“Despite previous promises, Howard and Costello have announced the end of Medicare. This echoes back to when the Fraser Government abolished Medibank” said Dr Schrader, Secretary of the Doctors Reform Society of Qld, today. “The AMA has been undermining the public’s confidence to set the stage and provide an excuse for the government’s plan to get rid of bulk-billing and Medicare.”

“The Liberal Party and AMA have a long history of opposition to Medicare’s principles. Howard previously described bulk-billing as ‘scandalous’ and Medicare a ‘monster’. These views have been muted in recent years knowing that harming Medicare loses votes. AMA federal president Dr Kerryn Phelps let slip that ‘the problem for governments is that Australians love Medicare’.” said Dr Schrader. “The looming war in Iraq has also provided a convenient distraction from their plan and an excuse for restricting funding.”

“Medicare never has been a safety net and was never meant to be a safety net. Medicare was designed to be universal, for everyone.” said Dr Schrader. “In saying otherwise, Howard and the AMA are rewriting history.”

“Howard and Costello’s plan of bulk-billing only for pensioners and the low-incomed is the death of Medicare. Howard says we can no longer afford universal health insurance and Medicare but the two-tiered Americanised system he seeks to inflict on us will cost more, not less.” said Dr Schrader. “The Government can afford the arguably worse-than-useless 30% private health insurance rebate that costs the taxpayer over $2 billion every year and provides greatest benefit to the rich.”

“The foundation of Medicare is its universality, that it is available to everyone. Health care is a public good. You never know when you might need care and we’re all in it together. The belief that health care is a shared responsibility where those who are well-off subsidise those who are sick and less well-off. You get care according to your needs and pay according to your means. The best way of achieving this is to pay through the tax system.” said Dr Schrader. “Medicare provides this.”

“User fees, such as copayments on top of the bulk-billing Medicare rebate, advantage the rich and doctors. The rich pay less tax and the users (usually the sick and poor) pay more. Getting rid of bulk-billing with compulsory copayments even with safety nets would hurt ordinary Australians who wouldn’t quite make the safety net.” said Dr Schrader. “There is world-wide evidence that shows user-fees benefit the rich and hurt the sick and poor. This is in terms of payment, access and health outcomes. Universal health insurance schemes, such as Medicare provide the most equitable and efficient health systems.”

“Copayments are simply a means of shifting costs from public to private pockets - shifted from taxpayers to users of care. It is quite simple. Wealthy people pay more taxes and sicker people use more care. Wealthy people tend to be healthier and poorer people sicker. So wealthy people pay more if the costs are borne through the tax system and less through private fees. It’s the reverse for the poor. Any transfer of payment from taxation to user-pays benefits the wealthy.” said Dr Schrader.

“The double whammy is that the evidence shows user fees deter the use of appropriate health services and have been linked to poorer health outcomes for the sick and poor. One such example is that after copayments were introduced on optometrist visits in the UK, cases of undiagnosed glaucoma (a treatable cause of blindness) increased.” said Dr Schrader. “Copayments also result in improved access for those most able to pay since these charges primarily deter those with lower incomes.”

“So the wealthy pay less of the costs and get more of the care; the poor pay more and get less. Copayments are a tax on the sick and poor.” said Dr Schrader.

“Our only chance of preserving our well respected universal health care system is to strengthen and maintain Medicare based on funding through the tax system. Bulk-billing and universality must not be destroyed. The government needs to adequately fund the health system and investigate innovative policies to encourage bulk-billing. Contrary to what Dr Phelps and the AMA says, Australians have not considered health care to be free and most ordinary citizens have said they would be prepared to pay more tax to support health care. This is the most equitable and efficient way of providing health care.” said Dr Schrader. “With political will Medicare is sustainable.”

4 March 2003

Dr Tracy Schrader

Dr Peter Davoren

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