Australian primary care policy in 2004: two tiers or one for Medicare?

Hal Swerissen

doi:10.1186/1743-8462-1-2

Abstract

The recent primary care policy debate in Australia has centred on access to primary medical (general practice) services. In Australia, access is heavily influenced by Commonwealth Government patient rebates that provide incentives for general practitioners not to charge copayments to patients (bulk billing). A steady decline in key access indicators (bulk billing) has led the Howard Government to introduce a set of changes that move Medicare from a universal scheme, to one increasingly targeted at providing services to more disadvantaged Australians. In doing so, another scene in the story of the contest between universal health care and selective provision in Australia has been written. This paper explores the immediate antecedents and consequences of the changes and sets them in the broader context of policy development for primary care in Australia.

Highlights

Primary health care and community care can be thought of as a set of health programs and services
Most discussions of the primary health and community care services sector suggest that it has the following characteristics: (1) It is the first point of contact with the health system
This may occur through general practice, community health services, and pharmacies

Summary

Introduction

Primary health care and community care can be thought of as a set of health programs and services. It was proposed to introduce a Medicare Benefits Schedule item for nursing support in general practice and improved internet access and online billing for GPs. MedicarePlus provides rebates for up to five allied health consultations delivered to patients with a chronic condition or complex care needs, for and on behalf of a GP. With the introduction of the safety net, the potential for incurring unmanageable costs is significantly reduced and bulk billing rates for this group may decline Whether effects like these are experienced in practice will depend on factors such as the real value of GP rebates, patient need, capacity to pay, GP supply and regulatory constraints. National planning and priority setting processes for primary health and community care to ensure greater alignment of Commonwealth and State priorities

Australian Institute of Health and Welfare

Findings

Sax S: A Strife of interests: politics and policies in Australian