Open Letter to Sussan Ley on Medicare changes

Dear Sussan,

I am glad common sense prevailed today and you called a halt to the changes that were to take effect on Monday. I see this as a reprieve, but not a victory. You have made it very clear you are intent on making changes.

I am disappointed you place the emphasis on consulting with the medical profession. I assume the public, the patients, the ones who pay the insurance premium are just lumped in under the category “others”. I’m not an “other”, Sussan, I am one of the many for whom Medicare actually exists. Medicare doesn’t exist for the medical profession, Medicare exists for the patients.

As First Dog on the Moon so beautifully reminded us all, Medicare is forty years old. I have absolutely no difficulty in accepting that a forty year old system may need updating. Imagine if we were all still driving T-model Fords. There are no doubt efficiencies that could be implemented, perhaps the item numbers may need a complete revamp, an alternative could be found for sick leave certificates and prescription repeats. The possibilities are endless, I agree.

The stakeholders you need to engage with are the patients, the customers of Medicare. Good change management is crucial. Consultation involves listening and understanding, not simply meeting with interested parties for appearances then ignoring their input to the discussion and acting in a unilateral or dictatorial fashion.

Certainly doctors need to be involved in the discussions, for it is the medical profession that administers much of the system. Doctors determine the item numbers, for example, and much of the data capture is now done directly at medical clinics. Any changes certainly need the agreement of the medical profession to function smoothly.

Should changes involve an increase in the Medicare levy, an option favoured by almost everyone I have spoken with, or a reduction in rebates, there must be a suitable transition period to allow the families of Australia to adjust budgets accordingly.

Patients are a mixed demographic. There are those patients that are ill for a limited period of time. A little like the partner visa battle, such patients are consumed by their illness at the time, but once well again want to just get on with their lives and leave the past and pain behind. Then there are patients who develop or are born with ongoing conditions. Such patients may be at various levels of normal activity: their condition may be manageable or in remission, or they may be severely disabled. There are potential patients who expect they are indestructible and ignore all talk of ever being a patient. What this means for you is your customer base is very diverse and often does not speak with one voice. It is your responsibility to ensure the various voices are heard and to speak for the vulnerable. You took an oath to serve the people.

There is a national patient group, the Australian Patients Association. I have reached out to ascertain the Association’s views on changes to Medicare.

You have an opportunity to improve Medicare for the benefit of the Australian people. Don’t fritter such an opportunity away. The Australian people have a right to a universal health system that is appropriate to Australia. We don’t need another country’s system, we need something designed for us and with us. We need any changes planned carefully and implemented in a way that doesn’t undermine the health of Australia. We need access to quality care without facing bankruptcy. We need to be able to afford the ancillary care that is often necessary such as physiotherapy. We need to be able to afford the blood tests and imaging required for diagnosis and the medication to treat or manage our conditions.

We need our doctors to be able to run their businesses, participate in high quality CPD and not be encumbered for life by student debt. We don’t want only the children of the very rich to be able to afford to become doctors, we want to best and the brightest.

For your reference, may I refer you to articles I have written to support our health system.

Don’t destroy our health system, Sussan. The RACGP petition sends a very clear message: heed that message.

Kind regards,


Robyn Oyeniyi

13 comments on “Open Letter to Sussan Ley on Medicare changes

  1. […] Yes, I read that too. When you look at that Guardian article and that High Court situation together, what do you see? Not to mention the recent Medicare debacle. […]


  2. The comment below was made on the Facebook page. I felt it should be available to readers here.

    * * * * *
    “The System” seems to becoming the way of “The Company” in that it becomes an entity in and of itself where human beings are mere numbers and files and not proper, living people at all. The system, in this instance, is merely the framework for delivery of services and should be referred to only as that fact, whereas sick people, in this instance, require the services provided by the system as efficiently and cheaply as possible.

    A nation of sick people is not going to be able to sustain the economy and neither can a system. Just like education higher costs do not make anything more efficient, or worthy, quite the opposite in general, while removing much of the government, bureaucracy, both federal and state, would save hundreds of millions of dollars.

