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Transcript of doorstop interview: Canberra: 16 August 2018: Medicare bulk billing rate hits historic 86.1 per cent

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Authorised by Greg Hunt MP, Liberal Party of Australia, Somerville, Victoria.

The Hon. Greg Hunt MP Minister for Health


16 August 2018



Topics: Medicare bulk billing rate hits historic 86.1 per cent

GREG HUNT: I’m delighted to announce that Australia has today achieved record bulk billing levels. That’s 86.1 per cent for GP visits. That’s the highest level on record and that’s for the year just ended, for 2017/18. It’s up from 82.2 per cent under the previous government, and what that means is that for every 100 visits to the doctor, 86 of those visits are completely free.

That means more people than ever are accessing the doctor without having to pay any costs at all. At the same time, I welcome the AIHW report which deals with the important question of who has to pay some contribution at some point during the course of a year. And what that tells us is that of course we see that doctors are overwhelmingly focusing on providing lower income Australians with free access and so I want to thank them and acknowledge them for that work.

JOURNALIST: The (inaudible) report mentioned out of pocket costs being out of control. Are the Medicare rebates for GPs and for the patients at a suitable level?

GREG HUNT: I think what we see is that bulk billing has gone up. So more doctors are providing completely free services than ever before and it’s not just because of population growth. As a percentage of the population, we’ve gone from 82 per cent under Labor to 86 per cent under us of services that are accessed from GPs are now completely free. So the doctors themselves are providing those services without charging anything additional.

But where there is a cost, one of the things I have asked the Chief Medical Officer to do is to work with all of the different groups on a transparency model, that has never occurred before in Australia. There’s never been such a model under Labor and I am very confident that what the Chief Medical Officer will do will help, in particular, to assist with those out of pocket costs. But the highest bulk billing rate means the highest number and proportion of Australians visiting their GPs without having to pay a cent on record in Australian history.

Authorised by Greg Hunt MP, Liberal Party of Australia, Somerville, Victoria.

JOURNALIST: But the Medicare data relates to services that have been bulk billed rather than individual patients, so is this data misleading as experts have said?

GREG HUNT: No, actually, it’s the AIHW who have said that the bulk billing rate is 86.1 per cent. But let me give you an example. If two people go to the doctor, one person visits ten times and all of their services are free and another person visits ten times and nine of their services are free, those 19 visits would represent a bulk billing rate of 95 per cent. But the AIHW data would show it as 50 per cent of people have some out of pocket cost, even if it was only one out of 20 services across them.

JOURNALIST: But it’s not one out of 20 services because it’s $3 billion collectively between 2016 and 2017. That’s not a small figure. Are you saying that people should be expecting to pay money when they go to the doctor? Are you hoping to bring that number down to zero?

GREG HUNT: What we’re doing, of course, is driving up bulk billing levels to the highest on record in Australian history. And those bulk billing levels mean people are paying nothing. When somebody is bulk billed that by definition means they have a zero cost and so, today, we have the highest proportion of Australians and the highest number of Australians ever, visiting the doctor without having to pay anything. Four per cent higher, approximately, than it was under Labor and, very importantly, what the ABS data also shows is a 39 per cent drop since Labor was in government of those people who are deferring visiting their GP, a 39 per cent drop of those who were deferring visiting their GP.

So we want to continue to work on out of pockets, but what this data today shows is really two things. One, the highest level of people visiting the doctor without ever paying anything in Australian history, and secondly, what we also see is that the doctors themselves are focusing on ensuring, and this is the AIHW findings, that the lower income people are those that are far more likely to have bulk billing and have no contribution at all.

JOURNALIST: Is there an issue with locality though? Are you- take an area like Sydney’s north far higher for medical services, for GP services, than most other places in the country. Is that a fair model to have?

GREG HUNT: Well, this is the data that the AIHW has prepares and so let me give you two examples from that. Where we are in the South Canberra area, about 78 per cent of people might pay something at some stage during the course of a year. In Barkly in the Northern Territory, a lower income population, about 9 per cent of people make some contribution at some stage.

