#Medicare architect calls for doubling of levy
MARK COLVIN: Universal free access to visits to the doctor could be on the way out.
The Federal Health Minister, Peter Dutton, has flagged the idea of a co-payment for wealthier Australians.
The Minister says Australians should have a “frank and fearless discussion” about the health system and how we pay for it.
But the Opposition is accusing the Government of attacking Medicare.
One of the architects of the system has told PM that there is a simpler and more equitable way of raising money to pay for health: increase the Medicare Levy.
But, as David Mark reports, the Health Minister has ruled that out.
DAVID MARK: The Federal Health Minister, Peter Dutton, acknowledges that Australians hold Medicare dear. But he also says he wants to overhaul the system.
PETER DUTTON: And I want to make sure that, as our population ages, as we need to pay for new technologies and new life-saving drugs, that we have a system that will continue to grow and strengthen into the future. So that’s why we’re having a national debate. I think it’s important and I think it’s important that people are properly informed about the reasons why we need to strengthen Medicare into the future.
DAVID MARK: The levy we pay for Medicare started at 1 per cent and is now 1.5 per cent of our incomes.
JOHN DEEBLE: We actually portray the levy as equivalent to a premium.
DAVID MARK: A private health insurance premium?
JOHN DEEBLE: Exactly the same idea.
DAVID MARK: That’s John Deeble, an Emeritus Fellow of the ANU. He’s also one of two men credited with proposing a universal healthcare system for Australia, one that ultimately led to Medibank and then Medicare.
JOHN DEEBLE: And when the costs go up, the levy would go up in line with the costs.
DAVID MARK: But the levy has only ever covered a percentage of the total public healthcare cost: at the moment around 18 per cent, according to the Australian Institute of Health and Welfare.
On 7.30 last night, Peter Dutton flagged new means of paying for health, including the idea of a co-payment.
PETER DUTTON: Many Australians already pay a co-payment when they go to see the doctor. Now, the issue is: how you guarantee access, particularly for those who are without means, and how you don’t deter people from going to see a doctor if there is some sort of a payment mechanism in place.
DAVID MARK: The Opposition’s health spokeswoman is Catherine King.
CATHERINE KING: What you now are starting to see is Peter Dutton start to attack Medicare and basically say, “We think we need to start opening this up, opening this up for having consumers pay far more for their healthcare than they do already.”
DAVID MARK: The issue for critics of co-payments and other user-pays ways of charging for healthcare is equity.
Emeritus Professor John Deeble says, under a co-payment system, poor people have to pay more as a proportion of their income.
JOHN DEEBLE: Because it’s not related to their income. It’s related to their use. But it’ll be the sickest people who pay the most, no matter what you do on a user-pays basis.
DAVID MARK: And do the sickest people tend to be the poorer people?
JOHN DEEBLE: They tend to be.
DAVID MARK: His answer to the problems facing the Australian health system is to raise the Medicare Levy.
JOHN DEEBLE: If you relate health care costs against income over time, it should be about 2.7 and 3 per cent. Let’s say it should be 3 per cent.
DAVID MARK: Double it?
JOHN DEEBLE: Double it.
DAVID MARK: But the Health Minister says that won’t be happening.
PETER DUTTON: Well, the Medicare Levy at the moment is at 1.5 per cent and the Federal Government has no plans to increase the Medicare Levy.
But I’d make this point: the Medicare Levy at 1.5 per cent raises just under $10 billion a year. All up we spend in this country $140 billion on health each year. So even if we raise the Medicare Levy to 9.5 per cent, for somebody on an average wage of $77,000 we would be taxing them $7,220 to meet just the Commonwealth contribution.
JOHN DEEBLE: No, of course it’s not. It’s rubbish.
DAVID MARK: John Deeble.
JOHN DEEBLE: That means that the Government would spend no money out of revenue. But what he was saying is that, you know, it would be 9 per cent instead of 1.5 per cent. He’s already said what, implied what the proportions are. The Government would save all that money. If he put it up to 9.5 per cent, you would be entitled to a rebate of your tax for that amount.
DAVID MARK: John Deeble, Australians don’t like tax rises and Australian governments certainly don’t like implementing tax rises. Do you think there’s any will within Government, or for that matter within the community, to see the Medicare Levy double?
JOHN DEEBLE: I think it’d be the easiest thing to sell that you can possibly imagine.
DAVID MARK: Why is that?
JOHN DEEBLE: Because it applies to everybody and it can be sold as fair. It can be sold as the only thing that is fair. Everything else would be random in the way it works and it would work to the detriment of either the sick or the poor or both.
MARK COLVIN: Emeritus Fellow of the ANU John Deeble ending David Mark’s report.
Source: ABC NEWS