Stephen Cenatiempo:
Time to catch up with the Assistant Minister for Charities, Competition and Treasury. Or have I got that in the wrong order? A Member for Fenner, Andrew Leigh. Andrew, good morning.
Andrew Leigh:
No wrong order, Stephen! Great to speak to you.
Cenatiempo:
Too many bits in there, so. Yeah, anyway, but they’re all important. Let’s talk about this $8.5 billion policy. Why is it that both sides of politics seem to think that bulk billing is the only thing that matters?
Leigh:
Well, Medicare is a fundamental Australian institution. It means that you can go and see a doctor when you’re sick without worrying about the cost. And certainly, for many Canberrans, that cost has been adding up. We know that getting a bulk billing doctor here in Canberra, if you’re on a low income but you don’t have a Health Care Card, has become increasingly tough. So, this policy is a gamechanger. It will ensure that more Australians can see a bulk billing doctor. It’ll be critical here in Canberra. And as you said, Peter Dutton, the man who once said there were ‘too many free Medicare services’, is signing up to this at the last minute because he realises that his record on health is dismal.
Cenatiempo:
Well, but that’s the point. But that ties into exactly what I was saying about this Mediscare campaign, which is all lies. I mean, the whole – I’ll give you an example, and I’ve heard you say it, too, that Peter Dutton ripped $50 billion, $50 billion – I think it was $50 million out of the hospital system. Not true. It was money that was promised and never delivered. So, it was never taken out of the hospital system.
Leigh:
Well, let’s go to the Australian Medical Association. They estimate that the freeze to Medicare rebates started by Peter Dutton resulted in $8 billion being stripped from Medicare over the coming years. Now, that’s the AMA’s number on that. He put in place a freeze on Medicare rebate…
Cenatiempo:
Let’s be honest, the AMA had a vested interest.
Leigh:
Well, I’m giving you a third party, Stephen, because I know that you’re wanting independent analysis on this. It was an independent survey that found that Australian doctors rated Peter Dutton the worst Health Minister in living memory. These are simple facts.
Cenatiempo:
Hang on, let me stop. Well, that’s not a simple fact. That’s a – well, the Australian Medical Association represents a very, very small number of doctors in Australia. I think it’s running at about 30 per cent now, firstly, so it’s not representative, and secondly, they have a vested interest. They’re going to say what suits them, not what suits the country.
Leigh:
Well, that’s their economic analysis of the effect of Peter Dutton’s Medicare freeze. The survey is what Australian doctors thought of Peter Dutton. And the fact is that this announcement will ensure that by 2030, 9 out of 10 GP visits will be bulk billed. We’re going to get more bulk billed practices – at least one in every electorate across the country. For Canberrans, people remember the National Health Co‑op where you didn’t have to have a Health Care Card in order to be bulk billed. The closure of that practice has meant that it is now very hard in my electorate of Fenner to find a bulk billed doctor unless you’ve got a Health Care Card.
Cenatiempo:
But Andrew, doctors are now saying that this policy is not going to increase the bulk billing rate and not going to increase access to bulk billing doctors.
Leigh:
Well, certainly the peak bodies have been strongly supportive of what we’ve done. The ACT government has talked about this as being a game changer. We understand the value of getting more doctors and more nurses in at the same time. And that’s why there’s the nurses and doctors training program sitting alongside this. We need more professionals in order to support an ageing community and a growing one.
Cenatiempo:
No doubt about that. We need more doctors. And when you say the ACT government’s supportive of it, that’s because it lets them off the hook for their failures in keeping GP clinics open in Canberra. But I’ll give you an example. Now, this is according to Google. So, I’m not, you know, and correct me if I’m wrong, but as an Assistant Minister, you’re on somewhere in the vicinity of a quarter of a million dollars a year, you can afford to pay $50 bucks to go to the doctor. Why shouldn’t you?
Leigh:
Well, this isn’t about me, Stephen, and I certainly agree. When you get to the very top of the distribution, you can have an argument about bulk billing. But I think for somebody who is on the minimum wage, who doesn’t have a Health Care Card that they’re really struggling to find a bulk billing doctor in Canberra right now, as a result of the former government’s policies.
Cenatiempo:
But that’s not what this is about because the Prime Minister has said one in 10 visits to the GP will be bulk billed. That’s not the most vulnerable. That’s everybody.
Leigh:
Nine in 10 is the goal by 2030.
Cenatiempo:
Yeah, that’s what I’m sorry, yeah.
Leigh:
The Albanese government is strongly supportive of getting Medicare back to where it was. The whole promise of Medicare is that healthcare would be ‘cheaper, simpler and fairer’ and it’s been struggling with that ever since the freeze put in place by the Coalition.
