Interview - AMA Vice President, Dr Mukesh Haikerwal with Matt Brown, ABC Radio 'AM' - Medicare Plus

HAIKERWAL:            The mood amongst general practitioners has been quite upbeat, obviously from a low base, but we see a lot of good in what's been announced. There are some concerns, however. These are around the limitation of some of the workforce issues to areas of need, and of course all of Australia will soon be an area of need if we don't address this across the board.

BROWN:                    But the Prime Minister says that doctor shortages in particular areas are a major reason why bulk-billing rates are so low in those particular areas, and that this effort to boost the medical workforce in those areas will help address that slide in bulk-billing.

HAIKERWAL:            It's absolutely essential to address the areas in need and to provide more medical services into those areas. The cost base and the reduced numbers of consults that are free with a 50 per cent discount due to bulk-billing is because the true cost of the Medicare rebate no longer reflects the cost of providing that service.

BROWN:                    So you're saying that there's still this basic issue with the value of the Medicare rebate has been unaddressed?

HAIKERWAL:            The Medicare benefits schedule does not reflect the true cost of providing a service, and that's why it's not being used as a guide to access the safety net. That's recognition of a failing in the Medicare rebate and I think that's something that needs further work.

BROWN:                    But Tony Abbott says that boosts to the rebate are limited because the Government wants to focus on the needy.

HAIKERWAL:            There's no doubt that there is a limited budget out there and the Government has come a long way towards improving its previous package.

The downside of not addressing the Medicare rebate issue is that in a few years time we'll need yet another rescue package as the value of that rebate diminishes and the value of the incentive payment for bulk-billing also diminishes.

BROWN:                    So should this rebate issue be a make or break issue for the package?

HAIKERWAL:            Look, I think the package stands on its own and I think that in the time that we have available it'll be difficult to fully address the rebate issue.

I think the rebate issue, however, is central to the survival of Medicare in the long run, and that's something that will continue to be debated and certainly will be a core element of the election.

BROWN:                    You don't think that the safety net the Government's announced, the expanded safety net, will look after those people who have high medical expenses but don't get bulk-billed?

HAIKERWAL:            The current, the new safety net takes into account 80 per cent of the true cost of providing a service. That is a very significant added benefit. It, however, does underline the fact that the Government itself doesn't therefore believe the Medicare benefit schedule is of value.

BROWN:                    And why do you say that you're worried some people will fall through the safety net?

HAIKERWAL:            When arbitrary limits are set, $500 and $1,000 in this case, based on income, there will always be a group at that margin that may well fall through. I think that this is best accommodated with some flexibility around the way in which the safety net is calculated.

BROWN:                    You keep coming back to the overall value of the rebate, so if Senators are looking to you for guidance, given that you've said much of the package is positive, are you saying they should go ahead with it and try and address the rebate issue later?

HAIKERWAL:            I think that the package, as it stands, is worthy of consideration. I think the rebate issue cannot disappear and will certainly be a major issue as we head into the election campaign.

Ends