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Into the 21st Century: A Fairer Medicare

Not long after Dr Bill Glasson had succeeded Dr Phelps in 2003, bulk-billing had declined to about 66 per cent from its 1997 peak of about 80 per cent. The Government therefore introduced a $900 million Fairer Medicare package, which (among other things) provided incentives to GPs to bulk-bill, and a range of so-called safety net measures that covered patients’ out-of-pocket costs over a certain amount. The response was not good, including that by the AMA, and the package was sent off to a Senate committee. The committee was not impressed either, describing the package as “a decisive step away from the principle of universality that has underpinned Medicare since its inception”. So, with a 2004 election in sight, the Government had to find a Plan B: Medicare Plus. This package (at a cost of $2.85 billion) retained bulk-billing incentives but expanded the safety net concessions, added a dental plan for people with chronic or complex health conditions, and provided new medical school places in rural and remote areas. Though the AMA thought that Medicare Plus meant “a more complex Medicare and more red tape for doctors” and said that it was still concerned about the Government’s “focus on bulk-billing as a cure for the ills of the health system”, the new package – “a positive second-best option” – was slightly more acceptable, it said, and called on the Parliament to pass the enabling legislation. Meanwhile, the medical indemnity issue continued to bubble along, dominating the AMA’s agenda in 2002 and into 2003.