The Turnbull government declared its “rock solid” commitment to universal health care with a $10 billion pledge to health in the 2017-18 Federal Budget including the staggered withdrawal of the Medicare indexation freeze and establishment of a Medicare Guarantee Fund to ensure longevity of universal health care and access to medicines.
The Fund, to be underpinned by the Medicare Levy on taxpayers with a top up from personal income tax receipts, would ensure that Medicare and Pharmaceutical Benefits scheme remained sustainable into the future.
— Australian Treasury (@Treasury_AU) May 9, 2017
Seeking to draw a line under the damaging Mediscare election campaign and tensions with doctors over the indexation freeze, Treasurer Scott Morrison announced that the government would resume indexation for GP bulk billing from July 1, 2017, for standard GP and specialist consultations from July 1, 2018 and for specialist procedural and allied health from July 1 2019.
He also announced the reinstatement of the bulk-billing incentive for diagnostic imaging and pathology, including x-rays, scans, blood tests and pap smears.
Combined, these about-faces would cost $2.2 billion over the next four years, he said.
“Tonight we put to rest any doubts about Medicare and the Pharmaceutical Benefits Scheme,” Morrison said in his budget address to parliament.
— Scott Morrison (@ScottMorrisonMP) May 9, 2017
Health Minister Greg Hunt said all Australians could be assured that “Medicare is not only here to stay, but will be strengthened into the future”:
Australians can be assured that the Turnbull Government’s commitment to Medicare and universal health care is rock solid. We want Australians to continue to have access to the best health care system in the world – and a strong, sustainable, best clinical practice Medicare is essential to this.
As leaked ahead of Tuesday’s budget, the government also committed to full funding of the National Disability Insurance Scheme via a 0.5 percentage point increase to the Medicare Levy to be ringfenced for this purpose.
Morrison committed $80mln to people with a mental illness resulting in a psychosocial disability who had been at risk of falling through the cracks of the NDIS transition, though this funding is contingent on matched commitments from the states and territories.
Perhaps unsurprisingly, prevention and social determinants were given short shrift and the “glacial” pace of the MBS thaw would see out-of-pocket costs continue to balloon, undermining the universality of Medicare, warned Lesley Russell from the Menzies Centre for Health Policy at the University of Sydney:
A vision for the future and real reforms are shockingly absent in the budget: the Health Care Homes project has been delayed, although it will now include community pharmacy; the MBS Review has continued funding, but only for three years; the investment in prevention (beyond sport and immunisation) is miniscule and doesn’t come close to reflecting the intergenerational burdens of cost and lost productivity; there is nothing to progress needed integration of mental health and substance abuse services into primary care and of hospital and community care.
Medicare freeze- in place until 2019, five year freeze
Hospitals- no new $$
— Catherine King MP (@CatherineKingMP) May 9, 2017
Some of the headline numbers include:
- $2.4bln extra funding for Medicare over the next 4 years
- $1.2bln for new medicines & ‘landmark’ agreements with Medicines Australia, Pharmacy Guild & Generic and Biosimilar Medicines Association to reduce cost of drugs by $1.8 bln over 5 years, including drugs that have been on the PBS for 10-15yrs
- $2.8bln in additional hospital funding over the next 4 years
- $115mln boost for mental health including a $9.1mln telehealth scheme for regional areas and $11.1mln prevention initiative for suicide hotspots as well as $50mln in prevention and support for ADF members, veterans & their families
- $1.4bln for research over the next 4 years including $230mln for cancer research & screening
- $1.4bln allocated under the new Medical Research Future Fund by 2020-21 including more than $640mln in its first year for projects on childhood obesity, pandemic vaccines and antimicrobial resistance
- $374.2mln for My Health Record
- $145.5mln for PHNs for after-hours services
- $44mln each for the MBS Review and Medical Services Advisory Committee
- $15mln each for heart health initiatives and the buildup to the 2018 Gold Coast Commonwealth Games
- $14.1mln vaccination catch-up program for children aged 10-19 and a $5.5mln immunisation awareness campaign
- $4.1mln 4-yr extension of the Supporting Living Organ Donors program
- in aged care, $5.5bln to continue funding the Commonwealth Home Support Programme
Tonight’s Budget delivers on our rock-solid commitment to Medicare, hospitals, mental & preventive health, and investing in medical research
— Greg Hunt (@GregHuntMP) May 9, 2017
Here’s the snapshot breakdown of health spending.
Closing the Gap meets Jobs and Growth
There was little on offer for Aboriginal and Torres Strait Islander Australians in the Federal Budget, with Indigenous Affairs Minister Nigel Scullion emphasising greater employment and investment in Indigenous businesses as the government’s priority.
