phonakins

Promises, Promises – Health Announceables vs Their Likely Reality this Election

(aka why GPs aren’t going to go back to bulk billing but it might save the few remaining bulk billing practices if you’re lucky to have one near you that caters for ongoing patients and more complex needs aka not an urgent care clinic which has a place but isn’t the answer we’re looking for)

Upcoming Changes to Bulk Billing Incentives in General PracticeStrengthening Medicare with more bulk billing from 1 Nov 2025. The Australian Government is investing $7.9 billion to expand eligibility for bulk billing incentives to all Australians and establish the Bulk Billing Practice Incentive Program to support general practices to bulk bill all patients — The Claim

So, this is the measure that Labor reckons will get bulk billing at GP’s back to 90% of consults. It was a key part of the campaign, along with more urgent care clinics – which are GP practices you can drop into for a one-off consult for something acute but not needing hospital – like back pain or a sprain or something. They say go there for a break but I’m not confident all centres have X-rays so it’d be best to check your local one before deciding there over the Emergency room.

The first version of the increased bulk billing incentives came in for kids and concession card holders in November 2023. If your doctor took it on that’s awesome, but very few did in Newcastle and Lake Macquarie. One local practice will do it for under 14s and over 65s, but not for concession card holders between those ages (or 15-17 year old kids). Most practices, including the one I go to has a discounted upfront fee for concession card holds – some have different levels for blue and green concession card holders and for kids. Upfront GP costs about $100 here with Medicare card only and $80ish for concession, with the $42 rebate for a standard level B consult.

The extra incentive, depending on location, gives an extra $20+ per consult to the practice, if they bulk bill the patient. There’s a loading of 12.5% too in the new version if they bulk bill all patients. They also need patients enrolled in MyMedicare, yeah yet another program rather than upping the medicare benefit paid across the board.

The patient des not get this if they’re privately billed. SO most of us are still going to be out of pocket $40-$60 a visit if we can afford to front up the cash. So, many are still stuck rationing their ongoing healthcare to if they can afford it, or if they can GET to a urgent care clinic (not at all easy by public transport) or waiting it out til it’s an emergency and being thankful in NSW that if you have a concession card you can get free ambulance.

Personally, I’m continuing to schedule my GP appointments for ongoing care and scripts around pension days so I know I’ll have the money upfront. But not everyone can work that, or be able to be down $40-60 after the appointment even with rebates being paid back that night – and not everyone even has a regular GP or one taking on patients in their area.

We’ve used the urgent care clinic for stuff, but it’s completely unsuitable for mental health care or anything ongoing physically.

The base rebate needs to be higher – enough to either incentivise bulk billing or to allow people to get the money together to go knowing they’ll get most of it back to then be able to afford their regular expenses or medications that are prescribed.

Another announceable at the end of April was the “1800MEDICARE“..

Whether you need expert health advice or reassurance, the registered nurses at 1800MEDICARE will be there all day, every day, to provide advice and refer you to the health service you need – whether that’s your regular GP, the local hospital or a Medicare Urgent Care Clinic.

So, at the initial level, the 1800MEDICARE number and service is a rebranding of the Health Direct line, staffed by nurses 24/7 in conjunction with the states. I’ve used that service personally and at work, and have been transferred to them from 000 (don’t worry it wasn’t life threatening) for more thorough triage and consult.

What 1800MEDICARE is adding to this is a GP service between 6pm and 8am, able to give you a prescription after hours when urgent care clinics aren’t open. For me, if I got a script from them it might be helpful and I could fill it at 8:30am weekdays locally when the chemist opened, or if some one was able to drive there’s chemists 15 minutes away open 9-4 Sat, 9-2 Sundays. They can order bloods I guess to then get done in business hours? But I’m not really sure how much more they can offer that the nurse line can’t. So it’s a helpful extra service, but not going to solve the problem people have of not being able to afford to have an ongoing GP.

If you need urgent GP care that can’t wait for your regular GP to be available, the triage nurses will connect you to a free telehealth session with a 1800MEDICARE GP via phone or video, available all weekend and weeknights between 6pm and 8am.

On your phone and in the comfort of your home, a 1800MEDICARE GP will provide the free care you need, like an emergency prescription for your regular medication, or treatment for an illness or injury.

I’m currently waiting for my GP to call, since I changed my appointment today to telehealth since I’ve been snotting up the place. After the call, reception will call me to get my card details for the $80 fee, of which I’ll get $42.85 back from Medicare this evening. Fortunately I have been into the clinic in the last 12 months so I AM eligible for the rebate.

So I’ll save the mental health promises and anything else I think of for next time.

Love yas!

So, Labor, are you going to use your power for the good of the vulnerable or for the good of your donors?

Ahh, well, that was a little disappointing. I remember last election, when Labor got in my mental health nurse saying “you must be happy with that result” and I was extremely cautious in my response, feeling like I was expected to be happy, but very much wanting to wait and see how it panned out for me and the causes I care about.

