Prime Minister Anthony Albanese1 has deflected calls for Labor to increase bulk-billing subsidies for GPs by claiming Medicare rebates were frozen by the previous coalition government when Peter Dutton 2was health minister.
The claim is misleading because it omits to mention that the rebate freeze was initiated by Julia Gillard's Labor government in May 2013. The coalition continued and then extended the freeze after it won government in September 2013.
Mr Albanese made the claim during an ABC Melbourne radio interview on August 53.
In response to a question about whether the government will increase Medicare rebates for GPs, the prime minister said: "We have a comprehensive plan for GPs including ways to support bulk billing … The rebate was frozen when Peter Dutton was the health minister so many years ago and has stayed at the same rate."
The radio discussion referred to concerns from doctors' groups4 that rising operational costs have made bulk billing5 unsustainable for many GP practices.
GPs who bulk-bill are directly reimbursed a set fee6 by the government. GPs who don't bulk-bill are free to set their own prices, with patients required to cover any difference7 between the cost of the treatment and the Medicare rebate.
The rebate value of all eligible healthcare services is listed in the Medicare Benefits Schedule (MBS)8.
Medicare rebates have generally risen in line with the Department of Finance's Wage Cost Index (WCI-5)9, which is a combination of a wage index and the Consumer Price Index (CPI)10.
However, in the 2013/14 budget11 the Labor government announced a temporary pause on the indexation of MBS fees until July 1, 2014 (page 177).
According to the budget papers, the pause was intended to shift the annual indexation date back from November 1 to July 1 each year to align MBS fee rises with financial years.
Pushing the November 2013 MBS indexation back to July 2014 would also save $664.4 million over four years, the papers said.
The coalition won power in September 201312 and Mr Dutton was installed as health minister. The new government chose not to overturn Labor's planned indexation freeze, with Mr Dutton claiming at the time that poor economic conditions13 meant it was "difficult to unwind these sort of measures".
The following year, the coalition government extended the freeze to July 201614 but reinstated indexation for GP services (page 139).
In December 2014, Mr Abbott and Mr Dutton announced a new four-year indexation freeze15 that also included GP services. The new freeze was initially scheduled to run until July 2018 then extended in subsequent budgets to July 202016.
In 201717 (page 14), the coalition announced a phased lifting of the freeze18, beginning with a return to indexation for bulk-billed GP visits from July that year.
The prime minister's claim that the rebate was frozen when Mr Dutton was health minister is technically correct but misleading, given the freeze was initiated by the Rudd19/Gillard20 Labor government.
Professor Helen Dickinson21, a professor of public service research at UNSW Canberra22 who wrote a 2019 article23 about Medicare rebate indexation, said Mr Albanese's claim did not tell the full story.
"The initial temporary freeze was made when Labor were in government and this was intended to run from November 2013 to July 2014. So I don't think it is accurate to say that the freeze began under Peter Dutton," Prof Dickinson told AAP FactCheck in an email.
"The coalition were not under any obligation to continue the freeze but they did identify that health expenditure had grown significantly.
"At the time, they proposed a number of potential reforms to health policy (such as the ill-fated co-payment plan24 for GP services and pathology and imaging services amongst others). In my view, the failure to pass any of these other reforms meant that the government decided to stick with the freeze as a way of controlling expenditure."
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