Speaking to 2LA about the medicare rebate freeze

27 May 2016

BRIAN CARLTON:A couple of months ago before it became known we were definitely going to a July 2 double dissolution election. It was shaping up as a no contest.

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It really was. Malcolm Turnbull was streets ahead in the personal popularity or better Prime Minister scores. The polls were indicating that the Coalition had a two party preferred lead and was unassailable and here we are, seven weeks to go in the campaign and we have a contest. Make no mistake. We have a proper contest on here.

It is also a contest for ideas in the large extent and the big ticket issues in Tasmania are as you know: jobs, health and education. In this case, we will have a chat about health. Labor has unveiled a plan to effectively unwind something that they started back in 2013 when they put a freeze on the indexation, the indexed increased on the rebates paid to doctors, for each of your visits. So there is a certain amount paid back to the doctor for a bulk billed visit and over time as the CPI rolls in, they gradually increased to take into account the extra cost of living. So back in 2013, the then Labor Government decided to freeze that. When the Coalition got in, they decided to extend the freeze for some years. Doctors then came out and said this is going to cost the average patient somewhere between fifteen and twenty dollars per visit as the amount the Doctors get back from the Government is reduced. So, what has happened today? A $12 billion dollar plan over twelve years has been announced to effectively unfreeze those freezes. So the rebates will now be indexed as the cost of living goes up. On the line is Stephen Jones, he is in Townsville and he is the Assistant Shadow Minister for Health and the latest spokesperson for rural and regional health so he is right in our bailiwick here, dont worry about that. Stephen Jones Gday, how are you going?

SHADOW ASSISTANT HEALTH MINISTER, STEPHEN JONES: Good mate, good to be with you Brian.

CARLTON: Thats the way. Tell me how you are going to pay for this? Because that is the big question, $12 billion bucks over twelve years, thats a serious amount of coin?

JONES: Budgets are all about choices and we have had a look at what is in this budget, Malcolm Turnbulls budget and we take the view that it is more important to save Medicare and ensure people can afford to go to their GP than it is to give tax cuts to multi-national companies so that is one of the areas we are looking at to saving money.

CARLTON: But its not really a saving though is it Stephen, because the Government hasnt actually spent that money, they have ear marked it and you are saying we wont spend it, so how does that count as a saving when it is kinda, not really?

JONES: Because it is what is in the forward estimates mate, but the key point here is this, is that what the Government is proposing to do is false economics, because somebody who delays going to their GP, or doesnt go to their GP and gets worse, their condition becomes worse, they either become more expensive to treat or they present themselves to a public hospital which is one of the most expensive places to deal with a health issue. We already know that this is happening, in my conservations with GPs throughout regional and rural Australia, they say, whenever we start talking about the GP tax, or cuts in rebates to Medicare, people will stop going. Their appointment lists will start dropping off so we know it is already happening. What Labor wants to do is put a shot of confidence in the arm of people and say we will restore Medicare, we believe it is critical to health care, particularly in regional Australia, so we are going to inv est in it so you can invest in your own health.

CARLTON How then do you account for the rates of bulk billing under the Coalition going up compared to Labors? 75 per cent of Doctors bulk billed under Labor, it is 85 percent under the Coalition.

JONES We put in place a range of processes to improve bulk billing. We have seen it drop in some areas, particularly if you look at the difference between regional Australia and the capital cities. Ironically it is in the areas that you need bulk billing the most. So in regional Australia in areas where people have lower incomes, these are the places where bulk billing rates are at the lowest, compared to the cities. These are exactly the sort of areas where you need policies such as this Brian. When I talk to Doctors, they say if this rebate freeze continues, we will have to pass costs onto up to twenty dollars per patient per visit and if we dont pass it on, to the poorest in the community, we have to pass that cost onto somebody, so it means the middle class will need to pay more when they go to their Doctor so they can help cross subsidize the people on lower incomes. Now we think there is a better way to do it. We think it is a much bette r way to do it through the Medicare system

CARLTON One issue that is being campaigned on pretty heavily here in Tasmania, by Jacqui Lambie, or by the Jacqui Lambie Network, the Senator, is that the freeze also included pathology. Now youve not unfrozen that pathology and diagnostic imaging are left out of this. Any particular reason?

JONES We will have more to say across the rest of the health portfolio in the coming weeks Brian. We have put some certainty in around GP consultations today, in the announcement Bill Shorten has made today, but dont think this is the last thing we are going to have to say about health because we do believe this election has to be a referendum on the future of Medicare and the future of health care services in this country.

CARLTON Again, you are going to get whacked around the head by the Coalition who are going to say look, we are in a bit of a difficult budget situation, we tend to be spending way more than we are actually receiving by way of tax revenue and other revenues for Government. We just cant afford to do this kind of thing. I mean how do you broadly respond to that? I mean I know you are offsetting the cost of this against the savings you are making not passing on tax cuts to small business, but there is no budget fix there Stephen. There is no bringing down of spending which I think is what most people ultimately want to see, despite the complaints when it affects an area that concerns them. I think overall we want some proper budget management here as well.

