Brick by brick we say goodbye to Medicare

Michael Springer

3 years ago

One of the great moments of social accomplishment which arose out of the election night in 1983 when Bob Hawke and the Australian Labor Party (“Labor”) were so emphatically elected to power was the knowledge we had Gough Whitlam’s important social reform of free universal health care would be restored, after the Fraser Government had privatised Gough’s Medibank. That enthralling night in 1983 heralded the introduction of Medicare in 1984, a social initiative which meant as much to Bob Hawke as it did Gough Whitlam.

Turn the hands of time forward 39 years later and what we now have regarding universal health care is a shadow of what used to be the socially responsible policy of universal health care under the umbrella of Medicare. Before I take you to the evidence I have received from Australians who assert the Liberal Party is pulling apart the structure of Medicare brick by brick (the identity of these witnesses has been protected to ensure they are not subjected to febrile reactive commentary of trolls whom may wish these people harm), there are issues in relation to our universal health care system in which I am either personally subjected to, or which impoverished Australians are now experiencing reduced funding under the Morrison Government. My personal experience shall be addressed in the paragraph immediately below, followed by the Australians who have reached out to me about the insufficient Medicare rebates.

There was also an announcement made by Mr Morrison on Friday, 25 March 2022 regarding endometriosis and pregnancy funding, an announcement which generated criticism online by women as being a product of cynical political motivations of an unpopular Prime Minister in the last weeks of an electoral cycle. Now before anyone begins to type the words of scorn directed at me regarding Mr Morrison’s announcement, may I say I have deep sympathy for any woman who has suffered endometriosis or pregnancy problems, as my wife and I suffered a harrowing 5 years of trying to fall pregnant until our bundle of joy being our daughter was born in December 2012. I recorded our harrowing journey, including the mental health aspects of it, in an article I published on LinkedIn during 2015.

As many of you are aware, I suffer from a Major Depressive Disorder, various anxieties, and post-traumatic stress (‘PTS’). Some of my mental health problems stretch all the way back to 1979. Indeed, you may say my mind has been a torture chamber since I was 9 years of age, as I endured either the mental health problems themselves, or alternatively battled very low self-esteem or self-confidence which was a product of the torture of my mind, and the mental concerns I held about my body. When I had my mental health breakdown at about this time last year, I was fortunate to have private health insurance to ensure I could be treated by a psychiatrist at a private hospital immediately. Many Australians are not so lucky to be insured to this level of medical protection, or they don’t have any insurance at all. Nevertheless, notwithstanding my private medical insurance protecting me financially in relation to my treatment at the hospital of my choice by my psychiatrist, it does not provide sufficient coverage for me regarding the extremely necessary psychological counselling I must participate in if I wish to become healthy again.

Now, once again, before the Liberal Party screaming trolls embark on a journey of criticising me again, I acknowledge psychological counselling was first added as part of item 80110 to the Medical Benefits Schedule (‘MBS’) in November 2006. However, 16 years later, 10 of which years have been under the rule of Liberal and National Party Federal Governments, there is a significant financial and social inequity which now arises regarding psychological/ psychiatric treatment. I must incur over $2,000.00 of psychological counselling costs, in which I am only partially rebated at about 50% of the cost of the therapy, before Medicare increases to absorb approximately 80% of the psychologist’s fee. I have not worked since early March 2021, so every dollar counts on my budget. However, I am fortunate to live in a highly advantaged area of a major city, because for every Medicare dollar spent in my area on psychological counselling, the least fortunate areas only receive 76 cents.

The inequity of the rebate system regarding psychiatric treatment is even more extreme, as for every dollar of our public money we disburse for psychiatric treatment under Medicare, disadvantaged Australians only receive $3.45 compared to the highly advantaged areas of the nation receiving $7.70. This inequitable disbursement of funds under the present Medicare system of psychiatric/psychological care has been previously reported by the ABC in December 2020, yet the Morrison Government has not seen fit to ameliorating the inequity in the system since that ABC report. Medicare was established in the interests of equity, not inequity.

