Tag: medicare

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.

With MPs heading back to Canberra, what’s on your wishlist this cost-of-living crisis?

Saturday afternoon saw a flutter of tweets speculating about what might be served up to us plebs after Labor MPs return to Canberra early to solve the cost-of-living crisis and their slump in the important but not important at all polls.

I have my theories about what is possible and likely. And since I have a personal blog I get to write about them, with no qualifications other than I, too, am here in this country at this time, reading news and feeling the vibes.

Extending the energy rebates – This is an easy one as they’re only set for this financial year, so Labor will pop them into the May budget and probably even further expanded. I know they vary by state, but people already receiving concessions on their bills here in NSW got $125 a quarter off their bills automatically, and it was recently expanded to more families, but you have to apply. Not sure if they’ll up the value, or give it to more people. But it will be there for 24/25 and in place for the 2025 election.

Increasing the energy supplement in welfare payments – This famously hasn’t risen since its introduction in 2013 is it isn’t indexed. I get $10.60 a fortnight as a partnered disability pensioner. Could I see them doubling that supplement? Maybe? No, it’s not a huge amount extra, but it’d be extra targeted at the poorest on a hot item. It wouldn’t come in immediately though, might not even be til September if it’s a May Budget item.

Back to school payments – Yeah, it’s always a hot topic at this time of year, how expensive it is to send kids to public school, uniform and shoe costs, materials, backpacks, laptops and more. But it seems more pointed this year, perhaps it comes alongside the increasing stories of families living in tents, when they then have to find money for a laptop, let alone a place to reliably use it or charge it. It would be popular and really couldn’t be criticised. Cash payments to parents of school aged kids, non-means tested would be the fastest way and the most effective – but they do love their vouchers :/ It would take immediate heat off the government too, because they’ll need sometime that looks like it’s happening NOW, and feeding a clothing kids looks good.

Welfare Payments – I don’t see an increase to base rates happening this budget outside indexation, which is why I think the energy supplement may be a way to go about increasing the amount people are getting slightly, without angering the usual. I mean I WANT them to raise all payments above the poverty line, and I will push for that and ask for that and make arguments for it. But I don’t see it coming from this meeting, and not in the May budget. Would we believe them in they take it the the election though without any significant movement in the previous years? Yeah nah. That ship has sailed for Labor and unless they do blindside us in May with significant increases, particularly at the JobSeeker and Youth Allowance rates, noone’s going to believe their “good intentions” come 2025.

Rejig of Stage Three – Greg Jericho and The Australia Institute have done the legwork for them, giving them a model that flattens out the cuts a bit more while not removing them completely. You need to remember Labor voted for the bill in the first place and have been extremely insistent on keeping that promise to the top end. It also leaves them with money to put towards those other payments. I mean, they COULD just bring back the Low and Middle Income Tax Offset that was so sorely missed last year, that hit a lot of people unexpectedly. It’s an option. They won’t scrap stage three though.

A picture of Lego Unikitty with a tie and glasses drawn on, speech bubble with the quote “Business, business, business. Numbers. Is this working?”

Business business business (is this working?) – I really don’t know or care what they do for businesses, I’m sure that there will be heaps. Yeah, my partner is self employed but we really don’t get any of the subsidies and such that are out there at this level *shrugs*

From the previous cost of living measures that haven’t excited me all that much, I don’t think this meeting will bring more rent assistance, and while personally more money is nice rent assistance is way too little too late and not given to enough people. They need to buy more public housing now, since building is going to take forever. Acquire vacant properties, put them in the public housing pool in a couple of months. Maybe they’ll extended the increased medicare bulk billing incentive? But to who and how? And is it too late with doctors dropping bulk billing as I type? They won’t do anything with medicines, that was already a big one. Unless they lower the safety nets? Personally I need less upfront costs for medical care and medicines, not rebates that kick in later. If I avoid the doctor cos the upfront cost is too high, I’ll never reach the safety net. And I’ll be more expensive down the track.

What do you think will come out of Wednesday’s meeting and the May budget and will it actually make a difference to you?

 

How Labor Ensured the Death of Universal Bulk Billing

Yes yes, the LNP froze the Medicare rebates for years, pushing GPs away from being able to bulk bill all their patients, but many still chose to bulk bill, or offered bulk billing to kids and concession card holders. Others moved to private billing entirely, with some offering a slightly lower upfront cost if you’re a cardholder, but not all.

In all the cases where the GP is choosing to bulk bill or take a lower upfront payment they are effectively having to absorb that cost into the practice and have to covered by full fee paying patients.

But the changed to have a different bulk billing incentive for those that have a concession card and those that don’t has certainly stopped some bulk billing non-eligible patients, as they would then be worth $13 less per consultation, and where is the sense of obligation to bulk bill regular patients if they are worth less on the books than those with concessions and kids?

The RACGPs recommends a level B consult fee of just over $100. So, when they bulk-bill a patient, they are accepting a lower payment than if they charged them privately. If they private bill though, the patient will only get the regular rebate back, and that $20 is lost to the empty promises.

Who does the bulk billing incentive apply to? This incentive only applies to the following vulnerable patient groups, and only if they are bulk billed: Children under 16 years Commonwealth concession card holders (Centrelink or DVA cards): Pensioner Concession Card Health Care Card Commonwealth Seniors Health Card How much is the bulk billing incentive? The bulk billing incentive applies to eligible patients as per the following locations: Metro (MMM1): $20.65 Regional centres (MMM2): $30.15 Large-medium rural towns (MMM3-4): $31.95 Small rural towns (MMM5): $34.05 Remote communities (MMM6): $35.80 Very remote communities (MMM7): $39.65

So, when Labor defend the stage three tax cuts with the bulk billing incentives and the chance they make a difference to people’s ability to access the medical care they need, I laugh and cry.

If you’re on $45k, you’re unlikely to have a health care card (you might if you have a family member with a disability) so your 43c a week isn’t exactly going to cover the $90 upfront my GP charges, or the $70 with concession. You might be able to buy some of that “summer sports gear” for a certain upcoming long weekend, but you won’t be able to cover the “$30” meds that went up to $31.60 on Jan 1.

So, while the LNP starved Medicare, by creating a three-tier system, Labor are killing the last of the will for universal bulk-billing. So every time they tout the tripled bulk billing incentive, remember that it only applies to kids under 16, concession card holders and some eligible Indigenous Australians, and so leaves out the precious middle Australia that I thought they were trying to win over? No?

Who even is the Labor target market these days?