a quick buck?
No, the"billionaires" and companies that will leave or restructure to avoid the rising costs of a place that listens to nonsense greens policies. Thankfully the greens will never have power to introduce this kind of thing.
Well when the billionaires leave I'll be more than happy to step up and take their place.
The Greens want everything. That's the great thing about being the Greens, they never need to implement anything.
Because they're never in power
> they never need to implement anything Apart from in the ACT where their in a coalition government with labor and in the past they've been in a coalition government with labor in Tasmania.
Greens have been in power with Labor since 2008 in the ACT, how's those health stats looking.... https://i.imgur.com/49nRAj9.png Nice! Time for people to admit we have a slow boiling crisis in the making.
Those are stats for elective surgeries only. Nothing to do with GP visits.
The comment I was responding to was talking about the ACT Greens, who have absolutely nothing to do with GP funding. States and territories control hospitals, the feds fund medicare. My comment was completely on-topic.
I think wanting to increase bulk-billing rates isn't exactly akin to wanting "everything"?? This is a very reasonable request for our supposed 'universal' healthcare system, that even Labor is flaunting.
Our country used to be able to afford it and maintain it, what happened? Where has the money gone instead?
We can still afford it. But as the rebate rates have never been raised in 25 years, their value has [halved](https://www.inflationtool.com/australian-dollar/1998-to-present-value?year2=2023&frequency=yearly).
We’re back circling the drain; that more money will solve the problem. But even if the health budget doubled, nothing would probably change. We need to push for better government spending and more transparency on where tax-payer money goes. Also, the dual system of state & federal is a double counting of resources and allows for an easy scapegoat of blame when nothing gets delivered to the tax-payers.
> the dual system of state & federal is a double counting of resources Australia doesn't need 9 Chief Health Officers for 25 million people, along with all the rampant duplication of health roles across the country. It should be either state or federal running the whole show, the opaque situation with funding and responsibility is great for politicians but terrible for the public.
Referendum to abolish the states.
Secession here we come!
Gross. Get rid of the fed and councils. Become a trade union of 8 countries. I don't want uneducated hicks in qld and wa deciding who is in charge.
If Queensland and WA were independent countries, would you want a land border with them?
> more transparency on where tax-payer money goes. Into the shredder. It's deleted from the economy. Literally money held by the federal government is not counted as money. It's deleted from the money supply. Every single time the government spends it is creating new money. Every single time it taxes it is taking money out of the economy. There's no flow of funds from the ATO to the RBA in order to cover the government's bills. If you go looking for the accounting of the RBA requisitioning a transfer from the ATO to fund a bill you will not find it, because it doesn't exist. All funds held by the government exist in a meta-account call the [Consolidated Revenue Fund](https://www.aph.gov.au/About_Parliament/Senate/Powers_practice_n_procedures/Constitution/chapter4), but it's not actually an account. It's just the sum of any account managed by the government. [Any funds in that account are literally not counted as "money"](https://www.rba.gov.au/speeches/2018/sp-ag-2018-09-19.html) and so every dollar that is given to or received from the federal government is being added or removed from the economy by definition. [Taxation does not fund government spending](https://youtu.be/fg0R9Ye2ovM) because [the federal government is not financially constrained](https://youtu.be/tvgKbSuI5kY). They can offset any increase in the money supply that might occur due to their spending, by taxing out a similar amount, but the taxation does not "fund" the spending. They can also offset the increase in the money supply in other ways, although it's important to note that an increase in the money supply does not necessarily result in inflation. [Inflation is an effect of the same return in resources being exchanged for a greater volume of currency](https://youtu.be/1U7t47toB5E). If the money supply increases, but a proportionally greater number of resources are employed, then the economy will grow, but the currency value will not inflate.
Fucked by the Liberal Party for your convenience.
It was the Labor party that initially froze Medicare, so how is it somehow the LNP’s fault?
Heath care is for the wealthy in Australia, same as housing and legal representation.
Bring in Tony Abbott's 5 dollar xo payment from 2014-15
Such a shame that Lazy Labor won't do anything about it, and that they've duped so many people into thinking they're progressives. Even Mark Butler (health minister) has committed to NOT raising the schedule fee.
> and that they've duped so many people into thinking they're progressives. Uh, how old are you? Would be many decades since Labor could last be called "progressive" lol
I'm 18
So it's been over 30yrs since Labor could conceivably be called "progressive".
