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Speaker 1: My name is Lily Maddon and I'm a proud Dunda

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Speaker 1: Bungelung Calcottin woman from Gadighl Country. The Daily oz acknowledges

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Speaker 1: that this podcast is recorded on the lands of the

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Speaker 1: Gadighl people and pays respect to all Aboriginal and Torres

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Speaker 1: Straight Island and nations. We pay our respects to the

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Speaker 1: first peoples of these countries, both past and present.

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Speaker 2: Sentimental man or woman. All right, are we ready?

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Speaker 3: Good morning and welcome to the Daily os. It's Tuesday,

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Speaker 3: the seventh of February.

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Speaker 4: I'm Zara, I'm Sam. Happy birthday, Zarah.

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Speaker 2: Thank you so very much, so.

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Speaker 4: Good.

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Speaker 3: It's a birthday, but another day, another podcast, and we've

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Speaker 3: got some important things to talk about today. We've spoken

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Speaker 3: before on the Party about some of the issues facing

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Speaker 3: our health system and it's something you, our TDA audience,

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Speaker 3: feel very strongly about as well.

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Speaker 5: I recently went to GPE to get a mental health

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Speaker 5: plan review. It cost me one hundred and sixty dollars

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Speaker 5: up front.

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Speaker 6: Sorry, yeah, paid for a two and a half minute appointment.

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Speaker 2: It's just getting out of control.

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Speaker 3: Last week, leaders from across the country met and discussed

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Speaker 3: the healthcare system and they talked through some of the

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Speaker 3: areas of potential reform. So we're going to look at

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Speaker 3: what recommendations were made in the deep dive today and

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Speaker 3: whether or not they'll help with some of the issues

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Speaker 3: that we've heard from the TDA community.

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Speaker 2: The first am. There was some news from the Federal

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Speaker 2: Greens yesterday.

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Speaker 4: That's right, send them to Lydia Thorpe announced yesterday she

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Speaker 4: will leave the Greens and remain in the Senate as

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Speaker 4: an independence This is a bit of Thorpe speaking at

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Speaker 4: a press conference yesterday.

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Speaker 7: This country has a strong grassroots black sovereign movement, full

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Speaker 7: of staunch and committed warriors, and I want to represent

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Speaker 7: that movement fully in this Parliament. It has become clear

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Speaker 7: to me that I can't do that from within the Greens.

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Speaker 3: A New South Wales Parliamentary inquiry has issued an interim

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Speaker 3: report on former New South Wales Deputy Premier John Barrolaro's

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Speaker 3: appointment to a New York trade role. It found the

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Speaker 3: appointment had quote all the trademarks of a job for

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Speaker 3: the boys. It also found that former Trade Minister Stuart

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Speaker 3: Airs had some involvement in the protess. Airs resigned from

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Speaker 3: his trade role last year, amid an ongoing inquiry into

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Speaker 3: the matter.

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Speaker 4: A magnitude seven point eight earthquake struck Turkey yesterday. It

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Speaker 4: caused buildings to collapse, and while we don't have an

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Speaker 4: exact figure yet, significant casualties are thought to be likely.

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Speaker 4: The shaking was also felt across the region, including in

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Speaker 4: Lebanon and Syria.

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Speaker 3: And the good news, of course, we could not go

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Speaker 3: past the absolute goat, Beyonce, who has beaten the record

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Speaker 3: for the most Grammy wins ever in history. Listener won

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Speaker 3: a number of awards at yesterday's Grammys. This was her

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Speaker 3: delivering her acceptance speech and.

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Speaker 2: I'm trying to just.

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Speaker 8: Receive this night.

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Speaker 2: Thank you so much to the Grammys.

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Speaker 7: Thank you.

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Speaker 3: Okay, So when we put out a call on Instagram

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Speaker 3: for people's recent experiences with our healthcare system, we were

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Speaker 3: overwhelmed with messages like this.

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Speaker 9: Hey, I'm just responding to my recent GP experience.

