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23 Jan 2017

WARREN MOORE:                    Now, I did mention this earlier in the program, but the question is are you willing to pay more tax to boost the public health system? A possible increase in the Medicare levy could be underway, with the Australian Medical Association releasing a pre-budget submission over the weekend, saying that half a per cent rise would raise about $4-5 billion for health care. The levy was last increased to fund the National Disability Insurance Scheme; are we prepared for another rise?

                                                                Joining me on the line is the AMA President Dr Michael Gannon. Thanks for your time.


MICHAEL GANNON:                 Good afternoon, Warren.


WARREN MOORE:                    Well, you think that the increase is the way to go if we need to fund more for Medicare?


MICHAEL GANNON:                 Well certainly we're not calling for it in our Budget submission, but we're good at identifying areas of increased spending, and the way the Government arrives at that total package is their business. We've seen the Medicare levy used in the past temporarily for measures that don't relate to health. What we're very clearly calling for is that if Australian taxpayers are going to pay more in the name of the Medicare levy, then that funding should absolutely be quarantined for spending in the health portfolio.


WARREN MOORE:                    Yeah, and I know another concern you have of course is if there's extra money from the Federal system you're worried the State governments might pull back.


MICHAEL GANNON:                  Well, the States of course have the responsibility of funding public hospitals. I've always been very sympathetic with how difficult it is to be a State Premier or a Territory Chief Minister trying to fund services from a very narrow tax base.


And one of the other things we're going to be releasing in coming months is our Public Hospital Report Card, and that doesn't make for good reading.


We see that with various metrics like surgery waiting times, emergency department response times, we're plateauing or going backwards in many areas. So, certainly, the States need to do better; the Commonwealth has to make their contribution to those public hospitals as well.


WARREN MOORE:                    Okay, so I mean, when it comes to the Medicare levy though, surely that's a tool the Government can use if we're going to continue to talk, as we have many times, about this problem with an ageing population, and therefore the sustainability of Medicare going forward?


MICHAEL GANNON:                  Well certainly it's one option open to them, and it's certainly one that I'm sure that they will consider. We've stopped short of calling for it. It's very easy for lobby groups like ours to ask for extra funding, and it's certainly not our job to identify savings in other critical portfolios. I mean, we are being responsible in saying that we believe the Government should be aiming for a balanced budget, and we're being responsible in saying that there are other key areas of health spending.


But one of the things that our Budget submission says very clearly is that health should be seen more as an investment, not a cost. There are certainly areas within the health portfolio, like general practice, like public health prevention, like decent public hospital care, that will reduce expenses further down the line.


WARREN MOORE:                    Another aspect of this, I suppose, is the fact that other options have been found politically unpalatable, such as the co-payment. I mean, that's died a death; we never hear of that anymore.


MICHAEL GANNON:                 Well the co-payment is political poison for the Coalition Government. I cannot see them going down that road. I think they have a lot of insight into exactly the damage that caused and the trust deficit that represents, both with GPs, other specialists, and patients in Australia. Now, I don't think they're willing to revisit another model; certainly, the two models they put forward did not include appropriate protections for the neediest in society, that's why they failed politically. We believe that patients should make a contribution towards the cost of their health care, we're not against that idea, but we need to make sure that the neediest patients in our community don't have barriers to accessing that care.


WARREN MOORE:                    Well that was, I guess, a problem with the co-payment. I wasn't against it initially until I heard some callers say, well, what happens if you've got a pensioner who decides not to go to a doctor when they should because of the co-payment, even though it was only a few dollars?


MICHAEL GANNON:                  Look Warren, I can tell you from numerous conversations that I've had with senior politicians and senior bureaucrats, is that it might be hard for some of your listeners to picture these patients, but I've seen them every week of my life throughout my career.


There are people who, for whatever reason, do find it very difficult to find what other people would regard as even small amounts of money. There are some people for whom life is that tight, and they will eschew important things like a visit to the GP to spend on other factors. Now, that shouldn't be seen to blame them, that's just a fact of life, that many in our community, things are very tight. And sadly, if you've got … the costs add up, and even if it's only, let's say a $5 co-payment, if you've got three kids and then you turn around and go and pay another three lots of subsidised prescription medications, even if that's the case you're often talking about pensioners who might be on five, six, seven different medications from chronic diseases. These costs add up for people on meagre fixed incomes.


WARREN MOORE:                    What about the idea though of the wealthy having to pay for their own way? I know this is talked about from time to time. Many would say, look, everybody should pay for their own way. I agree with you that if you've got, for example, a family, you want to make sure their kids are looked after and that can all add up, but do you think there should also be a point where if somebody's a multi-billionaire they shouldn't have access to Medicare?


MICHAEL GANNON:                  I think we're very close to having the balance right in Australia. And let's not forget there are governments across the planet that are struggling with the same things we're struggling; they're struggling with how you pay for the fabulous technology, the fabulous new operations and new medications that we can offer people, with narrow tax bases, with ageing populations, with the obesity epidemic. I can assure you that this problem is not unique to Australia.


I think we're not far off the mark in terms of getting the balance right with the amount that people contribute to their own health care, but I think that it's important that public hospital care is there for everyone irrespective of their means. But the way that our progressive tax system works, it means that the wealthier are more than contributing to both their health care and to those of many others. We're not far off having the balance right in terms of taxation measures and patient contribution measures. We can always try and do better.


WARREN MOORE:                    Okay, and before I let you go, have you had the chance to talk to the new Health Minister as yet?


MICHAEL GANNON:                 I have. I spoke to Mr Hunt twice on the day that his appointment was announced. That was the day after I last spoke to you, Warren. Your mail was correct. I look forward to meeting him maybe as soon as next week.


WARREN MOORE:                    Okay, and of course you'll be talking about that freeze on the rebate, I imagine.


MICHAEL GANNON:                  That will be at the top of the agenda, Warren.


WARREN MOORE:                    I'm sure it will be. We might get a follow-up after all that happens. Thanks for your time.


MICHAEL GANNON:                 Okay, that's a pleasure.


WARREN MOORE:                    Dr Michael Gannon is the AMA President. And, well, they're not suggesting it, but they just obviously believe it's likely to happen. That's why they've put forward in their pre-budget submission what should happen if there is a half a per cent rise in the Medicare levy. It would bring an extra $4-5 billion, and they want to make sure that that all stays within the health portfolio, which it needs to do because it's just not sustainable, as we keep saying, with the ageing population. 

Published: 23 Jan 2017