    Anyone who works in the health system will testify to the amount, and uselessness, of paper shuffling, meaningless graphs, layers upon layer of supervision for the most highly trained doctors and nurses there have ever been; this is what “the system” really consists of while those at the “coal face” struggle against increasingly insurmountable odds, from keeping up with that bureaucracy to staff shortages and ongoing education. Layers and layers of predominantly Registered Nurses and highly trained health professionals, all attending meetings and spending all day on computers to achieve very little other than the slowing down of service delivery, who should be better employed supplying the services they have been trained for. If the “paperwork”, computers, were removed and those people were on the wards the nurse shortage would disappear, front end nurses and doctors could receive a decent pay rise at the same time as millions of wasted dollars could be recovered.

    40 years ago it took 4 people to administer a hospital of 2,000 patients and all its allied staff; these days it takes about 20 people to run a day care centre of 40 patients. Of course the world has become more complex, even to requiring increased supervision, bit that does not mean the entirety has to be given over to pointless exercises and clipboard carriers.


    • This was my reply on Facebook.

      * * * * *

      Tim we do seem to do a lot of admin for no good reason these days. I notice it everywhere not just the health system. There is no value add in it at all.

      To protect ourselves from any consequences of charges of non-compliance with everything, we over record, over report, over analyse.

      Thank you for your thoughtful contribution. I will share this on the actual article.


  3. Just think what a difference it would make to the current Medicare situation if the Liberals actually created the promised 1 million jobs – REAL jobs for AUSTRALIANS – in the promised time-frame! That’s 1 million more tax payers paying the Medicare levy! Medicare would be sustainable for a long time indeed.

    Liked by 1 person

    • Now there is a damn good point! You know we are the 13th largest economy in the world, but have only 0.3% of the world’s population?

      But we can’t afford Medicare, or asylum seekers or climate protection. So the government tells us.


  4. Good on you Robyn. Exactly my sentiments and those of hundreds of thousands of others, I am sure.

    Personally I paid the Medicare Levy for 37 years till I retired 3 years ago, in which period I very rarely went to the doctor or used my Medicare Card. Now in my late 60s I might start to need to see the quack a bit more often the past. Which means for 37 years I have subsidised everyone else going to the doctor whether rich or poor, which is the intention of the Medicare system, but if the LNP destroyers have their way, I now will have to pay through the nose to get medical attention when I least can afford it.

    All these cuts and charges are only designed to benefit LNPs cohorts and donating corporations as they will be going to establish a “research fund” owned and operated by them whose only research will be aimed at how to fleece the general public of their hard earned money and nothing to do with medicine.

    Unless the increase and cuts are directly benefitting the Medicare System, then the whole comedy is just that a sick comedy.

    Roll on 2016 when we can kick these destroyers of the Australian Lifestyle out of office for all time.

    Liked by 1 person

    • Carmen, that whole “oh, we have to make Medicare financially viable by cutting the rebate but will put the cut into a research fund” made no sense at all – no change to the bottom line, just a reallocation of outflow.

      Many people are too young to remember life before Medicare!

      Liked by 1 person

  5. Sentiments I totally agree with. I’m in the position of requiring frequent and ongoing The one thing that bugs me sometimes is the notion that the expense of the system is some runaway monster in action and that it will become unsustainable, phrases and words being chucked around the place with gay abandon to justify fiddling with the basic tenet of our Medicare.
    In reality Australia spends less on health than many OECD countries, examples being the USA, Canada, France and NZ.
    Also the ‘$billions out of control gloom and doom’ stuff doesn’t ring true when you check the historical percentages of GDP spent here.
    Its changed barely a skerrick over a very long period.

    Liked by 2 people

  6. I got an email from Bill Shorten today asking those of us who really care about Medicare to write to Sussan Ley on a personal level. So I did & it pretty much said what you have said in your blog.
    I reckon that the levy should be raised. The reason for raising it shouldn’t be too hard to explain surely & I think that most workers would be quite happy to agree to it especially if it keeps our Medicare near the very best in the world.
    Well done Robyn. Don’t let this one go girl!

    Liked by 2 people

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