Patients will continue to be hit with rising out-of-pocket health costs under the Turnbull government's slow thaw in the Medicare rebate freeze, experts have warned.
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Health Minister Greg Hunt's staged approach has left doctors divided, with the Australian Medical Association pledging its support for the government's policy reset, and the NSW arm of the lobby group describing it as a "crushing blow" for GPs.
The policy took the focus in Federal Parliament on Wednesday, as Labor accused the government of building its health budget on "smoke, mirrors and false guarantees", as Mr Hunt declared the Coalition were "Medi-friends" to the opposition's "Medi-frauds".
Under Tuesday's budget, the government will gradually lift the Medicare rebate freeze starting this year, with bulk-billing incentives for GP consultation. GP and specialist consultations will be indexed from 2018, specialist procedures in 2019, and targeted diagnostic imaging services in 2020. The measures will cost the government $1 billion over the forward estimates, but only $9 million in the first year.
AMA federal president Michael Gannon praised the government's moves, but the AMA's leadership in NSW broke ranks to brand it a major disappointment.
State president Brad Frankum??? said the "small and incremental" increases to the Medicare bulk-billing incentive and Medicare rebate were not enough.
"This is not an encouraging start and we won't see patients' Medicare rebates indexed again until July next year," Professor Frankum said.
"At this rate it will be many years before patients see an appreciable difference in out-of-pocket costs. This is a crushing blow for general practice in NSW and continues to be an ongoing problem for specialists and the patients who need their care in this state."
Prime Minister Malcolm Turnbull defended the plan.
"What the government committed to in the budget was to unfreeze the freeze on indexation put in place by the Labor Party. It was your freeze," he said in question time. "What we are doing is restoring indexation in a measured and consistent way."
Policy expert Lesley Russell, of the Menzies Centre for Health Policy, said a vision for the future was "shockingly absent" from the health budget. She said the "glacial" pace of the Medicare Benefits Scheme indexation thaw meant many Australians would continue to face higher costs.
"We really have to ask questions about what this means for people who are already struggling to afford the specialist and allied health services that they need," she said. "It seems to me that those costs are going to grow rather than shrink over the next couple of years."
Stephen Duckett, health program director at the Grattan Institute think tank, said it was too early to tell whether the government's plan would be enough to keep bulk-billing rates at their current levels.
"Practice costs and income expectations of staff have not increased dramatically over the freeze period as the consumer price index has been moving slowly," he said. "But each additional day of a freeze means costs and revenues fall further out of alignment."
AMA Victoria president Lorraine Baker said the budget would not make healthcare more affordable for people in her state for at least another 12 months.
"We would have liked to have seen the freeze lifted and indexed from now," Dr Baker said. "But at least there's been progress in the right direction, and that is that we have an acknowledgment from this government that the Medicare system needs to be supported."
Radiologists complained about the long wait for indexation, while the Consumers Health Forum said: "The staged lifting of the freeze in the budget does mean that many families on average incomes still face the risk of co-payment increases they can ill afford for at least another year."
With Rania Spooner