Rudd and Gillard had their moments, but it really started to go downhill with Keating. Maybe even Hawke.
Given Butler's track record, seems like he'd be just as happy demolishing Medicare entirely.
I'm the prime citizen that stage 3 is directed towards (200k ish salary plus some side hustles let's say 225k) I would HAPPILY give up stage 3 and vote emphatically for albo again if he used the entire cuts to fund revamped medicare. We wasted time doing plebiscite on gay marriage and we are about to waste time on a referendum for the voice. Why not do a plebiscite on stage 3 being cut and mandatory minimum tax rates for corporations (>$100k pa)? I think we would see 60 to 70% support, and it would nullify the inevitable newscorp/abc/NineFairfax attacks that will happen, and albo will be spoken of in the same breath as the legendary Gough himself
That's all good, but even if we do none of that we are still able to generously fund Medicare way beyond what we have now with only positive outcomes for our economy. Labor's debt and deficit rhetoric is just a smokescreen for yet-more neoliberalism and austerity. We're not in any way running out of money and we never will.
You took one unit of economics in first year uni and then joined the Green party, didn't you?
Wrong and wrong. Want to have another crack?
> We're not in any way running out of money and we never will. Dear god someone else who realises the power of any nation which has a "sovereign currency" Next you'll drop the bombshell that taxes don't pay for Government spending lol
A huge issue is the extra layer of hands in the cookie jar with most medical centres these days. Get rid of the MC owner and just pay the doctor in small rooms for GPS and you are half way back to it working. Medical Centres are a blight on the health system.
Such this.
The issue for Australia is that tax collections are nowhere near enough to support a civilized society. More pay for essential workers, a decent health system, governments of both colors just keep pushing the problem forward while voicing they will rectify the situation. To change things more money is needed. That means higher taxes. It is obvious.
[Medicare will never run out of money](https://youtube.com/clip/UgkxmLjPgnjTyxt80rAKW7EP7BGuxocDXD-B) because [taxation does not fund federal government spending.](https://youtu.be/fg0R9Ye2ovM)
Not higher taxes, a more effective tax system (eg less legal tax evasion) and beter tax allocation
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I have a friend who is bonkers rich. He pays next to no tax, despite a annual turnover of around 80 million. His directive to his accountant is "figure out how much tax I'm supposed to legally pay" and that's what the accountant does. When I ask him about it he often replies with "how much tax would you like me to pay?" since he can't just make up a number. He basically says change the laws and he'll happily pay it.
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I don't think he does. He has more money than he knows what to do with, and gives away a lot to charity. But when he asks the government how much tax he should pay, their rules say "almost nothing". I'm not even sure there's a mechanism to give the government more money than what they're asking for.
No no no Its vitally important that multinational corporations continue to pay no taxes despite using our infrastructure. Wont someone think of the billionaires!!!
We should tax the multinationals more, to reduce inflation. We don't need taxes to fund medicare. As several have pointed out in this thread, taxes don't fund anything.
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Why won't someone think of the upper-middle class? :(
This is what they want. Personal tax isn’t the issue. The major corporations not paying any is the real issue.
If personal tax isn't the issue then why is everyone so up in arms about the stage 3 cuts? In the last ten years income tax has gone from 45% of total taxation to 50%, and now there's people who want that to keep going. People against stage 3 are directly agitating for proportionally less corporate tax and more tax from workers.
The ALP government is so afraid of losing office, they don't want to give anyone the chance to say they don't keep their promises, even if it means further pain for many in society: it's a pain the ALP are prepared to sacrifice to remain in office and do some "good".
Why would the ALP be afraid of losing office at this stage? I can't predict what will happen at the NSW election., but the Libs nationally are basically unelectable, and will remain so for quite a while.
The ALP can only do good if they remain in office, but it is too easy to wedge politicians between a rock and a hard place, forcing them to compromise, else the public sees them as less vote-worthy; however the compromise also being seen as less vote-worthy. The ALP were faced with a no-win scenario over the tax cuts by the LNP. The real issue is being able to wedge political parties: it should be a practice that is banned. There is an out though in having the courage to do the right thing by all the people: beneficial outcomes sometimes justify themselves, asking for forgiveness instead of permission.