JONES I couldnt agree more. Couldnt agree more Brian. Which is why we have over the last nine months, been steadily releasing policies with a combination of savings. For example, we wont be proceeding with Malcolm Turnbulls expensive baby bonus. We think we have a good system with our paid maternity leave system in place. We think the unaffordable baby bonus scheme that Malcolm Turnbull has been putting forward, we dont need it. We think hands out to people who are carbon polluters is not necessary, its not working, we can knock that one on the head as well. So it is not true to say we havent been identifying savings, we have looked at multinational tax avoidance, we have looked at the excessive tax concessions that are going to high end superannuation earners so we have been steadily over the last nine months releasing these sorts of policies and the Government has identified waste and we think there are some things we can agree on, so we will say, yeah we will do that. We are not blindly just saying no to things because we are in opposition so we have adopted some of those things and put some more thought of our own. In fact, some of those ideas are so good that Malcolm Turnbull tried to pinch [them] in his first budget last month.

CARLTON The claim from Labor and I guess from Doctors too is that the Coalition freeze which again was kicked off from the Labor party back in 2013, the freeze was going to cause Doctors to just what, start charging people where they were bulk billing before? Are you worried in perhaps rural and regional areas you will have Doctors worrying they cant make a living working in these sorts of towns with that sort of rebate coming back from the Government and they might shut up what was the actual impact of the freezes remaining in place until 2020 as the Government planned in rural and regional areas of Australia, particularly here in Tasmania?

JONES Great question, as I have been getting around the country, I have been talking to Doctors who were saying we have a choice to make. I can probably keep this practice going for another year or so but if the rebate extends, we will have to close up shop. And the other point is they are finding it very difficult to attract new doctors, particularly in country areas, because there are Doctors who can charge a lot more in the big cities then they can out in the country where people dont have the incomes. You are making a choice, you have spent twelve years of your life studying, you probably have a big university debt and the rest of it, I can pay that off relatively quickly, in the city or I can go to the country and probably never pay it off. A lot of people are making an economic decision about that and not setting up practices in the Country. It is impacting on the number of doctors available in the country as well.

CARLTON Now there is some carrot here for the Doctors, obviously, is there any stick involved because there is no guarantee that I can see that Doctors will actually pass on the or continue to bulk bill or pass on the savings ultimately to patients. What guarantees are in program that the savings will actually be passed on?

JONES Look, I think the guarantee in the program will be the people who are visiting those surgeries, those Doctors surgeries, and saying you have run a big campaign, you asked us to sign your petition to back in this policy change so that you can continue to bulk bill me, if you are not going to do that, then I will be moving to a different Doctor and we know that there is competition amongst Doctors in many areas, not everywhere.

CARLTON Assuming there is only one in regional and rural areas.

JONES And that goes to my very point mate. If we want to continue to have people out practising in these areas, where incomes are lower, we need to be able to support those rural and regional practices.

CARLTON Tell me, I have to ask you this question Stephen, David Feeney, this is a bit of a problem isnt it, there has got to be some sort of move in the party to have him disendorsed. I mean the idea that he has kept so many of his investment properties off his pecuniary interest register for so long now, a couple of years, its unconscionable. How can, especially when you guys are campaigning against the negative gearing situation, the process as it is now, you want to change that. Here is a very senior member of your Party who is in a difficult seat at the moment, lots of challenges there from the Greens. Bill Shorten has to disendorse him or remove him.

JONES No, I think it was a dopey thing mate and it sends a message to all sides of politics and there have been others, Tony Abbott with some of his.

CARLTON Stephen, a NSW Premier, Barry OFarrell, had to fall on his sword over a bottle of wine.

JONES He fell on his sword over a bottle of wine because he gave false evidence in a court about it. Thats why. Now lets be frank about it. There is a whole heap of other smelly stuff around that as well Brian, but lets just cut to it, I think he has done the wrong thing, he apologised, he said he is going to sort it out. I dont think the Federal election is going to be pulled out [of] because of this. When I talk to people in the street, they want to know about the future of Medicare, they want to know about the future of their school funding, they want to know who has a better plan for jobs in their region, not about some bloke from Melbourne who they have never heard of.

CARLTON But that bloke from Melbourne is a Federal politician running for office, for a major political party and he has been breaching the rules that apply to all Parliamentarians. Now if any normal citizen breaches the rules, the social rules and legal rules, they are sanctioned, there is not going to be any sanction here apparently.

JONES Like I said Brian, I think it was a dopey thing to do, he is getting a boot in the pants over it, I dont think it is going to be the issue that determines the election. That will be around health, it will be around education, it will be around the jobs of all Australians, not one politician from Melbourne.

CARLTON I still think your Leader could show a little bit of backbone here. He needs to do these kinds of things, he needs to be seen as a bit tough, as a bit of a Leader and I dont think letting Feeney get away with this is going to do him any good at all in the long run. Anyway Stephen, I appreciate your time, thanks for having a bit of a chat and we will see how things play out.

JONES Great to talk to you mate.