Nevertheless, the disassembling of the Whitlam/ Hawke social initiative of Medicare extends beyond psychiatric/ psychological care, as we are now witnessing an entrenched system under Liberal governments of disassembling Medicare brick by brick regarding the payments or rebates made under the MBS, as is evident from the experiences of the people I have been contacted by (for the sake of their privacy they shall remain anonymous) requiring public health care:

1 DW has suffered from a variety of health problems during her lifetime. She has told me she now has to pay over $300.00 for her Shingles vaccination, which used to be on the PBS and is still free for people aged over 70. DW is not 70, but she suffers from bouts of shingles about once every 18 months, therefore she needs the vaccination. Her blood tests are only authorised once a year by the Medicare rebate. In 2003 DW also paid $2295.00 to have 5kg of angiolipoma removed from her body, a cost which she paid upfront and then discovered Medicare would not rebate her because a plastic surgeon performed the operation, which Medicare deemed as ‘cosmetic’. DW appealed the decision and was successful. She is very concerned with the way the current government and the Howard Government have approached medical rebates under Medicare. She has also told me about the uncertainty and worry amongst the aged community in relation to hip, knee, and shoulder replacement rebates, because they may have to pay large out of pocket fees.

2 Cat needed an MRI of her knee, but it’s no longer subsidised for over 60s according to her GP. She had to settle for a less comprehensive x-ray. Cat informs me it is painful for her to stand for more than an hour or to use public transport. She has also told me the job agency she is using can only offer her unsuitable jobs, in that they are unsuitable because of her medical condition.

3 GRF is a breast cancer survivor. GRF told me since being diagnosed and treated for breast cancer in 2017, there are now no more free mammograms for her, and from now on she will have to pay for her mammograms. GRF has also told me it’s her opinion the defunding of Medicare by the current Federal Government is real, and it is worse for people with more invasive cancers as they don’t receive Medicare rebates.

4 RW is a disabled and impoverished woman. She says most people on benefits can’t afford to pay for pathology, and if you get a knee scan only one a day is covered under a Medicare rebate. RW says the same rebate policy applies to shoulders scans. She also told me if she needs an ultrasound, it’s just too much money for her to afford as an upfront cost. Finally, RW told me obtaining free mental health services for a person in her physical and financial position is very difficult, and there are no free psychiatric treatments available to her.

5 DMP is under 65, so free eye checks are now only available every 3 years whereas once they were free every 2 years.

6 TFC receives a Disability Support Pension (‘DSP’) because she suffers from a physical disability and autism. She told me she is currently being investigated for endometriosis. TFC couldn’t get an abdominal and pelvic scan bulk billed together, nor can she afford an MRI. TFC told me she is now stuck on a waiting list for a laparoscopy while elective surgeries are postponed because of Covid. She also told me the increased cost of pharmaceutical supplies means she now can’t afford melatonin to assist her with her sleep. In addition, TFC also can’t afford some of the blood tests she needs performed, and she even must pay in full for the vaccine boosters she needs due to one of her conditions causing her to experience complications with her immunity. The medical costs TFC must pay has made it impossible for her to survive on the DSP and to access the medical help she needs to keep her medical conditions stable.

7 SLJ has told me because of her age it will cost her close to $500.00 for a mammogram and ultrasound, to ensure the lump she has in her breast isn’t malignant. SLJ quite rightly asserts early detection of breast cancer is crucial for survival, but the system makes it financially difficult for her to have regular mammograms and ultrasounds. SLJ also queries how young women can afford these medical treatments.

8 ME suffers from an illness which requires medical intervention by a rheumatologist. She informs me her specialist, which ME must consult with regularly, costs her personally after the Medicare rebate $150.00 per consultation. It is a long-term illness which ME suffers from, and the Medicare rebate is insufficient to pay for consultations and then pay for her other costs of living.

9 CK agrees endometriosis is debilitating and painful, but she told me women who are facing life or death breast cancer diagnosis now must pay up to $800 for an MRI, due to Morrison’s cuts to Medicare.

10 JP told me she was recently informed she may have to pay $1,200.00 for a Familial Hypercholesterolemia blood test, which will be an out-of-pocket cost.