It all started here.

Growing up, mum was in and out of hospital. Rheumatoid arthritis crippled her joints and she was on the invalid pension.

We lived in public housing. And having a safe, secure roof over our heads meant everything.

For me, politics has always been personal.… pic.twitter.com/7rursL5YCu

— Anthony Albanese (@AlboMP) May 2, 2025

The night before this weekend’s election, Albo wheeled out his childhood and how that set him up for success, and boy were we cynical in response. I mean, Labor has not helped people like his mother at all. Public housing is barely a thing and dwindling slowly. Yes, there may be “social” housing builds but the rent is higher and the conditions less kind to tenants. DSP and other pensions have not gone up this term, despite Labor members claiming so. The only increase in them has been due to legislated inflation and much of that because inflation was so high when Labor came in.

The $20 a week that Jobseekers and Youth received is long gone and was less than the previous governments increase ($25/week) in real dollars.

Rent assistance for those 14% of welfare recipients who get it has gone up to a whole $100/week max with those two “real” increases this last three years. It still isn’t giving people access to private rentals in this country, with Anglicare’s latest snapshot showing someone like Albo’s mum (who would have been unlikely to get DSP for arthritis these days but would have benefitted from Labor reinstating single parent payment for kids up to 14) not being able to afford any private rentals in the greater Sydney area.

So, on Saturday night I had two reactions, one was disappointment and skepticism that Labor will do anything progressive with their second term and continue as they have the last three years – fiddling around the edges, saying they can’t be too bold, working with the LNP to pass watered down legislation like the NACC through the senate. The other part of me wants to be hopeful that the “just give them time” people actually were right and they will actually be bold this term because they have no opposition to fear losing to. (I really don’t believe this but I WANT to be proven wrong about this for so many reasons)

"If we were going to make changes, then why haven’t we?"

can I apply that to everything else we thought you'd make changes on @AlboMP?https://t.co/6RMoeRl0HH pic.twitter.com/KOugbIODEr

— 💜 phonakins 🍉 speak because your voice shakes (@phonakins) May 1, 2025

Our work here has barely begun. We saw the glimmers of hope that there was becoming enough glaring evidence before the election that the suspensions to payments and compulsory activities for JobSeekers and younger disability pension recipients were illegal as well as useless and expensive to administer for few positive and many negative impacts.

One in 5 adult suicides are on the JobSeeker payment. Fourteen per cent are on the Disability Support Pension.

Something needs to give – payments needs to be raised above the poverty line. The country can “afford” it, it won’t impact your precious inflation in any significant way, and the benefits to the health and happiness of people should be enough to sway even the most miserly. It’s the right thing to do.

There ARE easy fixes, and the government has the evidence it needs to implement them. It just needs to want to do it and stop sacrificing the poor.

6 weeks until the People Against Poverty Summit. Trying to get my rest on so I can get back into helping with preparations and be able to travel u there for in and a few other things we may plan for the week before or after. I worked Friday and Saturday supervising exams which rekt me and gave me a cold, and I’m trying to remind myself I made the right call to decline working the Sunday at the last minute even though the money would have been great it would have knocked me out for the week for sure. Pacing pacing, both physically and socially – it takes a lot out of me.

There was a pre-conference online session last week on running a street kitchen – given the despair some a feeling it’s worth a watch if you want some ideas for help to help people practically in your immediate community.

If you’re in a position to help us with the costs of getting people in poverty to the conference, consider donating here. Or if you’re able to host someone from out of town or want help to attend, check the linktree.

Routine and Pacing – staying sane when you get a little off

Touch grass they say – but don’t repeatedly kick the same toe on things, it gets tiring after awhile, and it doesn’t give it a chance to heal and somehow you’re still hobbling weeks later.

So I got overloaded, took on too much mental load, spread myself too thin, so I’m cutting back on somethings, to make life sustainable.

I’m ensuring I follow my little routine, that includes meds and white hot chocolates, and winding down after dinner. This means I’ll be declining after 6pm meetings from now til the conference in June. I’ll be showered and onesied on time, meds around nine, white hot chocolate before that. Breakfast has gone back to porridge sachets for winter – except this week since my partner bought a dozen hot cross buns I’m trying to get through!

I’m going to go back to (close to) daily Japanese practice and streaming. Started on a new vocab game yesterday. So, the plan is an hour of practice followed by variety game streaming a few mornings a week, no real schedule it’ll depend on everything going on around me and of course it’s more about getting back into good habits that nourish me – and the Japanese language has always been that for me. Recommendations for websites and programs to use are more than welcome – I know Duolingo did that things with more AI use since I was last using it, so while I’ll probably tap into that a little, I’m all for a scattered approach. I’ll set up my second cam for colouring and kana practice, and perhaps my cheap graphics tablet if I can find a kanji program that would work well with pen input rather than mouse. There was a program I had on an emulator that I was going to use with that but then I did a system reinstall and it’s gone.