Cenatiempo:
But again, and this is a criticism of both sides, why not come up with a bold policy that actually looks at the structural problems with our healthcare system instead of just throwing money at it and saying bulk billing is the answer to everything.
Leigh:
We don’t have a system in which GPs are employed by the government as they do for example in the UK the National Health Service. That’s a system where the government really does have control over all the levers. Ours is a private system, a system in which we’re able to provide rebates to doctors, but we need to use incentives rather than simply a command and control system. What this new policy does is it puts in place the largest single investment since Medicare was created, with the aim of increasing bulk billing rates and getting them back to where they were before the crisis that was caused by the former government.
Cenatiempo:
Well, wouldn’t it be easier if you want to get bulk billing rates to help the people that it’s needed to have a 2 tier system which is what Peter Dutton tried to do when he was Health Minister. Now the policy that was written by his staff was a lot better than the one that Treasury finally approved. But as I say, I mean if you can afford a co‑payment, you should pay a co‑payment. That would take a lot of pressure off the system and allow the most vulnerable to be bulk billed when they need it.
Leigh:
Well, Peter Dutton tried to end bulk billing entirely. So, what he wanted to do was make sure that no one got to go to the doctor without paying.
Cenatiempo:
Yeah, with a $7 co‑payment. I mean fair dinkum.
Leigh:
That was his initial plan. And then when he couldn’t end bulk billing, he started the 6‑year freeze on Medicare rebates which we’ve spoken about before. No one has a worse record on Medicare than Peter Dutton. No one has a better record on Medicare than the Labor government.
Cenatiempo:
Well that’s not true, that’s politics. That’s pure politics.
Leigh:
Name a health minister who has a worse record than Peter Dutton on Medicare.
Cenatiempo:
Mark Butler.
Leigh:
Mark Butler has set about restoring Medicare, has made the greatest investments into Medicare and has ensured that that we are putting Medicare at the heart of the Australian health care system.
Cenatiempo:
Well on his watch, bulk billing rates have gone from 89 per cent to 77 per cent.
Leigh:
The number you’re starting off with is of course a COVID number. Naturally bulk billing is going to be high when you’re including the RATs and PCRs, all of which were bulk billed. But if we look at the true bulk billing rate, when we came to office, doctors were warning that bulk billing was in ‘freefall’. We had a real crisis in Medicare. Labor has set about addressing that crisis since we came to office.
Cenatiempo:
Well okay, but isn’t it interesting, you’re addressing it in the, in the lead up to the election, not while you’re actually in government. All right, let’s move on to some other issues.
Leigh:
This is one of many announcements we’ve made in bulk billing.
Cenatiempo:
Yeah, well, you know, and, and the, and it hasn’t. Well, as I say, bulk billing rates are still in freefall. Now the government is helping 62,000 charities by ensuring that states and territories collaborate effectively with the federal government. How does this work and what’s, I mean, I guess this is your portfolio. What sort of duplication happens in this area?
Leigh:
Too much, to be honest, Stephen. I would like it if charities were spending less time complying with different federal, state and territory requirements and more time helping the vulnerable. Most people running charities are doing it voluntarily. They’re filling out the paperwork in their spare time. So, that regulatory duplication is something we’re trying to address by getting state and territory representatives onto the charities commission board. And that’ll reduce some of the duplication and allow charities to do the kind of ‘report once, use often’ approach. There’s a charity passport which allows them to have a single point of contact when they’re dealing with government. And, you know, it’s all about just reducing their paperwork burden.
Cenatiempo:
Yeah, it’s. I mean, I guess the difficulty you have here is that there’s enough evidence that there are charities out there who are doing the wrong thing, and I suppose you’ve got to protect or safeguard against that, but I imagine the vast majority are doing the best they can.
Leigh:
Absolutely. It’s a great sector and it’s a real privilege to work with them, to do the charity forums and hear about all the work they’re doing – the arts sector and the environment, helping out the kids sport – all of those terrific things charities are doing. You’re spot on, Stephen, you’ve got to have that integrity in place. If charities do the wrong thing, we’ve got to crack down on it, otherwise the integrity of the system is a threat. But the vast bulk of charities are strengthening the Australian social fabric every single day.
Cenatiempo:
Is the Prime Minister going to go and visit the Governor‑General on Sunday?
Leigh:
Your guess is as good as mine. The boss will make a decision when he decides to, but he’s somebody who believes that we ought to have longer terms. So, I think that you can expect that he’ll be continuing to govern and continuing to focus on leading.
Cenatiempo:
Andrew, good to talk to you. We’ll catch up in a couple of weeks, maybe. Unless there’s an election called.
Leigh:
Look forward to it. Thanks.
Cenatiempo:
See ya mate. Andrew Leigh, Assistant Minister for Competition, Charities and Treasury and Member for Fenner.