Budget 2023 health impact: winners and losers

Treasurer Jim Chalmers has announced a $5.7 billion funding boost to Medicare, $951.2 million for digital health and $737 million to combat smoking and vaping as a part of the Federal Budget 2023.

Minister for Health and Aged Care Mark Butler said. “Our historic investments in Medicare will triple the bulk-billing incentive, in the largest increase to the incentive in the 40-year history of Medicare.

“We’re delivering cheaper medicines for 6 million Australians, halving the costs of medicines and halving the number of visits to the doctor and the pharmacy.”

Key highlights include:

• $3.5 billion in bulk-billing incentives with immediate benefits for more than 11 million Australians.
• Making common medicines cheaper. Australians will be able to buy two months’ worth of medicine for the price of a single (one-month) prescription for more than 300 common PBS medicines.
• Extending public dental services. 360,000 adults on lower incomes will have continued access to public dental services.
• $358.5 million for Medicare Urgent Care Clinics.
• $143.9 million for after-hours primary care, with improved access to after-hours care, through the Primary Health Networks After Hours Program and Healthdirect.
• MyMedicare: A new voluntary scheme to create a stronger relationship between patients and their primary care teams. MyMedicare will provide practices with more comprehensive information about their regular patients, while giving patients and their care team access to additional funding packages, tailored to their health needs. MyMedicare will also support longer GP telehealth consultations with reduced administration for practices ($5.9m); provide new funding packages for general practices to provide comprehensive care to patients who are frequent hospital users ($98.9m); and for Australians in residential aged care ($112.0m).
• $98.2 million for new Medicare rebates. Patients who require consultations of longer than 60 minutes will receive a larger Medicare rebate — giving doctors support to provide high-quality care to people with chronic or complex needs, including mental health issues.
• $47.8 million for wound care. Patients with diabetes and chronic wounds, in particular, will benefit from this additional funding to improve access to more affordable, high-quality wound care.
• $445.1 million to expand general practice
• $951.2 million for digital health. The Australian Digital Health Agency will upgrade and modernise My Health Record, making it easier for patients and providers to use and support the secure, safe and efficient sharing of information. This will improve health outcomes for patients and reduce duplication in the system.
• $29.8 million as an initial investment to reduce fraud — including a taskforce within the Department of Health and Aged Care to oversee longer-term improvements to Medicare integrity.
• $81.8 million for changes to scholarship arrangements.
• $4.5 million for expansion of Single Employer Model trials.
• $10.7 million for primary care placement.
• $46.8 million to fund Medicare rebates for care provided by nurse practitioners.
• $1.2 billion for community pharmacies.
• $586.9 million for improved mental health.
• $247.4 million to tackle smoking and vaping.
• $502.2 million for stronger preventative health.
• $68.3 million for better drug and alcohol prevention and treatment.

Vaping, tobacco use and cancer programs

Professor Simone Pettigrew, Director of Health Promotion and Behaviour Change at The George Institute for Global Health, said, "We are really pleased to see the strong focus on eradicating recreational vaping and reducing tobacco use in the budget. This is a major health policy initiative and it is really encouraging to see Australia taking the lead in this area.

“The funding will support the implementation of initiatives outlined in the National Tobacco Strategy released last week, including a public health information campaign to discourage vaping; quit support programs; a new national lung cancer screening program; and programs for First Nations peoples.”

“We’re also really pleased to see funding for research into prevention and early intervention for chronic conditions, and the Health Star Rating System ($4.3 million and $3.2 million respectively).

“It is good to see that the government has listened to the advice of experts on maintaining a strong focus on tobacco as well as vaping. While smoking rates continue to decline, tobacco still causes 44% of all cancer in Australia¹. That’s why raising the excise on tobacco products is an important public health measure. This will help to drive down smoking rates even further, and raise $3.3 billion over four years.”

“Disappointing” preventive health spending

Pettigrew said it’s really important that the taxes raised from this measure are reinvested into health to ensure good health for all Australians.

“As a research organisation that focuses on health equity, we would like to see the government invest in the other priorities outlined in the National Preventive Health Strategy release in late 2021, including, in particular, improving access to and consumption of healthy diets and increasing physical exercise. Preventive health spending in this budget was disappointing, with only $53.4 million allocated over five years.

“Australia has the sixth highest rate of obesity among 22 of the OECD countries, and 95% of adults have inadequate fruit and vegetable intake, and 95% of children have inadequate vegetable intake². Diet and exercise contribute to the prevalence of chronic disease. 47% of Australians (11.6 million people) suffered from one or more of 10 selected chronic conditions.

“The funding allocated to preventive health seems out of balance with the burden of chronic disease on the population. Chronic conditions contributed to nearly nine in 10 deaths (89%) in 2020 and were involved in 5.8 million hospitalisations (52% of all hospitalisations) in 2019–20. Taking action on these important determinants of health will improve Australians’ quality of life and enable us to live longer, healthier lives.”

Allied health services

Professor David Peiris from the George Institute for Global Health said it was pleasing to see increased investment in Medicare, including tripling the bulk-billing incentive payment which will improve access to health care for those most in need.

“We also support the funding for improved access to multidisciplinary care in the community and commissions of allied health services to support care for chronic conditions, and funding for the improvement of chronic wound management.”

Peiris added that it was, “pleasing to see funding to put the Australian Digital Health Agency and My Health Record on a more sustainable footing; however, more will be required in future to deliver the government’s vision of more digitally enabled health care for Australians.”

A missed opportunity

The National Rural Health Alliance (the Alliance) said it sees the 2023 budget as a missed opportunity to significantly address healthcare needs in rural Australia.

“This is despite the major contribution by rural communities to Australia’s economic surplus this year and their poor health status, which is below that of their urban counterparts,” the Alliance said.

“While there are some modest measures included to improve healthcare access, this is not a budget that will provide rural health improvements — which is disappointing,” said Alliance Chief Executive Susanne Tegen.

“The Alliance is disappointed that significant reform of rural health care has still not been tackled, with these modest budget measures failing to address major medical and health workforce inequities. These measures also do not allow for the innovative community-led models of multidisciplinary primary health care that are desperately needed in rural areas.

“These same communities provide over 90% of the food on our tables and the majority of Australia’s national income. They deserve better,” Tegen said.

^{1 Alcohol, tobacco & other drugs in Australia, Tobacco – Australian Institute of Health and Welfare (aihw.gov.au)
2 National Preventive Health Strategy 2021–2030 https://www.health.gov.au/sites/default/files/documents/2021/12/national-preventive-health-strategy-2021-2030_1.pdf}

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