Scullion heaped praise on the controversial Indigenous Advancement Strategy and Community Development Program, and said more needed to be done to “break the cycle of welfare dependency and ensure jobseekers are actively engaged and contributing to their communities.”
Among funding announced in the Budget to support this aim:
- $146.9mln from Indigenous Business Australia to the DPMC to deliver workshops, business planning & training and loans to Indigenous entrepreneurs and ventures
- $55.7mln to reach Closing the Gap employment targets through improved training and mentoring, transition from prison to work and increased wage subsidies
- a $5.9mln trial of literacy apps in preschools to improve Indigenous literacy
Scullion said the government would expedite legislation to create a specialist Productivity Commissioner for Aboriginal and Torres Strait Islander affairs to lead a whole-of-government evaluation of how policies and programmes impacted on Indigenous Australians. This would be funded through “reprioritisation” of some $3 million from the IAS, he said.
Scullion also announced the establishment of a $50 million Indigenous Research Fund “to refresh the Closing the Gap agenda”.
“These measures will be designed and implemented in close consultation with Aboriginal and Torres Strait Islander Australians,” said Scullion.
“This reflects the Australian Government’s absolute commitment to a new way of working with Aboriginal and Torres Strait Islander people in genuine partnership.”
As leaked prior to the budget, Indigenous Australians present or near the site of remote British nuclear tests in the 1950s and 60s will be eligible for a veteran’s Gold Card covering most of their health costs.
Apart from this, there was little mention of Indigenous health, with the only new funding a $7.6 million National Partnership Agreement on rheumatic fever.
Fairness – with caveats
Morrison described it as a budget based on the principles of fairness, security and opportunity, and it was a mixed bag of sometimes contradictory imperatives.
Heartening those championing a #peoplesbudget, he slugged Australia’s five largest banks with a new six basis point levy expected to deliver around $1.5 billion in revenue every year to shore up government coffers.
The banks will also face much heftier fines for misconduct, a permanent banking investigation team will be established within the ACCC and an ‘open banking’ regime from 2018 will bring pressure to deliver cheaper, more effective services.
Morrison committed to a crackdown on negative gearing and multinational corporation tax avoidance.
He announced $375 million to permanently extend homelessness funding to the states “with a continued focus on supporting young people and victims of domestic violence,” and said the government would restore the pensioner concession card to those affected by the recent assets test change.
“This Budget also delivers important increased support for veterans mental health, protections for children within the family justice system, victims of domestic violence, closing the gap for Indigenous Australians and creating the National Redress Scheme for victims of institutional child sexual abuse,” Morrison said.
However, he detailed further cuts to foreign aid and punitive new measures for those on welfare, with failure to show up for appointments with Centrelink or to find suitable employment to result in reduced or cancelled payments, as well as a crackdown on jobseekers affected by drug and alcohol problems.
To this end, he announced a “modest” drug testing trial of 5,000 new social security recipients, where a positive result would lead to mandatory transition to the Cashless Debit Card for their payments, further testing and possible referral for treatment. In addition, he proposed denying benefits to those with a disability “caused solely by their own substance abuse”.
Morrison said the verification requirements would be strengthened for single parents applying for benefits as well as for new migrants accessing Australian pensions.
In education (as leaked pre-budget), schools fared well, with the Turnbull govenment committing to funding increases above inflation for the needs-based Gonski model, pledging $18.6 billion over the next 10 years.
Universities were targeted for savings and revenue, with student contributions to increase and a 2.5% “efficiency dividend” applied to institutions over the next two years to the tune of about $400 million.
Clouds over climate
The environment barely rated a mention in a Budget focused on infrastructure and residential construction, and there was scant funding to be seen.
Environment and Energy Minister Josh Frydenberg highlighted expansion of the Snowy Hydro Scheme, feasibility studies into gas pipelines from the NT and WA, and $110 million for a solar thermal plant in Port Augusta, as well as increased funding for the ACCC and Australian Energy Regulator to police energy sector conduct.
On the environment, he touted a $1 billion investment over 5 years in the National Landcare Program to benefit farmers of food and fibre.
“We will continue to support on-ground community projects that harness local know-how and deliver practical and tangible results,” said Frydenberg.
“This funding will put the NLP in an even stronger position to continue to deliver for our nation’s environment, including the Great Barrier Reef.”
“Resources for Indigenous Protected Areas will also be boosted to help provide employment, education and training opportunities for Indigenous people in remote areas while protecting our cultural heritage into the future.”
— ACF (@AusConservation) May 9, 2017
We’ve wrapped the reaction so far tonight, and there’s bound to be more in the coming days and weeks. As always, we would love to hear your thoughts, and be sure to keep the conversation going at #healthbudget17.