
Medicare was established as a universal healthcare system almost 40 years ago by the Hawke Labor government.
It's purpose was to provide access to basic healthcare for all. It is the envy of many countries and completely transformed our social fabric.
However, after relentless attacks and continuous neglect by successive Liberal governments, it is fast becoming a system where those who can afford it, can, but those who can't, miss out.
Nowhere is this felt more than in Tasmania.
Tasmania has the most rapidly ageing population in Australia and one of the the highest rates of chronic disease in the country.
Concurrently, we have below average general practitioner (GP) to population ratios.
Moving forward, and as the population continues to age, the demand for healthcare will continue to increase, with average GP visits needing to be longer and more complex in nature.
Irrespective of this, as a state we struggle to retain and attract qualified health professionals to care for our population.
These shortages are particularly felt in more regional areas and in smaller communities, such as Scottsdale in the North East.
The residents of Scottsdale and surrounding towns would love to have permanent doctors, but it is often difficult to attract and retain them.
Instead there is a revolving door of locums, who are unable to provide the continuity of care, which is desired by many, especially our ageing population.
It is also commonplace for people to be waiting weeks to see their GP with many also paying a large gap fee.
Pensioners, young families, single parents and new migrants put off visits to the GP or forgo other things because they simply cannot afford it.
According to the Productivity Commission's report on government services, Tasmania has the highest proportion of people who defer seeing a GP due to cost.
Eventually things can become an emergency and this places an additional burden on hospitals and emergency departments, which are already at crisis point.
Not only this, a specialist appointment can take months, if not years, especially if you do not have private health insurance.
The protracted waiting time also means additional complications often arise.
Further, if people are unable to see a regular GP it also means that vital information transfers, which often occur between GPs and specialists, can break down.
There are currently up to 100 GP vacancies in Tasmania.
We need more GPs and we need them now.
As it is, the number of medical graduates choosing general practice as their speciality is in steady decline, and with almost 40 per cent of GPs in Australia over the age of 55, the Morrison government must invest in the future of the workforce.
There have been multiple schemes tried by the federal Liberal government, but at the same time there has been a simultaneous ripping from the system.
The higher bulk billing incentives announced by the federal government this year simply will not cut it for Tasmanians and will not do enough to attract and retain doctors in the state.
As it is Tasmanian GPs are paid significantly less than what they would be if they worked on the mainland.
GPs working in rural and regional areas need more support, not just lousy announcements by the Morrison government.
As with the costs of living, the costs of providing care in general practice increase year in and year out, but successive Liberal governments have not matched these increases in patient rebates provided by Medicare, and thus, they have taken from Medicare by stealth.
The growing gap between the cost of providing care and the Medicare rebate, has had a significant impact on the long term viability of general practice.
Surgeries and clinics have had no choice but to charge a fee so that they can cover the costs of running a practice.
Now we are in a situation where for the first time in the history of Medicare, the average out of pocket costs for visiting a GP are higher than the Medicare rebate.
The issue of improving access to healthcare is not a simple one, but if the Morrison government is content with committing large outlays of cash for submarine deals in the name of our national security, shouldn't he also be content with investing in the healthcare of our nation?
Prior to the establishment of Medicare, there was no bulk billing and most of us had to pay for private health insurance to cover the cost of medical expenses and trips to the hospital.
We would also think twice about going to the doctor.
Alarmingly, this is sounding increasingly familiar and it is the reality of eight long years of a Liberal government.
The people of Tasmania need better access to healthcare and they need it now, not more failed attempts by the Liberal government, who is content with just tinkering with the edges and not to systemic change.
- Helen Polley, Labor Senator for Tasmania