Health Issues, 2004, Number 79, pp. 19-24. 1 From A Fairer Medicare to Medicare Plus: What are the Implications for the Future of Bulk-billing and Medicare?

The recent passing by the Senate of the Commonwealth government’s Medicare Plus package, followed a year-long debate about the future of Medicare. During this period a Senate Select Committee on Medicare was established to examine the government’s first package, A Fairer Medicare, and then reconvened to consider its second package, Medicare Plus. This article examines both packages and explores the impact that Medicare Plus will have, if any, on the rate of bulk-billing and patient out-of-pocket costs for general practitioner services throughout Australia and asks whether ‘Medicare Plus’ will strengthen or undermine Medicare. The Decline in Bulk-billing by General Practitioners The decline in bulk-billing and rise in out-of-pocket costs for general practitioner services in recent years has led to a significant focus on health policy, and specifically Medicare. Bulk-billing rose from 74.2 % in 1992-93 to a peak of 80.6 % in 1996-97 (see figure 1) before falling to 66.5 % in December 2003 (Commonwealth Department of Health & Ageing, 2004a). During this same period, out-of-pocket costs for general practitioner services have risen from an average of $6.90 to $14.03 (Commonwealth Department o