But the critical takeaway is 86 per cent of people are now paying nothing to visit their GP at any time, or 86 per cent of services are completely covered, and then in terms of the findings of the AIHW, which I really welcome, what they show is that lower income people are far less likely to pay anything at any time and the doctors are making, as is their right and their choice, the decision that some higher income people will make some contribution at some time.

JOURNALIST: Do you concede that the out-of-pocket costs are still too high, though, and what are you going to do to bring them down?

Authorised by Greg Hunt MP, Liberal Party of Australia, Somerville, Victoria.

GREG HUNT: Well, we have tasked the Chief Medical Officer, I have tasked the Chief Medical Officer, to work with all of the leading medical groups. And I have been part of that work with the AMA, the College of GPs, the College of Surgeons, the College of Physicians and other organisations where they have, for the first time, agreed that they will work towards a transparency model where fees will be available.

And this is something that has never happened before. So what we see is a 39 per cent reduction in people deferring their visits to the GPs. I want to drive that lower. We have an increase in bulk billing rates and we have the ability to drive things still further through the work of the chief medical officer.

JOURNALIST: Minister, with the bulk billing rate very high, but also out-of-pocket expenses very high, does that show us that there are, even though they’re a minority of cases, there are a few specific services that are costing people a tonne of money? And I’m thinking about things like MRIs here. What do you see as those problem services that are causing this massive spike in cost even though they’re a small number of cases?

GREG HUNT: So, there are some diagnostic services and some obstetric services, in particular, which have been raised with me and that's the area that the Chief Medical Officer is specifically focusing on. He's looking at a transparency model right across, right across the medical sector, with, I have to say, the very strong support of the medical sector and many of the leading physicians and surgeons and GPs have said we think there are a few people who are charging way too much. We want you to call them out by having their fees published and we will do that. And that's a very important moment. So as the outliers know that they can't hide in darkness.

JOURNALIST: Minister, can you clarify your 36 per cent figure in terms of the number of people avoiding or delaying getting medical care? Because the AIHW report had that 6.5 per cent of Australians delayed getting care. When was it per cent?

GREG HUNT: No. So just to correct those figures, what we've seen is a reduction from 6.8 per cent of people who deferred visiting the GP under Labor to the latest figures we have from the ABS that are slightly more advanced on those from the AIHW, they’re more updated, which has that at about 4.1 per cent of people. That represents a 39 per cent decrease from Labour's time to now in terms of proportion of the population who will be delaying.

JOURNALIST: Is that just GP though, or is that all Medicare services as the AIHW report looked at?

GREG HUNT: These are the GP figures where I have the comparator. The AIHW doesn’t provide a comparator for those previous figures.

JOURNALIST: So do you accept the 6.5 per cent? It’s 1.3 million Australians. Do you accept that figure?

GREG HUNT: Look, I accept all of the elements in the AIHW report. It’s a very important addition and something which was commissioned on the watch of this government. So quite significantly, what we see though in all of this is more Australians having free services than ever before.

Authorised by Greg Hunt MP, Liberal Party of Australia, Somerville, Victoria.

What we also see is a reduction in the number of people who are deferring services and that's across all of the different categories of ABS data. And as a consequence of that, we've made big progress. We have more people seeing the doctor for free than under Labor than at any other time since Medicare was started. But my task and my goal is to continue to do more on this front.

JOURNALIST: I was just wondering when we could expect to see that transparency model come into place.

GREG HUNT: So what we'd like to do is to ensure that the first draft is released in the coming months and that it is in place before the end of the first quarter of next year.

JOURNALIST: Minister, just quickly, finally, the AMA is saying they want more funding. The Medicare rebate for them needs to be higher. Are you willing to offer them more?

GREG HUNT: So what we've just done, of course, is to add a billion dollars by ending Labor's freeze. Labor started the Medicare freeze, we ended it. We've added a billion dollars to that and I think that's a very important thing. And what that means is that each year the Medicare rebates will go up because of the indexation.

Alright, thank you very much.