Healthcare for all? Sorting the facts from the rhetoric

Just how universal is Australia’s healthcare? With poor access to specialist services and a deficit of GPs in rural and remote areas, Medicare is becoming a sticking point this election, with debates ranging from mental health to dental appearing in political campaigns.

Labor Leader Anthony Albanese has accused the Coalition of “want[ing] to take the universal out of universal healthcare”, citing previous remarks made by incoming health minister Anne Ruston. In 2015, Ruston said the government needed “to seek some alternatives” for making Medicare sustainable, though has since said her position has changed.

But the pandemic has exposed gaping holes in the healthcare system, with a massive shortage of GP and emergency care in rural and regional areas. With mental health, long COVID-19 and affordability still a key concern, here’s what the parties are doing about it. 

How bad is it?

Australia’s healthcare system is one of the best in the world: we are the third top-performing country behind Norway and the Netherlands when assessing overall access to care, the care process, administrative efficiency, equity, and health care outcomes. 

But things are slipping: in terms of affordability and timeliness, Australia has fallen to eighth place — below average — thanks to people not having a regular GP, the lack of dental care, and difficulty in getting after-hours care. 

The country’s mix of public and private healthcare is also an issue, with private health insurance rebates costing Australian taxpayers nearly $7 billion per year. People have been slow to take up private healthcare and it hasn’t done much to reduce the burden on public hospitals.

And people in rural and remote areas of Australia lack access to specialist care. A higher proportion of Aboriginal and Torres Strait Islander peoples live in these regions, where mortality rates are 1.4 times higher than those living in major cities.

What needs to be done?

As COVID-19 has shown, access to equitable and high-quality healthcare is crucial to protect every Australian. Preventative care is incredibly important: across the pandemic, many people put off seeing a doctor or seeking regular treatments, burdening the system once the country opened back up and costing more money as illnesses had to be treated in later stages. 

One-third of medical practitioners working in Australia received their initial qualification overseas, with tough border policies impacting the workforce. There’s set to be a deficit of 123,000 nurses and 5000 doctors by 2030. 

The Rural Doctors Association of Australia has called for an inquiry into rural GP services, while the Australian Medical Association has requested a strong GP-led primary healthcare system, better investment in public hospitals, and the filling of service gaps for Aboriginal and Torres Strait Islander peoples and other at-risk groups.

What the parties are offering 

Cheaper medicines: At its campaign launch, Labor vowed to slash the maximum co-payment for scripts by $12.50. The Coalition has promised to slash copayments by $10 and will raise the income thresholds for the seniors’ health cards to $90,000 to allow more people to access cheaper medications and services.

Medicare urgent care clinics: To ease emergency department pressure, Labor will invest $135 million over four years to deliver 50 medicare urgent clinics based in existing GP clinics and community health centres to deal with sprains, broken bones, abrasions and minor issues. 

Rural workforce: Labor plans to change the rules to allow communities to recruit more doctors of their choosing and will restore Telehealth psychiatric consultations in regional areas after it was cut late last year.

The Coalition’s latest budget provides $224.4 million across four years to improve access to health services in rural and remote areas. The Coalition is also funding two new university departments of rural health in WA, along with $14.9 million for medical workforce scholarships. 

Dental: In the latest budget, the Coalition allocated extra cash so that more concession card holders can access dental care. The Greens have pledged to provide free dental care to everyone eligible under Medicare, and Labor has no dental plans. 

Aboriginal and Torres Strait Islander peoples’ health: All major parties have put forward plans to improve the overall health of First Nations peoples, with the Coalition pledging $4.6 billion over four years in the latest budget. Labor has promised to implement the Uluru Statement from the Heart in full, while the Greens have offered $371 million to Aboriginal Community Controlled Health services and $1.07 billion to build First Nations-owned healing places.