Tag: medicare

The impact of a livable welfare safety net on this World Mental Health Day

I’ve written plenty before about how different aspects of Australia’s public health care and social welfare systems have helped or hindered my mental health. Getting DSP was a huge factor in being able to stabilise my mental health. Not because of the extra money – My partner rate of DSP is $888.50 a fortnight before rent assistance (singles get $1,178.70), while jobseeker is $726.50/$793.60 without supplements, but because I get to know that I’ll have a steady amount coming in each fortnight, that I’ll be able to pick up work for extra money as it suits me without losing the payment, and I don’t have to jump through the hoops of Job “providers” anymore.

We have data here in Australia that suicides dropped when people were getting the COVID supplement (welfare at the poverty line) and there was less requirements to engage in useless mutual obligations. Internationally – Brazil gave poor people money and their suicide level dropped too.

We hear of the futility of giving people therapy when they don’t have stable housing, when they can’t afford their meds, when they’re harassed by external pressures.

I could only complete the DBT block I did because I didn’t have mutual obligations or a job, it WAS a full time job fore me, even though it was “only” two sessions a week. The amount of energy I had to put into that to make it work and then to carry out the work in my own life left little for other things.

Participants in the DES and CDP systems – being renamed to Inclusive Employment Australia and Remote Australia Employment Service (RAES) respectively will be getting a reprieve from mutual obligations until new year while those services change over to their new programs, logos and contracted providers. But JobSeekers in mainstream services will have to keep jumping through hoops, even though there’s more and more evidence of people being suspended from their payments illegally or incorrectly, and little desire for the government of the day to address it.

Cancellations of payments have been suspended but that doesn’t mean much when you still could find your bank account empty on payday due to error – whether it’s through incompetence, malice or system design. Not good for the mental health I’d say.

Getting to sign a new least for another 12 months on this house, even though it was a $40/week rent increase, lifted another weight that I didn’t know I was carrying. And even though the inspection this week came after the lease was sign, there was still that weight of hoping that we’d cleaned well enough, that the preexisting damage wouldn’t be blamed on us. That having another person living here but not on the lease wasn’t gonna be a strike on our record.

Albanese is bragging about the 2 million visits to the urgent care clinics. Which, as I always say, have their place. But don’t take the place of having access to a bulk-billing GP (lol there’s none here) who knows you and can provide continuity of care. ESPECIALLY for those who need it most. The GPs in this area charge $100 upfront ($80 with a concession card). I really doubt that many at all will be changing to all bulk billing come November First when the extra incentives come in. We’ll see though. My GP DID bulk me last visit, but that was probably because I was near tears about a few things including talking about how one of my meds is $95 a month and not on the PBS. Which I need to not feel guilty about – every time I post something about GPs not bulk billing people encourage me to ask to be bulk billed, but then there’s the flip side of GPs posting about how they hate to be asked, and my belief that the Medicare payments should be raised to a level where all practices are able to viably bulk bill all patients. Such a socialist.

So as we make the rapid run to Xmas, I’m relieved to have signed a lease through to November next year, am doing a couple days HSC exam supervision for the next month, and feel settled again after a few months that just kept throwing things at me.

What little things are you doing for yourself to stay sane, because we can’t rely on the government to do them?

 

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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.

To participate in the Program, practices will need to: Bulk bill all eligible services Advertise their participation in the Program Be MyMedicare registered (note that practices that are not already MyMedicare registered and wish to participate in the Program will be exempt from MyMedicare accreditation requirements). To register in the Program, practices will need to: register to participate in MyMedicare register to participate in the Program via MyMedicare.

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.

1800MEDICARE: Free urgent care on your phone and in your home 27 April 2025

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.

24 hour health advice you can count on 1800 022 222 Government Accredited with over 140 information partnersHealthdirect logo We are a government-funded service, providing quality, approved health information and advice Australian Government, health department logo ACT Government logo New South Wales government, health department logo Northen Territory Government logo Queensland Government logo Government of South Australia, health department logo Tasmanian government logo Victorian government logo Government of Western Australia, health department logo

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!

Step By Step – Labor Hoping to get a Second Time Around

Who remembers the 90s family sitcom Step By Step?

