The release of the Albanese government’s Strengthening Medicare Taskforce report is imminent and there is a sense of heightened anticipation about what impact this will have on Medicare and our health system in general. Although it is directed towards primary healthcare, it will likely have a ripple effect on all areas of the health system.
We have previously raised concerns about the crisis currently facing Australian healthcare and particularly public hospitals. In our article last year [link – Ambulance ramping is a symptom of a failing healthcare system] we explored some less obvious reasons why state emergency departments are the bottleneck in the system.
The State and Territory governments are firmly pointing their finger at underperformance of the primary health system. No surprise there since this is the responsibility of the Commonwealth. It is well known that there are not enough GPs to provide accessible, timely and affordable care. The reasons for this are as varied as the suggested solutions, so what are some of the possible outcomes of the Taskforce report which has primary healthcare as its focus?
- GPs may no longer be the sole gatekeepers to healthcare
- Nurses may take on a greater role in co-ordination of complex care to ease the burden on GPs
- Nurses, allied health professionals and paramedics may deliver prescribed aspects of primary care (such as chronic wound care), avoiding the need to first visit the GP for referral
- Pharmacists could be endorsed to issue prescriptions for common but relatively minor ailments that otherwise require a GP (such as urinary tract and skin infections)
One thing that seems unlikely is any significant increases to Medicare rebates https://www.theguardian.com/australia-news/2023/jan/23/health-minister-all-but-rules-out-medicare-rebate-increases-for-gps-to-boost-bulk-billing There has been a long standing campaign, led by the AMA, to increase Medicare rebates for primary care items. As it stands rebates are considered insufficient to make bulk-billing GP practices commercially viable. Requiring patients to subsidise their healthcare costs by paying gap fees leads to inequitable access to primary healthcare even with healthcare and concession cards. In turn, this increases the numbers of people presenting to hospitals seeking free care. The system is broken because patients who should be cared for by Commonwealth-funded primary care, instead become a burden on state-funded hospitals.
It is a complex problem that almost certainly cannot be solved by pouring money into the old system. Australia has evolved since Medicare was introduced almost 40 years ago in 1984. Healthcare has also radically changed in that time. Let’s hope the Taskforce has some innovative and creative solutions to our long term healthcare crisis.
