Topics: Out-of-pocket expenses, Medicare, PBS, codeine, gang crime in Melbourne
I’m joined by the Federal Health Minister Greg Hunt. Thanks for your time, Minister.
It’s a pleasure. Good afternoon and a Happy New Year.
Well, another year where I’m sure you’ll have plenty to talk about, because certainly as I said there, your portfolio’s front and centre of public debate in so many ways, isn’t it?
Look, absolutely. It’s hard to imagine a portfolio which would touch more Australians, and whether it’s mental health, whether it’s visiting the GP, whether it’s procedures or aged care, it all falls within Health, and it’s a real privilege to be able to do things like announce new drugs for lung cancer and for myeloma, which we did starting as on 1 January, that’s when you get a sense of how important it is and how it can literally save lives and transform lives.
Yeah, so true. The issue of health insurance, I know you made those reforms, those announcements in October which were generally welcomed, but out-of-pocket expenses.
It continues to be one of the bugbears, doesn’t it, and do you think there is something in this report from that committee saying that specialists, in particular, or medical professionals should publish their fee structure online?
So there are probably a small number of absolutely critical things. One is to bring down the pressure on private health insurance, which we’re doing.
Two is to make sure that the most common form of out-of-pocket that people could face is if they had to pay going to the GP and we’ve just announced the highest bulk-billing rate in Australian history.
So, 85.9 per cent, so basically 86 per cent of people go to the doctor on a day-to-day basis and pay nothing. And three is to work on the out-of-pocket specialists.
That’s where I’ve stepped in, I’ve asked the Chief Medical Officer to begin a process of increasing transparency, so as people don’t get bill shock.
They know what they are up for, they know what they are up for before they enter into an arrangement with a specialist, and that way they can make their own decisions in an approach which is fully informed.
And I’ve worked with the AMA and the College of Surgeons, and the College of Surgeons is really working very quickly at the moment to come up with a model, and I think you’ll find that the medical profession will be much more onside than some have reported.
Well, see, I think one of the things about this is it’s always a very sensitive time. We’ve all, or many of us, have been to our GP, and there comes that we need to refer you to a specialist comment, and that’s obviously a time where it’s a bit emotional, in many cases, so to make this an easy way of finding out this information’s got to be critical, surely.
I think it is fundamental that people are able to know what they will be facing in terms of costs, and I have had some surgeons say to me, well, I will charge a certain amount and be very clear.
Another surgeon of a similar competency will charge a much greater amount with quite an impact, and the patient won’t know about the quality of one versus the other.
It’s very much an area of faith, and so patients need to know about the quality of care and the cost of the care in advance.
What about the comments made by Michael Gannon, the President of the AMA, saying that there would be a number of different codes used by medical professionals and therefore it would be difficult to come up with a meaningful set of numbers, almost to say that the public wouldn’t understand what’s going on. Do you think we can come up with a meaningful way of doing this?
I do, and I’ve discussed it with Michael at length, and he’s supportive of greater transparency. I think there are one or two of the ideas in the Senate report that he thought were not going to work, but he and I met only just before Christmas in relation to a whole range of issues.
We spent a couple of hours together, and one of the questions that we want to work on together, and I think in a very constructive way, will be transparency of out-of-pocket costs.
So for the listeners, what does that mean? It means you know what you’re going to pay and you know what you’re going to get. In almost every other product, we know that in advance, yet there’s a bit of a sense that it’s almost impolite to ask what the fees will be, and it’s not impolite.
It’s fundamental so as people can ask, but people can also access the information that they’ll need as patients in order to make a judgement on the quality and the costs of their care.
Your portfolio obviously involves the issue, I think more than most, of the ageing population, and the word sustainable has been put with our public health system, and rightly so, for quite a long time.
Yet, as we saw at the last federal election, we had the Mediscare campaign of Labor, we saw it resurface only very recently at the Bennelong by-election.
Does that mean that there’s certain issues that the Government won’t tackle because they’re worried about the Mediscare campaign, such as, say, a co-payment, et cetera?
Well, we’re not proposing a co-payment, and I’ve ruled that out since the day that I came in, and that position hasn’t changed.
And in fact, the highest bulk-billing figures on record, which came out in December, in which we announced actually in Bennelong, are the strongest possible evidence that more people are being able to visit the doctor without having to pay anything.
Now, you always have to look to be efficient and effective, but what we’ve been able to do is strike agreements with the doctors, with the medicine makers, and with the device or what are called prostheses makers.
