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Transcript of interview: ABC News Breakfast: 26 May 2014: Co-payments

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E&OE Transcript ABC News Breakfast 26 May 2014

SUBJECT: Co-payments

MICHAEL ROWLAND: The Health Minister Peter Dutton is reportedly considering a compromise option in order to get that measure through the Senate and Peter Dutton joins us now from Parliament House. Minister, good morning to you.

PETER DUTTON: Good morning Michael.

MICHAEL ROWLAND: How far are you willing to compromise on this co-payment?

PETER DUTTON: We had put to us the co-payment should have been $15. We had a look at the New Zealand model where it's $17.50 and we believe we've struck the right balance at $7; $5 of which goes into the Medical Research Future Fund and $2 goes to the GP to supplement the money that comes from Medicare now. We believe we've got a good model to go forward and importantly we retain bulk billing to provide services ongoing for those who can't afford the $7 out-of-pocket fee and I think we’ve got a great basis for strengthening Medicare as you go forward.

MICHAEL ROWLAND: Are you prepared to go lower than $7?

PETER DUTTON: We're not. We are very keen to see this legislation through because there's been a 42 per cent increase in the amount of money spent on the MBS over the last 5 years. 10 years ago we were spending $8 billion on Medicare, today we're spending $20 billion per annum and I want to make sure we make Medicare sustainable and stronger into the future and that means people like you and I paying the $7 so we can keep bulk billing those people who are most in need.

MICHAEL ROWLAND: You’re going to have to do something based on what some of the minor parties are saying, along with the Labor Party of course, the Greens, the Palmer United Party, Nick Xenophon say they'll vote against the $7 figure so there’s no area for compromise on the amount is what you're saying?

PETER DUTTON: The Senators will preposition and we'll have discussions with them in due course but I welcome the position of the AMA which is not to oppose the co-payment. There are some issues they have difficulties with and we're happy to


talk to the AMA because Medicare and the way in which people interact with their doctors in that payment system is just one aspect of how we fund the health system and we provide support for chronic disease plans, we provide block funding, we provide money through Medicare Locals and through the primary care network otherwise to those people most in need so we've already started a conversation with the AMA and the college about how we can best provide services and support to those most in need, those with the most chronic conditions and it may be that it's a blended payment model or something different going forward so it's not just a discussion about co-payment but it's a more comprehensive discussion about how we can continue to provide what is, for the taxpayer, a multibillion-dollar investment going forward to provide support for those most in need.

MICHAEL ROWLAND: When you say "blended payment", what do you mean by that?

PETER DUTTON: If you look at some of the international experience and the advice and positioning of the AMA and the college that is to look at ways in which it is more effective than just 6-minute medicine if you like, to deal with people that have complicated presentations so people with comorbidities or complications that we want to try and provide services to in a primary care setting instead of turning up to an emergency department or being re-admitted to a hospital, there are smarter ways perhaps in which we can reward doctors going forward but if we want to make the system sustainable, particularly given the ageing of the population, the cost of medical technologies, genomic testing coming down the line, 7,500 people that will be diagnosed with Alzheimer's or dementia by 2050, we have to make structural changes now so we can strengthen Medicare and that's really what we've aimed to do within this package and I expect it should get support in the Senate on that basis.

MICHAEL ROWLAND: The $7 figure hasn't got support and so our viewers are clear, Peter Dutton, there's no room at all for you to negotiate, is what you're saying, on the $7 figure?

PETER DUTTON: We looked at a the $15 figure which was the recommendation of the Commission of Audit, $17.50 in New Zealand, $20-plus in other jurisdictions around the world; we believe that we have struck a balance, particularly given $5 of it effectively goes into the medical research future and that $2 of it goes to supplement that money which the doctors are already receiving so we can continue to provide support through bulk billing to those most in need.

MICHAEL ROWLAND: So $7 is your final offer?

PETER DUTTON: We have considered it and considered it extensively and through this measure we provide almost a half a billion dollars of extra support to GPs. We do want to continue bulk billing which is an effective safety net and there's a second safety net that once people get to the 10 services they can revert back to bulk billing if they're a concession card holder or under the age of 16, bearing in mind there are 8.6 million Australians who have a concession card in this country, that is a significant support base for those most in need. But for those who can contribute $7,


we expect that is a significant part of the system going forward so we can make Medicare stronger.

MICHAEL ROWLAND: Has the Government modelled different amounts for the co-payment?