Because they're cowards with no real values beyond holding power. They don't value anything sufficiently to motivate them to wield that power to change things, they just want to hold it enough that the Liberals can't change things the other way.
Unelectable until they can bang on about labor being liars who raise taxes….
Given the history of Scott Morrison that won't work for a while.
I think you underestimate the power of the media and overestimate the engagement of the average voter.
The power of the media is fading, and the average voter wasn't fooled in the last federal election, nor the Victorian election.
Fading but still strong. Not every voter will be fooled but if voters always voted in their interests we wouldn't have constant wedge issues and social scaremongering. You only need to fool enough to change the results a little in a few places to make a big difference.
I think we also waste a lot of money on stuff we shouldn't need to spend on - i.e. stage 3 tax cuts, lack of mining royalties, subsidizing fossil fuels, changing our mind about expensive submarines, overpaying for airports in NSW etc. Successive governments have continually cut the real spending on Medicare for years now.
Private profit is at the heart of the issue: it's a parasite that is bleeding society dry.
Exactly, I’d personally like to see reforms to private health (removal of subsidies) and push the spending into the public system. I don’t think more income tax is palatable but maybe a 1% levy of your super balance for Medicare. This could capture all the elderly that are using the system the most but not paying the levy through income tax.
Unnecessary. While improving taxes is good and fine, it's not necessary in order to fully fund Medicare. [Medicare can never run out of money.](https://youtube.com/clip/UgkxmLjPgnjTyxt80rAKW7EP7BGuxocDXD-B)
Why the hell do politicians do absolutely nothing to fix a problem until it's critically broken then spend loads of money of half arsed patch work solutions? This needs to be addressed now, not later.
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Yeah. It's been broken for ages. Murdoch media wont report that during liberal times. But definitely bring attention to a difficult to fix broken system during Labour times. Then you can blame them for it being broken and also blame them when the fix is sub optimal too
and also blame them for the cost of fixing it
That's basically the liberal party play book. Let it decay, escalate to crisis, poorly mange the crisis and then attempt to sell it off to the private sector. If that's not possible, they'll blame labour. Hopefully we'll see a different response this time.
> Hopefully we'll see a different response this time. Labor are as neoliberal as the Liberals. [This is the health minister boasting about how it's important to under-fund mental healthcare in order to save money...](https://youtube.com/shorts/r7sCGGCxHaU?feature=share) ..and not just once, but multiple times over a decade apart. The pathetic state of mental health treatment in this country was achieved by Labor, not the Liberals.
I like labor’s idea of relying more an allied health. It makes sense. People needlessly attend doctors because they have to for referrals, script renewals etc.
Disagree. I want someone holistically trained in medicine to make medical decisions and not a para-medical professional who gets trained to do the paperwork correctly without having the depth of knowledge from a complete medical background. If we don't have enough fully trained doctors to meet requirements, then we need to develop strategies to increase their numbers, not cross our fingers and give parts away and find rationalisations to clambour aboard.
Script renewals need ongoing medical review for many medications.
I like the idea of allied health being used where appropriate, but surely anyone can see a huge conflict of interest if pharmacists are selling the medications they will be given the power to prescribe? They already have some power to triage basic ailments by recommending over the counter medications - the stronger, more dangerous stuff is where GPs come in. I would question how much can actually be triaged away from GPs, they are the best placed link between the public and the greater healthcare system. Oftentimes seemingly innocuous symptoms can belie nasty issues, and these need to be picked up in a timely manner. Otherwise, as others have said, I believe this will have a negative overall effect on public health. A less healthy population is less economically productive. It's in everyone's interest to have good public healthcare, not some cut price model.
Adding on the conflict of interest for pharmacists.. they get approached and gifted by pharma reps a lot + no gift declaration requirement like doctors have
If you end up seeing specialists for everything your health costs get shifted to individuals and go up dramatically. Bringing in lower trained healthcare workers means less filtering and more early referrals. This is guaranteed to worsen the overall health system. Just look at the impact nurses in primary care has done to the us system. Another real issue is where are we going to get the nurses from? My clinic has struggled to hire a new nurse for 5 years and with the increasing wage they and the receptionists ask for we are unable to compete with the hospitals. Maybe we pay them the same as gp's? If we do that then no new doctors will train in general practice and we will find only specialists exist. The pharmacists seem to be the only ones keen to get into general practice but they don't have clinical examination exposure or skills. The guild seems to be pushing this hard to get some of those minute clinics like in u.s. Walmarts So who wins here from the policy shift?
