Grattan Institute calls for overhaul of ‘failed’ Medicare system

Photo: AAP

Medicare has failed and needs a complete overhaul as it no longer provides for Australians’ health needs, says a damning new report.

Forty years after the universal healthcare system was established, Medicare has not kept pace with changes in chronic disease and mental health.

For example, despite patients needing more complex care, appointments have been “stuck” at 15 minutes for the past two decades.

The report by the Grattan Institute calls on the Albanese government to fix the system, warning that “Medicare is in the grip of a mid-life crisis”.

It says blunty: “Medicare no longer works, for patients or GPs.”

“The way GPs work and get paid should be overhauled so Australia can turn the tide of chronic disease, keep more people out of hospital, and ensure poorer Australians get the care they need when they need it.”

The report released on Monday said the work of GPs had become much more complex, as the population has grown older.

Rates of mental ill-health and chronic disease have climbed.

“But the way we structure and fund general practice hasn’t kept up,” it states.

“GPs are struggling to meet their patients’ needs, and they lack the support of a broader team of health professionals to do so.”

The report said other countries have reformed general practice, and their rates of avoidable hospital visits for chronic disease are falling.

“But Australia is spending more on hospitals while neglecting general practice: the best place to tackle chronic disease.

“Patients suffer the consequences. People with chronic disease live shorter lives, with more years of ill-health, and lower earnings.

“Poorer Australians suffer the most: they are twice as likely to have multiple chronic diseases as wealthy Australians.”

Medicare doesn’t work for patients or doctors, says the Grattan Institute. Photo: Getty

Australia’s healthcare workers are also struggling.

“Hospital staff are overwhelmed with demand. And GPs tell us they are stressed, disrespected, and disillusioned.”

The report recommends major changes including employing 1,000 more clinicians, such as nurses and physiotherapists, in GP practices so doctors can work as a “team”.

“Second, Australia needs to change the way GPs are paid,” the report states.

“The current method is broken – it actively discourages GPs from working with teams, and it rewards GPs who see lots of patients in quick succession, rather than spending more time with patients who need more care.

“GPs should be able to choose a new funding model that supports team care and enables them to spend more time on complex cases, by combining appointment fees with a flexible budget for each patient based on their level of need.”

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