PETER DUTTON: Yes we have and we believed $15 was too high but $7 doesn't provide a deterrent but does help strengthen Medicare and give us the capacity to continue to bulk billing. Bulk billing is not about charging nothing for everybody who comes through the door and Labor's model frankly of giving everything to everyone for free, particularly when it’s paid for on the taxpayers' credit card is just not sustainable and I think on these measures we really do strengthen Medicare going forward and I think that's what most Australians expect us to do.

MICHAEL ROWLAND: And just to confirm - has the modelling also focused on lower payments below $7?

PETER DUTTON: We looked at a combination of payments and we believe the $7, $5 effectively going to the Future Fund to provide medical research, and $2 going to provide extra support for the doctors is a reasonable balance. We thought $15 was too high and I think in the measures we've put forward people will see that this is a structural change that will strengthen Medicare going forward and that's exactly what the Government is about.

MICHAEL ROWLAND: I want to go back to the Australian Medical Association, they do support the co-payment in-principle but also are concerned about the impact on some sections of society and they've cited what they're calling the young woman with a breast lump, and this according to a report in the 'Sydney Morning Herald' this morning who, according to the AMA, would be $63 out of pocket in co-payments alone once you factor in the mammogram, ultra sound, biopsies, pathology and follow up GP visits.

PETER DUTTON: It would depend on the doctor is the first point Michael because we have bulk billing in the system now so the doctor can decide whether or not somebody is charged and out of pocket or if they're bulk billed. If the doctor makes a decision that that young woman doesn't have the means to pay the $7 then they may well not charge that and bulk bill, but if they decide that that young woman is on $250,000 a year and they believe $7 can be levied then that's a decision doctors make now and will be made into the future. We think $15 would have deterred people from turning up to the doctors and we believe with the retention of bulk billing and the $7 as well as the safety net of once people get to 10 services within a calendar year that they can revert back to bulk billing if they're concession card holder or under 16, that they are collectively very important measures going forward and we've provided that safety net and we think it's a sensible position and that's frankly why the AMA has supported it in-principle.

MICHAEL ROWLAND: And finally on another subject Peter Dutton - are you completely comfortable with Bronwyn Bishop holding party fundraisers in the Speaker's office?


PETER DUTTON: Providing that none of the expenses bill back to the taxpayer, yes. I think the Speaker has, as is the case with previous Speakers, conducted these sort of events not at taxpayers expense and I think that is appropriate and details - I've only seen publicly reported so I'm not sure about the accuracy of them but the principle you asked me to comment on, that would be my response, and the detail, obviously Bronwyn Bishop can answer that.

MICHAEL ROWLAND: It doesn't trespass on the concept of an impartial Speaker, holding party political fundraisers in her office?

PETER DUTTON: I think Michael, if you look at the history of the parliament, the Greens, Liberal Party, Labor Party have held different functions here. We hold the mid-winter ball where people provide support to great causes; it is essentially for a commercial purpose. There are different ways the building is used for those sort of things, providing the taxpayer is not out of pocket for it, I think that's a general principle that needs to be adhered to and it has been a long-standing arrangement that the Liberal Party or Labor Party's conducted fundraising events but the taxpayer hasn't picked up the bill.

MICHAEL ROWLAND: Which other speakers have held fundraisers?

PETER DUTTON: I think if you look to the history I'm sure they can provide the details of discussions that they've had which aren't directly related to the office of the Speaker, as has, I'm sure, Bill Shorten within his office, had trade union leaders there before or people that bank-roll the Labor Party otherwise.

MICHAEL ROWLAND: That's there the Opposition Leader we're talking about. The Speaker's office k you nominate a past speak who has done something like this?

PETER DUTTON: I can't rule out that past speakers haven't done it because it is common practice across both parties across the parliament. And as I say, if the taxpayer is not incurring an expense then in-principle I have no problem with it. If your argument was that an officeholder within Parliament House was billing some sort of a party political gathering back to the taxpayer then I would be opposed to that but that's not the circumstances as they have been publicly reported. And as I say, I haven't heard the details independently verified but if you're asking me to comment on what's publicly available, providing the taxpayer is not picking up the tab for a union gathering in Mr Shorten's office or a gathering in Speaker Bishop 's office, then that's, as I've explained, my position.

MICHAEL ROWLAND: Ok, Peter Dutton, the Health Minister, thank you so much for joining us this morning.