Who will voters trust to deliver the $8.5 billion Medicare pledge?

Under a pre-election promise aimed at wooing voters struggling with soaring healthcare costs, Labor has unveiled a historic $8.5 billion injection into Medicare – the largest since its inception over forty years ago. In response, the Coalition, eager to neutralise health as an election battleground, swiftly pledged to match every dollar.

The pivotal question now is, who will voters trust more to deliver on this election pledge?

Labor’s Medicare funding promises that 90% of GP visits will be free from out-of-pocket expenses by 2030.

Federal Health Minister Mark Butler took aim at Opposition Leader Peter Dutton, honing in on his time as a former health minister.

“He started a six-year freeze on Medicare funding that stripped billions of dollars out of Medicare and froze the income of all of general practice. But when we came to government almost three years ago, bulk billing was in ‘free fall’. A free fall directly caused by Peter Dutton’s Medicare freeze,” Minister Butler said.

Treasurer Jim Chalmers confirmed that $5.4 billion of the $8.5 billion was already provisioned for in the MYEFO, leaving uncertainty about the source of the remaining funds and its impact on deficits.

Amid speculation of an imminent election announcement, Shadow Health Minister Senator Anne Ruston criticised the Labor government for neglecting healthcare.

“Australians deserve the quality healthcare that they have been successively denied over the last three years. We will not stand in the way of a mess that the Labor government have made that they’re now seeking to try and remedy,” Senator Ruston stated.

The Coalition’s $9 billion commitment includes matching Labor’s Medicare pledge plus $500 million for mental health support, aiming to sway voter sentiment.

Consumer Health Forum (CHF) CEO, Dr Elizabeth Deveny, said “What we have been consistently hearing from consumers for some time now is that they struggle to find providers that will bulk bill them, and they simply cannot afford to see a doctor.

“This investment, if taken up by GPs, will significantly reduce out-of-pocket costs when consumers see a GP.”

The Australian Medical Association (AMA) President and GP, Dr Danielle McMullen, cautioned against Labor’s ambitious promises. She said, “It is quite difficult to see how it will make a huge increase in some of our central, metropolitan areas. We expect there will be higher uptake in rural and regional Australia, but also areas of socio-economic disadvantage.”

Labor’s projections suggest their funding could facilitate 18 million additional bulk-billed visits annually, extending free GP access from children and pensioners to more Australians. Their policy includes broadened eligibility for bulk-billing incentives, a new rebate loading for exclusively bulk-billing practices, and investment in 400 nursing scholarships and 2,000 new GP trainees per year by 2028.

The taxpayer cost for expanding bulk-billing – now a bipartisan effort – will begin at $1.1 billion in 2025-26, escalating to $2.4 billion by 2028-29. Over the initial four years, expenditure will total $8.5 billion, with ongoing investment estimated at $2.5 billion annually thereafter.

The National Rural Health Alliance (NRHA), serving over 7 million people in rural and remote Australia, voiced “concerns about the delayed implementation of the bulk-billing changes, set to commence on 1 November. The success of these incentives hinges on having a local workforce and leveraging the economies of scale that urban practices enjoy. A multi-pronged approach will ensure equitable access to Medicare.”

The Primary Care Business Council (PCBC) Board member and lead provider of regional GP services, Dr Hamish Meldrum, said “Affordable and timely access to a GP should not be dictated by a patient’s postcode or bank balance. Australians will be relieved to know that, regardless which party wins Government at the pending election, this unprecedented Medicare reform will occur, ideally supported with other key policies to ensure the sustainability of general practice.”

A recent analysis by the Australian Institute of Health and Welfare (AIHW) revealed a decline in GP bulk-billing rates from a 40-year peak of 89% in 2020 to 78% in 2024, despite recent bulk-billing incentives. Cleanbill’s survey revealed a decline in practices fully bulk-billing patients, dropping to 20.7% at the beginning of this year from 35% two years ago.

While short-term measures to improve bulk-billing are welcomed, the Australian College of Nursing (ACN) urged sustained reform and implementation of the Scope of Practice Review recommendations, emphasising the critical role of nurses in healthcare delivery.

“The evidence is clear: nursing care today saves a hospital bed tomorrow,” said ACN CEO Adjunct Professor Kathryn Zeitz.

Recent polling indicates a tight race, with the Coalition holding a 51-49 lead over Labor in the two-party preferred stakes.

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