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Speaker 2: Two things.

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Speaker 9: First thing is I moved to Newcastle from Sydney and

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Speaker 9: I cannot find a GP. Most books are closed. In

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Speaker 9: all seriousness, I literally cannot find a GP. So I've

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Speaker 9: just been using online scripts. If I need to get anything,

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Speaker 9: I just self diagnose myself and the second thing is

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Speaker 9: I drove to Sydney to see my GP and get

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Speaker 9: a skin check. It's one hundred and eighty dollars, which

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Speaker 9: was insane. Like I was lucky, I had a little

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Speaker 9: bit of money saved, but honestly, it's just getting out

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Speaker 9: of control.

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Speaker 6: I had a few things that I wanted to speak

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Speaker 6: to the doctor about. After about two and a half minutes,

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Speaker 6: we actually got through my first two issues, and then

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Speaker 6: on my third ailment, when I went to go ask

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Speaker 6: the doctor, he rolled his eyes and said, there are

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Speaker 6: other people waiting. We're going to have to end the

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Speaker 6: appointment here. So yeah, paid for a two and a

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Speaker 6: half minute appointment.

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Speaker 10: The need or the idea that I have to pay

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Speaker 10: additional every time I want to get a new script

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Speaker 10: for medication that I will have to have DAN and

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Speaker 10: DAN once my lab seems it's really frustrating for me.

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Speaker 5: I recently went to my GPU to get a mental

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Speaker 5: health plan review. It cost me one hundred and sixty

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Speaker 5: dollars up front with a seventy dollars rebate. That was

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Speaker 5: my entire paycheck for the week, and as someone living

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Speaker 5: patrick to paycheck, it wasn't viable, especially when such prices

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Speaker 5: weren't really posted on the website or I wasn't really

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Speaker 5: aware of the price. You know, it exacerbates pre existing

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Speaker 5: mental health conditions.

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Speaker 3: So listening to the number and the volume of messages

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Speaker 3: that we received, it was very clear that there were

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Speaker 3: a couple of main issues that just kept coming up.

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Speaker 3: It was about actually being able to access a GP

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Speaker 3: and then having to pay more for that GP if

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Speaker 3: you were able to book in.

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Speaker 4: And the reason we wanted to talk about all of

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Speaker 4: this with you today is because at the end of

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Speaker 4: last week there was a national Cabinet meeting where leaders

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Speaker 4: discussed some potential reforms. Zara, let's start there. What exactly

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Speaker 4: was this meeting about?

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Speaker 3: I think before I answer that question, one thing that

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Speaker 3: I just want to flag is that I hope that

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Speaker 3: any GPS listening to this understand that we are talking

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Speaker 3: about the structural issues that are underpinning their profession, not

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Speaker 3: any specific issues with the GP workforce itself. And I

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Speaker 3: think that there's been so much focus on that over

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Speaker 3: the last couple of years and the fact that people

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Speaker 3: can't access GPS or that they're charging too much, when

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Speaker 3: in actuality, what this review showed us was that there

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Speaker 3: are really these underlying structural issues.

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Speaker 2: Okay, So a quick refresher.

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Speaker 3: National Cabinet is the meeting between the PM and all

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Speaker 3: of the heads of the states and territories. It occurred

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Speaker 3: during COVID and has carried on since and is a

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Speaker 3: good way for all of the leaders across the country

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Speaker 3: to come together and tackle big structural issues in this country.

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Speaker 3: And so in this last meeting, health reform was really

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Speaker 3: at the top of the agenda the federal government, so

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Speaker 3: Prime Minister Anthony Albanezi presented findings from an expert Medicare

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Speaker 3: task Force and it set out to find ways to make.

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Speaker 2: Healthcare more affordable and accessible.

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Speaker 3: So really clearly identifying, like we heard in those voice notes,

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Speaker 3: exactly what the issues are.

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Speaker 4: And talk me through some of the recommendations put forward.

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Speaker 2: I mean, they're not small.