Step by step
Day by day
A fresh start over
A different hand to play
The deeper we fall
The stronger we stay
And we’ll be better
The second time around
SO we’re getting Labor’s election promises now, ahead of a probably March 25 budget and some time before May 17 election. Today’s was building on their increased bulk billing incentives for concession card holders and kids, something I described as killing universal bulk billing. lol. Was I wrong though? The announcement today is trying to extend that to all Medicare card holders, but only if the GP becomes exclusively bulk billing. I have a  few concerns.
The rate for GPs to bulk bill will be $69.56 in the cities. My GP currently charges $80 upfront for those one concessions and $100 for regular Medicare card holders. Those rates seem pretty standard, and are higher in some places. So you’re asking GPs to take a $30+ cut per session to become bulk billing again.
It only applies if ALL patients are bulk billed. I’m sure many of us have had doctors in the past that have sometimes bulk billed (especially for follow up appointments or if they’ve asked us back) but also sometimes privately billed. So they won’t have that flexibility.
I’m going to assume it won’t, but I hope that GPs currently only bulk billing concession patients won’t lose those current incentives if they choose not to add regular patients to bulk billing.
The Medicare rebate remains around $43 for a regular level B consult, and doesn’t look to be going up any time soon. So privately billed patients who are then claiming rebates will continue to be $35-$55 out of pocket a session (using my GP’s current pricing).
There’s also concerns that this won’t apply to Mental Health and Enhanced Primary Care health planning sessions and these will continue to be a barrier to people seeking mental health and other allied health care.
There’s been lobbying around increasing the number of mental health (currently 10) and general allied health (currently 5 total) session people can claim on Medicare. Haven’t seen much about increasing the rebates for those (HUGE gaps huge huge gaps) especially with trying to keep people out of NDIS who need these. We’ll see.
So those are my Sunday thoughts.
It looks like I’m going to be using my words for an Online panel on March 11 – “Talking about Poverty: How to have conversations online, in the community and in the media” as a leadup event to the People Against Poverty conference mid-year. It’s free to come! And I’m terrified!
Let’s go!

Odds are, Bill, the sun WILL come out tomorrow, but the vulnerable will be worse off, and I don’t see Labor changing that any time soon

So Bill thinks we’re all getting a little hysterical when we say that people will die because of the NDIS legislation they’ve pushed through with Pauline’s help. He tells us not to be anxious and that the sun’ll come out tomorrow. I know it will Bill, it’ll be above average temperatures all week on the East Coast and all. But people will be worse off, and have their care needs neglected because of your legislation. They will also be more vulnerable to taking their own lives because of losing supports that keep them safe and healthy, and because of punitive Robo whatever actions you’re overseeing with the lovely staff leftover from Robodebt that have found new lives in the NDIA compliance teams.

I’m not going to put in links to reference this post, I’m sick, and have a GP appointment at 12.15. One that I get to pay $80 upfront for because your government has not helped Medicare bulk billing, and nowhere around here routinely bulk bills concession card holders anymore.

Jimmy’s also promised that he won’t do anything on the welfare end either in the lead up to the election. So, we don’t have to worry about being hopeful or disappointed and we can move straight into getting the Greens and Independents to promise real action on welfare. We have all the evidence that lifting welfare to the poverty line won’t affect Jim’s Inflation, but Labor won’t help us, so it’s time to go around them. Jimmy said this morning there’ll be a March budget ahead of the May election. So that’s his last chance to disappoint us and tell us he thinks we deserve poverty to make his bottom line look nicer.

Are you a unionist? How are you feeling about the Labor- Union relationship with the CFMEU? You don’t have to think that the CFMEU are good or bad to agree that it seems a bit of overreach and a real threat to the union movement to have worked with the LNP to impose 3 years administration….

So, I want a magic answer from the GP, I need to this cough gone. It’s getting in the way of me actually getting out and doing the things I’m otherwise ready to do mentally. I need to be able to talk. And yell. And scream. And rage against this fucking machine.

Middle fingers up til the reaper shows up.

Stares at a wall

Monday?

Taylor’s boyfriend looks scary.

Watchin Rafah, watching people ignore Gaza, wondering what that siren is in our street, apparently they’re looking for a man with face tattoos in Toronto.

Saw a new GP in the same practice. She seems good, sending me for tests, talking about my medication levels with me. Gotta get some bloods check my kidney and liver, an ECG for my heart to see if the mads are doing me more bad than good. See if my shakes have anything to do with that and a trippy heart.

Wasn’t bulk billed. $76 upfront, a woman apologising profusely for not being able to pay the other day, signs saying fees for late payment, and man yelling at the practice manager because they weren’t going to see him because he was owing money and shouldn’t have been rebooked in until it was settled. A growing line.

I did the grocery shopped and waited for my ride with the other pensioners outside woolies. More than a dollar a can for on special Diet Coke doesn’t sit right for me. But I’ll pay it. It’s my only real vice. But cadbury was $3 a block too so that was good.

Forgot bacon and mayo.

Oh well.