The Budget’s most significant measure in relation to
Medicare was confirmation of the Government’s position that it would not
proceed with changes announced in the Mid-Year Economic and Fiscal Outlook
2014–15. At MYEFO the
Government proposed modifications to rebates for Level A and B general practice
(GP) consultations, a $5 reduction in rebates for GP consultations for
non-concessional patients and an optional patient co-payment. Reversing these measures
is expected to cost the Budget $2.9 billion over the forward estimates.
Last year’s budget announcement of a $7 GP and pathology co-payment had been dropped
and replaced by the MYEFO measures. A pause on indexation of
Medicare rebates introduced in last year’s Budget remains in place until 2018.
Following broad opposition to its revised MYEFO proposals, the
Health Minister Sussan Ley recently announced a new approach. 
A review of all items on the Medicare Benefits Schedule (MBS) will be conducted
by a Review Taskforce to ensure these align with current clinical evidence. In
addition, a Primary Health Care Advisory Group will be established to: identify
ways to provide better care for people with chronic and complex conditions;
identify innovative care and funding models and improved treatment options for
mental health conditions; and, ways to improve integration between the primary
and acute care sectors. Lastly, it is intended that clearer Medicare compliance
rules will be developed in consultation with representatives from the medical
profession, clinical leaders and patient representatives. It is expected that
these processes will be ongoing, with priority action areas due to be reported
in late 2015. This approach has been broadly welcomed by
the medical profession, although they remain opposed to the pause in
The Budget allocates funding of $34.3 million over two years
to support these review measures as well as the activities of the Medical
Services Advisory Committee (which reviews applications for Medicare funding of
new medical treatments).
A number of new and revised MBS listings have been funded in
the Budget, at a cost of $39.8 million over four years.
New listings include introducing Medicare rebates for: second expert opinions for
certain types of pathology testing; telehealth optometric services; remote
monitoring of cardiac devices; new investigations for gastro-oesophageal reflux;
and intraoperative radiotherapy for breast cancer. Revised listings will apply
to paediatric surgical services and computed tomography colonography.
It is intended that savings of $144.6 million will be
achieved by modifying health assessments provided under the MBS that duplicate
child health assessments already provided by state and territory governments.
A Healthy Kids Check is currently funded by Medicare for children who
have received, or are receiving their four-year-old immunisation.
A number of jurisdictions also offer child health checks. For example, the
Victorian Government funds free regular health and development checks at Maternal
and Child Health centres for children up to the age of three and a half.
Currently, a child health check is required in order to obtain
a certain family payment. Under the Healthy start to school measure, parents
with a child turning four and in receipt of Family Tax Benefit (FTB) Part A,
may be required to arrange a child health check in order to qualify for the FTB
Part A Supplement. Health checks that meet
the requirements for this include A Healthy Kids Check as well as specified
child health checks that are conducted by state and territory jurisdictions.
Details of what the revisions to health assessments will be
are not provided in the Budget, but some media suggest that the rebates paid to
GPs for conducting the Healthy Kids Check might be halved.
If GPs want to make up for their lower rebate, they may choose to move away
from bulk billing these services. Parents may have to bear any additional cost
to access health assessments or may opt to forego the health check altogether. The
President of the Australian Medical Association, Professor Brian Owler, has
questioned whether duplication in child health assessments even exists. Owler suggests
that the proposed review into primary health care is best placed to consider any
changes to these assessments.
In another Budget measure, the Medicare Levy low-income
thresholds for singles, families, single seniors and pensioners will be
increased in line with movements in the Consumer Price Index , at a cost to
revenue of $231 million over the forward estimates.
Increasing these income thresholds is meant to ensure that those on low-incomes
remain exempt from paying the Medicare Levy. Legislation will be needed to
raise these income thresholds.
The Budget also reveals that Medicare expenditure is
expected to exceed $21.1 billion in 2015–16, an increase of 1.6 per cent from
the previous year. Growth in Medicare expenditure to 2018–19 is expected to be
6.7 per cent in real terms, which is below forecast growth in expenditure on
the private health insurance rebate (7.0 per cent), but higher than for the
Pharmaceutical Benefits Scheme (3.8 per cent) over the same period.
Total Australian Government expenditure on health is expected to be $69.4
billion in 2015–16. This is an increase of $2.3 billion from 2014–15.
Australian Government, Budget
measures: budget paper no. 2: 2015–16, p. 102; see also S Ley
(Minister for Health), Government
to consult on Medicare reform, media release 15 January 2015; Government
continues Medicare consultation, media release
3 March 2015.
Australian Government, Budget
strategy and outlook: budget paper no. 1: 2015–16, pp. 3–20.
Australian Government, Mid-Year
Economic and Fiscal Outlook 2014–15,
S Ley (Minister for Health), Abbott
government to deliver a healthier Medicare, media release, 22
A Tillet, ‘Doctors
back review of Medicare rebates’, West Australian, 23 April 2015, p.
measures: budget paper no. 2: 2015–16, op. cit., p. 104.
Ibid., p. 103.
Australian Government, Portfolio
budget statements 2015–16: budget related paper no. 1.10: Health portfolio,
measures: budget paper no. 2: 2015–16, op. cit., p. 103.
Checks can be undertaken by medical practitioners or by nurses under
supervision of a doctor. Details are in Department of Health (DoH), Medicare
Benefits Schedule, ‘Category
1 Professional Attendances: Note A26’, DoH website.
Department of Education and Training (DoET), ‘Your
Maternal and Child Health Service Visits’, (DoET) website. Child and
development reviews are conducted by nurses.
Section 61A of the A
New Tax System (Family Assistance) Act 1999 specifies health check
requirements. Certain exemptions for health checks apply. Parents will be
notified by letter if a health check is required. See also Department of Human
Services (DoH), ‘Healthy
Start for School’, DoH website.
DoH website, op. cit.
spending cuts a prescription for big changes’, Courier Mail, 13 May
2015, p. 6.
B Owler (Australian Medical Association), Transcript
of doorstop interview with Brian Owler: Parliament House, Canberra: 13 May
2015: 2015 Health Budget, 13 May 2015.
measures: budget paper no. 2: 2015–16, op. cit., p. 26.
Amendments to the Medicare Levy Act 1986 will be required.
strategy and outlook: budget paper no. 1: 2015–16, op. cit., pp.
Ibid., pp. 5–8.
All online articles accessed May 2015.
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