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Speaker 3: There were some fairly big picture structural recommendations that were

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Speaker 3: made in the report, and I'll start with one of those,

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Speaker 3: which was this idea of blended funding. So the way

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Speaker 3: that the system currently works in Astray is that if

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Speaker 3: you're seeing a GP for example, you're charged each time

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Speaker 3: for that consultation, and whether or not you're bulk build

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Speaker 3: is an issue for each provider, but you're build each time.

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Speaker 3: So what's being recommended now instead is a more bundled approach,

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Speaker 3: and it's as the name would suggest. So health professionals

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Speaker 3: are compensated per patient they see rather than per visit.

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Speaker 3: And it means that if you've been to see a

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Speaker 3: doctor but then have a follow up call with them

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Speaker 3: for whatever reason, it'll be easier for doctors to bill

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Speaker 3: you more collectively rather than charging you for every single interaction.

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Speaker 3: And Sam I was telling Nina, our producer before, that

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Speaker 3: I've had a scan and the results have now been

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Speaker 3: sent to my specialist, who I have to make another

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Speaker 3: appointment to see for her to tell me the results

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Speaker 3: and that'll put me, however, many hundreds of dollars out

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Speaker 3: of pocket.

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Speaker 4: Talk me through a couple more of these recommendations.

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Speaker 3: The task force recommended diversifying the health systems so that

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Speaker 3: other healthcare providers, not just GPS, but other providers like

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Speaker 3: no and pharmacists, would play a bigger role in how

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Speaker 3: people can access care. It also means that in those

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Speaker 3: communities that might be facing GP shortages, there would be

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Speaker 3: more options available and there would be financial incentives for

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Speaker 3: health professionals in different roles to start collaborating more. And

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Speaker 3: we've spoken about this on the pod before, this idea

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Speaker 3: that there should be more of a holistic.

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Speaker 2: Approach to health.

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Speaker 3: There's clearly a need for this, and I think we

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Speaker 3: heard that in the voice notes we played a bit earlier.

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Speaker 3: One was about the difficulty of getting mental health referrals

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Speaker 3: and the other about having to pay for a GP

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Speaker 3: consult to get a medication script. So those are the

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Speaker 3: types of areas where a more integrated system could help,

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Speaker 3: and that's according to the review that was handed down.

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Speaker 3: A pharmacist could take more of an active role in

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Speaker 3: offering prescriptions for example, like for the contraceptive pill, or

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Speaker 3: a mental health provider could be better integrated into a

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Speaker 3: general practice to make the process of getting a mental

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Speaker 3: health plan a bit more streamlined.

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Speaker 4: So we've talked about blended funding and we've talked about

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Speaker 4: a more multidisciplinary approach. Were there any others in the report?

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Speaker 3: So in the same vein as health practitioners working better together,

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Speaker 3: the report also made a recommendation on how data can

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Speaker 3: work better together, and that was through strengthening the digital

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Speaker 3: My Health Record system. And listeners might remember that this

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Speaker 3: was a very hot topic. A couple of years ago,

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Speaker 3: it sort of died away, but now it's being brought

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Speaker 3: back into the limelight. And so according to the report,

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Speaker 3: despite having a digital record system, a lot of our

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Speaker 3: information is still siloed. So that means that when you

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Speaker 3: go from one doctor to another, or you're referred to

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Speaker 3: a specialist by your GP, they can't actually always access

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Speaker 3: your data, and that means there's more risk of their

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Speaker 3: missing important information. So this report is really recommending a

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Speaker 3: sharing by default approach, but still with the ability to

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Speaker 3: opt out if you have any privacy concerns.

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Speaker 4: We're going to take a short break. We'll be right back.

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Speaker 4: So you've gone through three very distinct issues here, but

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Speaker 4: none of them seemed to me to hit this issue

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Speaker 4: that came through really loudly in the voice notes about

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Speaker 4: increasing cost and this increasing gap. Would that be a

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Speaker 4: fair enough assessment.

