40 Years Strong: Reform Medicare for a Healthier Future!

By Skye Cappuccio
CEO, Optometry Australia
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The 40^th anniversary of the introduction of Medicare in February 1984 is a time to both celebrate Australia’s universal public health system and consider how Medicare can be strengthened so it continues to meet the healthcare needs of all Australians, regardless of their income, location, or background.

Medicare enables optometrists to provide subsidised eye care consultations to patients, the overwhelming majority of which are bulk-billed.  This is vitally important in ensuring that primary eye care remains both accessible and affordable.

Optometrists provide over 10 million consultations to patients under Medicare annually.  For more than 80% of Australians, the local optometry practice is their gateway into the eye health system.

Optometry Australia is proud of the strong advocacy in our profession’s history, which ensured optometrist consultations are claimable under Medicare. With 90% of blindness and vision loss preventable or treatable if it is detected early, Medicare enables Australians to have their eyes checked regularly by their local optometrist at little or no cost.  Often, it is during these eye examinations that optometrists detect more serious eye health issues in asymptomatic patients.

However, Medicare’s 40^th anniversary is an appropriate time to consider how our universal public health system can be strengthened so that it continues to be fit-for-purpose to meet the challenges of an ageing population, an increasing prevalence of chronic health conditions, and ongoing advances in health technologies.

Optometry Australia strongly supports the Federal Government’s Strengthening Medicare work, including the Strengthening Medicare Report, the Mid-Term Review of the Australian Health Reform Agreements, the Scope of Practice Review, and the Digital Health Blueprint and Action Plan. It is also critical to ensure Medicare continues to enable affordable patient access to eye care through a comprehensive review of fees to ensure the Medicare Benefits Schedule is aligned with the true costs of providing care.

Eye health is a microcosm of the broader health system and faces many of the same issues:

• Patients with multiple, long term chronic health conditions.
• An increased demand for services.
• Specialist workforce shortages.
• A siloed system that is unconnected, inefficient, largely paper-based, and hard to navigate.
• Unacceptable wait lists and wait times in secondary care.
• Insufficient focus on preventative health.
• Funding models that don’t work for funders, health services, health professionals or patients.
• Health professionals who are underutilised and unable to work to their full scope.
• A seeming inability to integrate models of care that work into the broader health system.

Forty years on, Medicare remains the foundation stone of Australia’s health system and the central reference point for the future. However, like any forty-year-old, Medicare needs a proper check-up of its own. We all know the importance of following up any issues that are picked up during a health check with timely action, rather than ignoring them in the forlorn hope they will magically fix themselves.

The good news is that we know what the problems are, and we also largely know what is needed to fix them. The test for everyone with a stake in the health system is to have the courage to recognise that addressing the issues that are holding us back will deliver better health outcomes for patients and longer-term financial sustainability for the broader health sector.

Optometry Australia’s 2024-25 pre-Budget submission called for a comprehensive, independent review of Medicare scheduled fees for optometric items to ensure that they are aligned with the true cost of providing quality eye care; and an increase in the domiciliary loading benefit. Read more, here.