Medicare rebate changes disadvantage rural Australians, doctors say

Máire Kildare has tried twice to see a doctor over a video call from her home near the Clare Valley in South Australia. 

It was the only way she could access healthcare during the state’s COVID-19 lockdowns, but the internet connection upon which she was relying failed.

“They were booked appointments,” she told the ABC from her verandah, which she said was the only spot to get phone service. 

“They didn’t work, the calls just fell out.”

Now changes to Medicare rebates will mean people in rural Australia with poor internet connections such as Ms Kildare will receive less money back from the government, according to bush doctors. 

The latest Medicare Benefits Schedule, which came into effect on July 1, has removed a rebate for phone appointments longer than 20 minutes, but kept a rebate for video calls. 

Royal Australian College of GPs rural chair Michael Clements said regional patients didn’t have the same access to video calls as their urban counterparts.

A male doctor sitting in a chair and smiling at the camera. He wears glasses and a dark blue uniform.
Michael Clements says telehealth rebate changes will disadvantage vulnerable Australians. (ABC North Queensland: Chloe Chomicki )

“What this means is people with complex and chronic disease will get a higher rebate, if they’re privileged enough to have good access to internet,” Dr Clements said.

Poor internet connections

Telehealth is booming in the wake of the COVID-19 pandemic, according to a new report from tech giant Philips. 

The report shows 45 per cent of Australian healthcare providers prioritise investing in telehealth technology and 43 per cent think they will continue to invest in telehealth.

Doctor on telehealth
Technology giant Philips says 40 per cent of regional Australians don’t have internet connections that can handle video calls.(Supplied)

Philips Australia managing director Matt Moran said about 28 per cent of the population lived in rural and remote areas, and 40 per cent of those people had internet speeds that were less than 28 kilobits per second,” he said.  

Dr Clements said the cost of owning a smart phone or laptop with a good internet connection was prohibitive for some patients and others struggled to master the technology. 

“This policy is essentially telling patients that if you can’t use a video phone or if you don’t have access to good internet, the government’s going to rebate you for your health care with the GP less than if you’re privileged enough to have good internet access,” Dr Clements said.

Labor campaigned on protecting Medicare and argued that “cutting Medicare is in the Liberals’ DNA”. 

The new Labor Government has pointed to the trillion dollar debt it has inherited, with one source telling the ABC that keeping the Medicare rebate for long phone appointments would require cuts elsewhere. 

Assistant Regional Health Minister Emma McBride was not available for an interview. 

“As the Assistant Minister for Rural and Regional Health, I understand the importance of quality, affordable healthcare close to home,” she said in a statement.

“Australians should be able to get the healthcare they need when they need it, regardless of where they live.”