And in the case of the pharmaceutical manufacturers and the prostheses makers, they’re $1.8 billion and $1 billion of savings that we’ve been able to secure, and that gets reinvested respectively into more drugs at lower prices, and secondly into lower health insurance costs in relation to the prostheses or devices coming at a lower price. It allows private health to come down.
So they’re deep, fundamental reforms which we’ve done in the last few months, and they’ve been able to deliver very good outcomes for patients and very good outcomes for the sustainability of the health system.
So that’s my approach, to have these agreements with sectors in return for reform and therefore reinvestment.
Do you think, though, the Government has put its case strongly enough? As I said, it was resurrected, this Mediscare campaign by Kristina Keneally, with some effect, you have to say, even though she lost, and it was a hallmark of the last federal election.
It seems to be something that the Government’s not really putting the case strongly enough to dock the Mediscare argument or tactic out of the water.
Look, I think it had a big impact at the last election. I’d take a different view on the Bennelong by-election.
Having spent a lot of time on the ground, they tried it, in an ordinary by-election you would have expected a larger swing, and what we saw was far less than Labor was expecting, let alone hoping for, and most people just found that there was no context.
There were claims which were disproved immediately, and I think we’ve learnt from the experience of the last election, so we dealt with the fibs about having to wait for an hour at the Medicare office, when in fact the average waiting time was 13 minutes, and not one person in the numerous people who visited the Medicare office had to wait an hour.
So those types of things (inaudible) instantaneous response on, but more importantly for the public, the highest bulk-billing rate, downwards pressure on the historical changes with regards to private health, and now greater transparency on your out-of-pockets for visiting a specialist.
Okay, so what do you see for this year? The main thing we’ve talking about, I guess, this week – apart from the gap, of course, the out-of-pocket, has been to do with codeine. It seems to be the issue that’s not going to go away. Do you think when February comes it will settle down?
I do think that’s the case. I respect everybody’s views. It was a decision by the medical specialists on medical grounds in 2015, and that’s been the case. So there’s been the longest of long runs leading up to it.
The pharmaceutical makers have changed their lines, they are now offering different combinations of ibuprofen and paracetamol.
Of course, the codeine products are still available through the doctor, but because of the opioid crisis in the United States and the fact that we’re losing over 100 lives a year through over-the-counter codeine products here, the medical specialists, over two-and-a-half years ago, unanimously, unanimously, from every state and territory, made the recommendation which was then adopted by the federal regulator and is being put into law in every state.
Yeah, you had that pushback from the states, though. There was some pushback from the states.
Well, yes and no. There was some noise, but any state could opt out, and all of the states’ chief medical officers and pharmacy officers reaffirmed their unanimous support to the federal regulator.
So again, it came about because the opioid crisis is real. In Australia, we’re losing 100 people a year, which is, when you think of it, each road trauma is an immense tragedy, 100 road traumas or 100 opioid deaths is just a catastrophic human outcome, and when the medical profession says there are better, safer alternatives available, I think we have to respect their judgement and their decision two-and-a-half years ago.
Okay. Well look, just before I let you go, regarding the fact that your electorate is near Melbourne – around the Mornington Peninsula, in Victoria, of course a lot, obviously, being talked about again in recent days about Sudanese gangs, and I know the Prime Minister pointed the finger at the Andrews Government. Is it a concern for you, based on where your electorate is?
Yes, look, I have some very close friends, one of our family’s closest friends, who were assaulted. They were assaulted by African gang members.
This happened in Melbourne’s Northern Suburbs only a few months ago, an immense amount of trauma. So it’s real and it’s probably the number one issue in Victoria, I would say. I do think the Andrews Government has been in denial.
I know that there was a Federal Labor report where, recently on migration, where they denied that there was a gang problem, and in particular, an African gang problem in Victoria.
Now the Victorian police have acknowledged it. I think they’ve been in a difficult situation because the government in Victoria was denying it.
Frankly, the answer’s very simple. We’ve got State Opposition here led by Matthew Guy, and they have a proposal for tougher sentencing, tougher bail laws and better resourcing for the police and calling it for what it is, when it’s a gang crisis with a particular focus coming from the African gangs.
Well, political correctness has stopped this being resolved as quickly as it should, hasn’t it?
Well, I do think that, for whatever reason, the Victorian Government has been in denial, and I know talking to local police, they want to get out, get the job done.
They also want to make sure there are good social alternatives for a lot of these gang members, but frankly, there’s no substitute for tough policing, tough sentencing and giving the police the resources and the freedom to take the steps that they desperately want to take.
Okay. We’ll leave it there for now. Thanks so much for- we covered a fair bit of ground there, but happy new year and all the best for 2018.
Thanks a lot. Cheers.