As you can see from the evidence provided to me by the above-mentioned people regarding their own personal experiences in the public health system, there are significant inequities in Medicare rebates which arise from conservative governments slowly dismantling the universal health care system which Mr Whitlam and then Mr Hawke enacted for every Australian to benefit from. During the Howard years we witnessed the emphasis shifting from public health to encouraging (for use of a better word) Australians to pay for treatment in the private health system, to move away from a universal health care system paid for by our public money. The costs of private health insurance have increased significantly since Mr Howard first came to power, and it is now a system in which only the advantaged can afford top healthcare cover. Indeed, the current Leader of the Opposition, Mr Albanese wrote about the Howard Government’s broken promises in an article he published online on 15 April 2005. The disadvantaged people, such as the people who contacted me above, rely upon Medicare. It is a system of public health care cover which has suffered from the previous cuts made by the Howard Government, including locking the bulk billing rate into 66.5% of the GP’s costs.

Upon Labor returning to power Medicare was reconstituted by Mr Rudd’s proposed reforms in 2010 which were implemented by Ms Gillard’s reforms during 2011. Sadly, almost 1,000 further changes to the MBS have been made by the Morrison Government during 2021, which the Australian Medical Association described as ‘chaos’, including the costs of GP’s leaving a gap of up to 34% under the rebate scheme. The Howard and Morrison Government’s have destroyed what was the great social medical scheme of Medicare introduced by Mr Hawke in 1984.

Finally, I shall briefly return to Mr Morrison’s endometriosis funding announcement on Friday, 25 March 2022. As I stated earlier, I have only the deepest sympathy for women who have experienced problems with pregnancy and endometriosis, particularly as my wife and I experienced so many difficulties for approximately 5 years before we were fortunate to fall pregnant. As I also explained above, many women on social media on 25 March 2022 found this announcement to be a cynical announcement, given Mr Morrison’s political misfortunes now. Mr Morrison made the announcement in circumstances where the Newspoll published the previous day recorded his personal standing to be further diminishing, and the Roy Morgan poll published on 23 March 2022 listed him as the most untrustworthy politician in the country (it was quite an extensive poll conducted by Roy Morgan, with over 12,000 people being interviewed and the top 10 most untrustworthy politicians are Liberal and National Party and other politicians; no Labor politicians featured in the untrustworthy list). Channel 9 also interviewed Mrs Morrison on 25 March 2022. The very resourceful online journalist Ronni Salt has previously examined on 13 March 2021 Media Cloud, and she discovered either Mr Morrison’s communications team, or some partisan elements of the media, referring to Mrs Morrison’s personal health problems on the following occasions:

1 July/August 2018 when Mr Morrison was vying to become leader of the Liberal Party (don’t be fooled by that hand on Mr Turnbull’s shoulder).

2 April/May 2019 when Mr Morrison was campaigning for re-election.

3 September 2019 when the story broke about Mr Morrison trying to obtain an invite for Mr Houston to attend a dinner at the White House with former President Trump.

4 February/March 2021 when questions were raised about the alleged conduct of some Liberal members or staffers.

Now I can’t say definitively what motivated Mr Morrison’s announcement on 25 March 2022 regarding some funding for endometriosis and pregnancy treatment, but the announcement has been made right before an election will be called, and if it wasn’t a politically motivated initiative of announcements and personal revelations of a medical health problem suffered by women, then why didn’t Mr Morrison introduce the proposed medical funding during June or July of 2019? Notwithstanding what opinions you may form about Mr Morrison’s announcement on 25 March 2022, or Ms Salt’s previous investigations, one fact is certain; Medicare is slowly but surely being pulled apart brick by brick, particularly by the Morrison Government.

So here's how much Scott Morrison values women.

But before we look at this, I want to make very, very clear that I have enormous sympathy & respect for any woman brave enough to talk about her fertility issues & any struggles with depression – and that includes Mrs Morrison.

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— Ronni🧂Salt NowOnBlueSkySocial (@RonniSalt) March 13, 2021