Also keen to fill this board with stuff – Amazon slips or pictures from frens or whatever may come. I’m pleased to say I’ve a couple of regular monthly supporters here, and it’s such a mood boost even though one’s for $1/month!

Language matters but so do your goals

You know how some people use all the right buzz words but their heart’s not in the right place? Usually in activist spaces they talk the talk and can focus on the hot topics, but move on once it’s not cool anymore, or there’s a better opportunity elsewhere. Or, their methods don’t work to lessen or get rid of the root cause of a problem but mainly build systems to sustain bandaids around it. These systems and often businesses will call themselves “not-for-profit” but everyone being paid to do it lives a comfortable life that doesn’t need them to challenge whether they’re doing this the most effective way.

That’s a problem with everything being a business, or using the language of business in charitable endeavours. Are you working to establish new markets or expand your footprint? Are you doing ANYTHING to remove the need for your services? Does your model depend on continuing the status quo – do you need a steady supply of people or animals to keep suffering in order for your day job to continue? Are you treading water on their behalf? We’re all part of the systems, but it’s great to know where you fit in and question your role in keeping people down rather than actually improving their lot in life.

Do you claim to speak for the voiceless? If a person is conscious, they are likely able to communicate for themselves in some way. Even the pre-intentional or pre-symbolic communicator can communicate with those familiar with how they communicate. But if you’re seeking to be the voice of someone who can actually say what they need and want, what they struggle with and how they can be best helped? You’re probably talking over them rather than giving them the chance to speak to those in power themselves. Help them to learn “they ways” of policy jargon or talking in the media, rather than saying hey look at these people suffering give us money for short term remedies rather than addressing the problem.

You can help people short term, it’s okay. But you have to stop building your lives and businesses around keeping people down.

I’m repeating myself but so long as we’re seeing organisations aiming to expand themselves without daring to mention the causes of the issues – all the while talking for people in need rather than helping them speak for themselves – I’m going to have to.

We’ve announced the new dates for the People Against Poverty Summit – June 21 and 22 up in Maganjin/Brisbane. You can get tickets here – free and low cost tickets are available and people and organisations with money are encouraged to contribute more when booking or donate to the travel fund to enable us to get people in poverty from around the continent to the conference.

Our first online session is on Youtube for those keen to hear from me, Rick Morton and Kristin O’Connell about “Talking about Poverty” in media and online and IRL:

Also, if you’re inspired – get a Break The Poverty Machine tshirt or tote from the Antipoverty Centre store! It’s a great conversation started about tearing down the systems that keep people down in order to sustain themselves.

I get confused (and clumsy) when I’m tired

So tired. My foot hurts.

It’s not about a particular charity, I just talk about Foodbank because I’m a “customer” and we all need food.

I went into their ACNC listings today and this bit got to me (yes in amongst all the large amount of money changing hands for wages and rent and transport and buying food and selling food and school breakfast and so much more rather than just going directly to people in need to do with what they need to) from the Foodbank Victoria 2024 financials:

Advocacy - Be the leading voice for those in need of food We will deepen existing relationships and explore new partnerships that strengthen and expand our food relief work and allow us to be the voice and storyteller for all those in need of food relief.

“Advocacy – Be the leading voice for those in need of food We will deepen existing relationships and explore new partnerships that strengthen and expand our food relief work and allow us to be the voice and storyteller for all those in need of food relief.”

This is without any mention of the word poverty in the whole document. “Welfare” or “Pension” is not even mentioned. “Cost of living” is 3 times – in relation to increased demand and how “working families” and “the elderly” (not pensioners) are over represented as clients. Oh and decreased monetary donations such as at the checkout.

There is no lobbying from these organisations to raise welfare above the poverty line. Foodbank is a member of ACOSS, who also doesn’t have in its current asks welfare above the poverty line.

BUT TO SPEAK FOR PEOPLE IN NEED OF FOOD?

Do jam that pack of ANZAC biscuits in your mouth and shut up and listen to people in need. Let them talk for themselves and not through the filter of your organisational expansion goals.

Oh and it’s not one particular aspect of the reselling of donated or cheaply sourced groceries that gets me. It gets me that Foodbank highlights that they are struggling for food donations so has to buy it to keep up the supply. It bothers me that they then sell this on to local charities. It then bothers me that these charities feel the need to mark these up (a little or a lot) in order to fund their rent and emergency hampers. It bothers me that items end up similarly priced to supermarkets. It bothers me that there is so much machinery and expense around all this.

When people just need money to be able to buy their own groceries. When and what they need. Where they prefer to. Without restricted choices of what someone else considers important.

Yes, some people will always need emergency aid. There’ll be people with nothing for whatever reason – maybe they’re escaping violence or had a natural disaster or their house burned down, but guess what? When the rest of us can sustain ourselves, we have more to share directly with our neighbours and relatives and strangers who need a quick hand. Without the need for warehouses and charities taking details and eligibility and rationing something that’s actually pretty fucking abundant in this country.