Medicare is not 'free' – and it's not in crisis either


‘The age of entitlement is over’, we’re told. But aren’t we entitled to a decent health care system because we pay for it and voted for it (and because it’s the right thing for all Australians)? Annie Butler, Assistant Federal Secretary of the Australian Nursing and Midwifery Federation, examines some of the arguments floating around about Medicare.

As we now struggle with protecting our health system from the Federal Budget proposals and all this will bring, I find I am genuinely perplexed by persistent propositions from some quarters that health care in Australia is ‘free’. And therefore, that the budget measures for mandatory co-payments are warranted and fair because ‘you can’t get something for nothing’, ‘it’s about time we all paid a fair share’ and ‘the age of entitlement is over’ and other such platitudes.


Listening to all of this I have to ask myself, in all seriousness, what planet are these people on? Are they in some parallel universe version of Australia where the government collects its revenue from some other source than taxation of its people?

From the way these sectors are acting, one would think that politicians were being personally asked to fund public services from their own pockets.

This is what makes this Government’s Budget, apart from being cruel, harsh and unusually unfair, utterly ridiculous.

We pay for the systems and services we have. The Australian Government receives its revenue through a range of taxation measures on its people, mainly income tax, which it is then supposed to use for the good of its people.

Using the revenue collected from taxation, our health system is funded and administered by several layers of government, national, state/territory and local, and is underpinned by Medicare, the universal insurance scheme which covers medical services, prescription pharmaceuticals and hospital treatment.

Annie Butler (ANMF) speaks at the Dee Why RSL Forum

Annie Butler speaking about Medicare at a recent NSWNMA forum.

Medicare’s objectives are to make health care accessible and affordable to all Australians and to provide high quality care. It is indisputable that Medicare has done this very well since its introduction in 1984 by pooling and then distributing the resources the government collects from us.

The individual contribution to these funding arrangements is via our tax and the Medicare levy. Then there is private health insurance – if you choose to have it or even if you don’t, your tax is taken to contribute to the 30% rebate for those who do have private health insurance.

And then on top of all this, we each pay a further $1053 on average per year!

That’s not free – that’s paid for.

save medicare

But the Federal Government is trying to persuade us that because some services, eg. public hospitals and bulkbilling GPs, are free at the point of service, Australians have made no contribution to the health system.

While the assertion that we don’t contribute to our health system is simply ludicrous, it’s important to make the distinction between ‘free’ and ‘free at the point of service’.

Thirty years ago Australians agreed to the Medicare levy as a supplement to our other taxes to enable governments to meet the additional costs of the universal national health care system. Proportionally we all pay the same, ie. 1.5% or our taxable income, so there can be equal access to all services by all Australians.

This means that anyone, rich or poor, can go to the doctor or to a hospital when they need to without having to pay for the service when they receive it. This is the important, and wonderfully egalitarian, point – this allows everyone to receive the same level of care based on the clinical need they have regardless of how much money they have.

This Federal Government’s claims that our health care system is ‘free’ are simply untrue.

They are trying to hoodwink us into believing their preposterous claims that our health system is in crisis and that we’re running out of money because it’s ‘free’, so the good times have to come to an end. As I’ve just explained, this is nonsense.

This is not to say that we don’t need to make improvements to our health system and to Medicare or that we don’t need to prepare for the future. Of course we do, but there is no ‘crisis’, budget or otherwise, and with good policy decisions, better use of our resources and much fairer means of how the government collects these resources, this can be readily achieved.

(In fact, the ANMF has just submitted to the Federal Senate Budget Committee, the health and budget proposals we believe could address these issues – visit under Submissions for further information.)

The truth in this debate is that the Government is supposed to deliver quality, cost-effective services to its citizens, including healthcare, so it should design its budget to achieve this. But the Abbott Government’s Federal Budget 2014-15 has not been designed this way.


At the Medicare 30th birthday party earlier this year.

The Abbott Government’s Budget seeks to impose more costs and risks onto individuals through a very unfair distribution of resources, rather than meet people’s basic needs through equitable collective programs and processes and cost-effective government management.

The Abbott Government’s Budget is abrogating its responsibility to deliver important services to its citizens and the Government is trying to blame us for the problem.

So I think it’s time nurses and midwives told the Federal Government, “you can’t get something for nothing – you got given the power, now we expect the delivery of decent services and a responsible government”.

Join us in taking a stand against the Government’s Budget – visit 

Originally published in the ANMJ (Australian Nursing and Midwifery Journal) October 2014.




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