Australians will be spared expensive trips to specialist doctors and benefit from more telehealth appointments under a series of sweeping changes to Medicare.
Some GPs have begun telling patients to register for a free new government service called ‘MyMedicare’ which launched on October 1.
Under MyMedicare, Australians are able to formally register their preferred doctor’s clinic and GP with the government – if the clinic is signed up to the scheme.
A number of benefits will then flow to signed up patients and doctors under the Albanese government policy.
The federal Labor government has this month introduced MyMedicare where Australians can formalise their relationship with their GP to get access to new services compatible with the 21st century
Medicare change #1: Telehealth changes
One of the biggest changes – which has already kicked in – is that Medicare will cover longer telehealth doctor’s appointments for registered MyMedicare patients.
Telehealth appointments that receive a Medicare rebate were capped at 20 minutes. Patients who have registered with MyMedicare will have sessions longer than 20 or 40 minutes covered by Medicare rebates.
The government expects this will see Medicare rebates cover about half the cost of such a telehealth appointment, on average.
Australians can now have a long Zoom call with their doctor and will be spared from having to travel vast distances to see separate medical specialists if they register with MyMedicare (pictured is a stock image)
Medicare change #2: Specialist, GP shake-up
In further MyMedicare changes, being introduced over several years, GPs will be able to consult with a specialist and provide advice directly to a patient.
That’s instead of GPs always referring patients to separate specialists for a series of expensive in-person appointments.
This means a GP will be able to seek and provide advice from a dermatologist, a gynaecologist for women’s issues or a urologist who specialises in men’s health – rather than having to refer patients to separate appointments for every part of the body.
Lump sum payments will be provided to specialists so they share advice with doctors.
Get GPs ‘to do more’
Dr Stephen Duckett, an honorary professor at the University of Melbourne who ran the federal Department of Health and Ageing during the mid-1990s, said the specialist plan was designed to get GPs to do more.
‘You want to get the primary care system to do more so that the person who’s looking after your urology also understands about your heart,’ Dr Duckett told Daily Mail Australia.
‘You want to reverse some of this separation of the body into body parts and look at the whole person.
‘If you can try and get the general practitioner to do more, then that’s a good thing.
‘You’ve got continuity of care and especially in a system where more and more people are having multiple, chronic diseases, the more you can have one person really looking after them, supported by these other specialists without you having to go to the other specialists.’
Medicare change #3: Encourage bulk billing
From November 1, doctors will also be paid triple the bulk bulling incentive payments for appointments with children under 16 and patients with Commonwealth concession cards.
The incentives will be even bigger for doctors who serve patients who live in regional, rural and remote communities.
This will support Australians who ‘feel cost of living pressures most acutely’, the government said.
What experts think of the plans
Dr Duckett said the telehealth changes would bring the country’s healthcare system into the 21st century.
‘The Covid pandemic dramatically changed our views about telehealth and our inclination to use it, both telephone and video calls, and when you think about it, this is now 2023 and we shouldn’t basically have a health system which is stuck in the 1950s with face-to-face care for everything,’ he said.
Dr Duckett said MyMedicare addressed issues of medical honesty by requiring Australians to register their longstanding connection to a particular GP practice to enable telehealth to be covered by taxpayers.
‘What MyMedicare does is say, “Look, because you’ve signed up with the practice, it means you intend to have an ongoing relationship with that practice and you may well already have an ongoing relationship with that practice, and so we will trust the practice to use telehealth appropriately”,’ he said.
Tony Sara, the president of the Australian Salaried Medical Officers’ Federation, said longer telehealth consultations would be particularly valuable for patients who lived in regional areas, a long way from their doctor.
‘It can’t completely replace face-to-face care so it has a role to play, particularly in the bush,’ he told Daily Mail Australia.
‘It increases the reach of services, it doesn’t completely replace them.’
Bill Bowtell, an adjunct professor in health at the University of New South Wales, was a little more skeptical.’ He was a senior policy adviser to former Labor health minister Neil Blewett, who was in charge in 1984 when Bob Hawke’s government introduced Medicare
Bill Bowtell, an adjunct professor in health at the University of New South Wales, was a little more skeptical.’
He was a senior policy adviser to former Labor health minister Neil Blewett, who was in charge in 1984 when Bob Hawke’s government introduced Medicare, reviving Australia’s system of universal healthcare that briefly existing during the mid-1970s.
‘Telehealth is all very well, but it cannot be used as a replacement for in-person visits to doctors without co-payments and other charges,’ he told Daily Mail Australia.
This means MyMedicare may not address the Medicare gap issue with patients ending up being out of pocket because Medicare doesn’t cover the entire doctor’s bill, as many GPs decline to bulk bill.
The Australian Medical Association, which represents doctors, is concerned about the model of providing lump sum payments to doctors to encourage them to bulk bill and provide specialist advice after liaising with specialists.
President Professor Stephen Robson said the AMA was concerned Australia could emulate the errors of the UK approach, known as a capitation payment system.
‘The AMA will continue working with the federal government to ensure programs attached to MyMedicare improve access to care for patients and that these expand over time, while also ensuring that this does not lead to a flawed capitated model used in the UK,’ he told Daily Mail Australia.
Nonetheless, the MyMedicare changes could also help address Australia’s doctor shortage which has seen medical students opt to become specialists, who are typically paid more than double, or even triple, what a suburban GP gets.
Neurosurgeons had an average taxable income of $604,582 in 2020-21.
Dermatologists typically made $333,099 compared with $398,888 for gynaecologists and $458,794 for gastroenterologists who specialise in intestinal problems.
But general practitioners were typically paid $187,408, after work and investment property expenses were deducted for tax purposes.
Dr Stephen Duckett, an honorary professor at the University of Melbourne who ran the federal Department of Health and Ageing during the mid-1990s, said the specialist plan was designed to get GPs to do more
Dr Duckett argued this aspect of MyMedicare could solve Australia’s GP shortage crisis by making medicine for the suburban doctor more interesting, encouraging more medicine students to consider that field.
‘It will make the GP’s job more interesting and secondly, it will reduce demand for specialists and people who might otherwise wanted to become a specialist might say, “The GP’s work is more interesting and there’s going to be less work for specialists”.’
Since October 1, Australians have been able to register with MyMedicare by nominating a GP or Aboriginal healthcare specialist.
As of early October, 2,600 GP practices had registered with MyMedicare, accounting for almost 40 per cent of the 6,500 practices in Australia.