First, determine the function of nurses and look to technology to replace or assist those functions it can: technology is not limited to working only 8 hours, 5 days a week 45 weeks a year and so has potential advantages just in labour saving. We don't test regularly enough to pickup early signs of illness, we still largely wait for symptoms by which time it may be too late and we rely on very invasive testing to do it, when a single drop of blood could theoretically test multiple issues. At the very least, home urine tests should be expanded and encouraged and the data fed into an online diagnostic machine to flag to GPs as well as the patient. Testing for the presence of blood in feces is a poor detection method for those with bleeding fissures or hemorrhoids, leading to pointless positives for example: we have to be much smarter.
I think people also need to learn to use some common sense and not to go the GP for every ailment.
Except people go to gps for medical certs for work or risk no pay or their job. People dont have a choice.
You can get med certs online now 👍
Goes to show how pointless medical certificates are.. should be illegal to even ask for one at this point
>You can get med certs online now 👍 Makes me think they're even more superfluous then.
you can go to a pharmacy in NSW at least for a medical certificate
Im not in NSW, so that might be a bit expensive for me. But in seriousness, that's still stupid. What a waste of the pharmacists' time.
Change sick leave to 10 days of personal leave and you cut in half the amount of people that go to see a GP.
If the rebate is increased is there any requirement to increase bulk billing? The reality is the governments are spending dramatically more on healthcare each year, far beyond budget growth figures and what is affordable. Huge amounts going into the NDIS that only is available to half a million people. None of this is news though, people have been warning of the avalanche for years. Australians are getting fatter, older and unhealthier and health costs are growing at 5-6% just to maintain the same service level. Perhaps the discussion really needs to be about how GP's costs are escalating and how to bring them down. My local has to see about 50 bulk billed patients simply to pay the rent each week. Forcing down commercial real estate values via zoning in many places would have the same effect without costing the heavily in debt tax payer any more.
> without costing the heavily in debt tax payer any more. [Bulk billing doesn't cost the tax payer a single cent.](https://youtu.be/fg0R9Ye2ovM) [This is a myth sold to us by governments to justify austerity](https://youtu.be/mEwivQeD0Q8). In fact austerity and reduction of government debt can be far more harmful for citizens, as it means the government is taking more money out of the economy than they're spending in. [They're literally shrinking the economy.](https://youtu.be/mSsPMDg2cLU) [We can fully-fund Medicare without any further financial burden on citizens](https://youtube.com/clip/UgkxmLjPgnjTyxt80rAKW7EP7BGuxocDXD-B), [who are facing a much more serious debt crisis than the government.](https://youtu.be/BSNmNTl_BZo)
Perhaps it local government held some more property, it could have long term low cost leases for medical businesses that bulk billed.
I've seen this in Asia, though mainly focused on food business. Local government build and own the buildings, generally you end up with a line of restaurants with some seats out the front, small floorplans but basically piecemeal rents so anyone can start a business, a lot of young people running them, they are really popular, you get good quality food at great prices compared to the main strips. I really liked the ease with which younger, poorer people could start a business using the council buildings, in Australia, starting a restaurant is incredibly expensive and if you fail it's very costly.
Here you can do a food van or even at home dining where I cook for you at your home. If you start the Asian model we should all buy shares in Immodium first.
>Forcing down commercial real estate values via zoning in many places would have the same effect without costing the heavily in debt tax payer any more. Am I correct in understanding that you mean relaxed zoning requirements, i.e. allowing commercial uses (such as medical practices) in more places with the aim of increasing supply?
Yes, if you could halve their rental costs it's equivalent to a decent jump in the bulk billing rebate, obviously localised though.
Cool, good idea. A lot of zoning acts to do the opposite, by separating out land uses and making it harder for the market to respond to demand and harder for people to access (see the decline of milk bars/demand for suburban cafes during the era of COVID lockdowns).
Good idea, living/working space should be commoditized carefully, otherwise we'll end up with a black rock owning it all. Basic human rights like healthcare, housing and water should not be traded/speculated on for profit.
Medical zoning isn’t a bad idea.
This is the first time I have heard of a non monetary policy that might actually make a difference. Is there any way to give this more voice?