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Speaker 3: It would be, and there was some discussion of this

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Speaker 3: in the paper. So before I answer your question, let

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Speaker 3: me just do a bit of explaining on how the

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Speaker 3: system currently works and why that gap is actually increasing

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Speaker 3: for people.

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Speaker 2: So when you see a.

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Speaker 3: GP who does bulk bill, a portion of the fee

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Speaker 3: will be covered by Medicare which is the bulk billing part,

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Speaker 3: but there's sometimes what's called a gap fee, which is

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Speaker 3: what you'll have to pay out of pocket. Last year,

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Speaker 3: Federal Health Minister Mark Butler said that for the first

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Speaker 3: time in Medicare's thirty eight year history, the average out

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Speaker 3: of pocket payment or the gap payment for a medical visit,

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Speaker 3: was now more than what Medicare actually covers, and a

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Speaker 3: survey last year found that twenty two percent of gps

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Speaker 3: had recently changed their model away from total bulk bill

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Speaker 3: and so, Sam, I haven't forgotten your question.

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Speaker 2: I just wanted to explain that a bit first.

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Speaker 3: But the report was a bit ambiguous for lack of

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Speaker 3: a better word on this issue. There were no specific

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Speaker 3: recommendations about subsidies, but it did call for a strengthening

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Speaker 3: of funding, in particular for low income patients to access

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Speaker 3: care at no or low cost. This is something that

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Speaker 3: the Australian Medical Association the AMA.

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Speaker 2: Were a bit critical of.

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Speaker 3: They said that while they welcomed the report, it did

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Speaker 3: quote absolutely nothing to address the immediate cost and access

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Speaker 3: issues in the health system. We heard from Federal Minister

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Speaker 3: for Health Mark Butler over the weekend on Sky News,

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Speaker 3: saying that he was surprised by the AMA stance on this.

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Speaker 8: I've said that changes to the rebate are not off

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Speaker 8: the table. Of course, affordability was a major pressure that

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Speaker 8: we discussed at the task force, but I've also said

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Speaker 8: you can't just put more money onto the existing systems.

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Speaker 8: The existing systems do not reflect the needs of Australians today.

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Speaker 8: I think all healthcare groups who participated in the task force, frankly,

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Speaker 8: including the IMI, recognize that.

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Speaker 3: So the federal government hasn't exactly ruled out increasing the

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Speaker 3: government's subsidy, but they do seem to be pushing for

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Speaker 3: an overhaul of the system first and foremost.

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Speaker 4: Okay, And for everybody who sends in a voice note,

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Speaker 4: and for everyone listening to this who has resonated with

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Speaker 4: some of the issues that you've talked about, is there

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Speaker 4: a sense that these recommendations are actually going to come

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Speaker 4: to fruition.

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Speaker 3: Well, there was definitely a show of support from the

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Speaker 3: state and territory leaders. It's one of the few times

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Speaker 3: where there's a bipartisan meeting because not every state or

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Speaker 3: territory leader comes from the same party. So that's an

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Speaker 3: important place to be discussing structural issues like this.

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Speaker 2: There is already a.

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Speaker 3: Seven hundred and fifty million dollar fund from the federal

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Speaker 3: government to implement these changes, so we'll have to wait

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Speaker 3: and see how quickly some of these reforms are actually

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Speaker 3: rolled out.

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Speaker 4: And we really appreciate everyone's sending in their voice notes.

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Speaker 4: It really enhances the way that we can tackle such

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Speaker 4: a big issue like healthcare and make it your as well.

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Speaker 4: Really appreciate you joining us today on the Daily OS.

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Speaker 4: If you did learn something from today's episode, don't forget

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Speaker 4: to hit subscribe so there's a TDA episode waiting for

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Speaker 4: you every morning. We'll be back again tomorrow. When it's

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Speaker 4: not Zara's birthday, We're going to go enjoy that now.

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Speaker 4: Until then, have a wonderful day.