Freeze lift needed to re-set health agenda

A thawing of the rebate freeze will mark the beginning, not the end, of the health reform process, says AMA boss Michael Gannon

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The headline health issue for some time now has been the harm caused to patients (and doctors’ practices) by the long-running freeze on Medicare patient rebates, and the need for it to be unravelled as soon as possible.

With the federal budget less than a month away, the speculation in Canberra is no longer about whether or not the government will end the freeze.

The political reality is that the government has to end the freeze if it wants any chance of winning the next election.

The talk now is about when Health Minister Greg Hunt will announce the lifting of the freeze, the date it will be lifted, and how far across the medical profession will the freeze lift extend.

I have had a number of discussions with the minister pushing the AMA’s preferred outcome – to lift the freeze across the whole MBS schedule, and for it to be implemented as soon as practicable (for the AMA, that means immediately).

He has been very busy in what, I am certain, are difficult pre-budget negotiations within cabinet.

Minister Hunt is fully aware that the freeze affects not only patients attending GPs, but other specialists as well.

And he knows that it is just one of the elements putting more pressure on the value proposition of private health insurance.

It’s a measure that is increasing the pressure on our public hospitals. It has effects across the entire health system.

We will not know the government’s final decision until budget night, or just before, amid the now traditional round of pre-budget leaks.

The AMA has made it clear to the government and the public – as we did with our budget submission – that fixing the freeze is the beginning, not the end, of health reform in the current political cycle.

Everything in the health system is interconnected – primary care, prevention, public hospitals, private health, medical workforce, the PBS, mental health, aged care, palliative care, electronic health, Indigenous health. The list goes on.

The government is already working on reform in some of these areas, most notably the Health Care Home trial, the MBS review, and the PHI review.

There is also important work under way in rural health and reviewing medical training.

But fixing the freeze is the breakthrough the government needs to define its health policy narrative for the next two years and beyond.

The government is starting to realise that there are not huge health dollars to be found hiding under a rock.

It will give the government the clean air it needs to negotiate other elements of its agenda. The key theme must be looking at health policy and health funding as an investment, not a cost.

The Australian people sent strong health messages at the last election. They like Medicare. They like public hospitals. They like their doctors.

The public wants easy access to affordable, quality healthcare for themselves, their families and loved ones, no matter where they live and no matter their means.

That is the political reality. Australians care about health.

The AMA cares about patients, and we are the only body with the breadth of understanding of the entire health system to advocate for the best possible policies to ensure they get the care they need.

So, we want to work constructively with the government. We want to move forward. And we are.

We agree that governments of all persuasions should aspire to balancing the budget, but they must not keep cutting in areas like health, which can have devastating effects on working families and the disadvantaged.

The AMA is cooperating with all the reviews, and the government is starting to realise that there are not huge health dollars to be found hiding under a rock. But where there are genuine savings – savings that do not harm patients – we will help find them.

Health spending in Australia is not out of control. We just need to learn to spend it smarter and invest in the things that are proven to work.

Health Minister Hunt understands this. He wants to put in place some long-term planning, especially in general practice and hospital funding.

To let the minister pursue that vision, the government must remove the biggest impediment to progress – the Medicare freeze. And the sooner the better!

Dr Michael Gannon is President of the AMA