A new report says Medicare no longer works for patients or GPs.

The Grattan Institute report ‘A new Medicare: Strengthening general practice’ calls for an overhaul of the way GPs work and get paid so Australia can turn the tide of chronic disease and keep more people out of hospital.

The report says Australia’s universal healthcare system has failed to keep up with changes to health needs.

Since Medicare started four decades ago, the review finds that GPs’ work has become much more complex, as the population has grown older and rates of mental ill-health and chronic disease have climbed. 

However, the way the Commonwealth structures and funds general practice has not kept up, according to the report. 

Despite patient care becoming more complex, appointments have been stuck at an average length of 15 minutes for the past two decades. GPs are struggling to meet their patients’ needs, and they lack the support of a broader team of health professionals to do so.

“Other countries have reformed general practice, and their rates of avoidable hospital visits for chronic disease are falling,” Grattan said in a statement. 

“But Australia is spending more on hospitals while neglecting general practice: the best place to tackle chronic disease.

“Patients suffer the consequences. People with chronic disease live shorter lives, with more years of ill-health, and lower earnings. 

“Poorer Australians suffer the most: they are twice as likely to have multiple chronic diseases as wealthy Australians.”

The analysis says that Australia’s healthcare workers are also struggling, with hospital staff overwhelmed by demand and GPs reporting they feel stressed, disrespected, and disillusioned.

The report recommends big changes.

First, it says that general practice needs to become a “team sport”, with many clinicians working under the leadership of a GP to provide more and better care.

To achieve this, the federal government must dismantle the regulatory and funding barriers that force GPs to go it alone, the report says. 

To accelerate the change, it calls for 1,000 more clinicians, such as nurses and physiotherapists, to be employed in general practices in the communities that need them most.

Secondly, the Grattan report says Australia needs to change the way GPs are paid. 

“The current method is broken - it actively discourages GPs from working with teams, and it rewards GPs who see lots of patients in quick succession, rather than spending more time with patients who need more care,” the experts claim. 

They say GPs should be able to choose a new funding model that supports team care and enables them to spend more time on complex cases, by combining appointment fees with a flexible budget for each patient based on their level of need.

“Medicare is in the grip of a mid-life crisis,” says report lead author and Grattan Institute Health and Aged Care Program Director Peter Breadon.

“Our fix will give more patients better care, and boost GPs’ job satisfaction – and it’s affordable.

“The Albanese Government has set aside $250 million a year to fix Medicare. That money can fund the recommendations in this report, repairing the foundation of Australia’s healthcare system and creating a new Medicare that is ready for the decades ahead.”