Below is the section of Opposition leader Bill Shorten’s Budget reply speech (read in full here), where he outlines plans to address out-of-pocket costs for cancer patients.
As Croakey’s series on out-of-pocket costs has shown, these are a real barrier to healthcare for many people (and not only cancer patients).
It is also worth noting that reducing the burden of cancer requires more than improving access to treatment; it also requires increased investment in prevention, and in addressing wider health inequities.
Below Shorten’s speech extract, see some responses to the budget reply.
Bill Shorten writes:
I want to conclude by talking to you directly in your lounge rooms about our vision for the most significant investment in Medicare in a generation. Cancer is one of the biggest killers in our nation. Not for nothing is it called the emperor of all maladies.
One in two of us will be diagnosed with cancer at some stage in our life. One hundred and forty-five thousand of our fellow Australians are diagnosed with cancer each year and 50,000 die. One way or another, we will all witness the ordeal.
I saw it with my mum and her battle with breast cancer. Chloe and I have seen it with dear friends of ours—some old, some far too young.
Cancer is frightening. It’s isolating. It’s exhausting. And all too often, though, it’s impoverishing. For so many people, cancer makes you sick and then paying for the treatment makes you poor. I think a lot of Australians would be surprised to learn that all these vital scans and tests and consultations with specialists are not fully covered by Medicare. Instead, they cost hundreds of dollars, adding up to thousands out of your own pocket.
Australia has the highest rates of skin cancer in the world, and most people pay over $5,000 for the first two years of their treatment. One in four women diagnosed with breast cancer pay over $10,000 for two years of scans and tests. Some men with prostate cancer are paying more than $18,000. And if you’re in stage 4 cancer you have to quit work, so your finances are already under horrendous strain.
If you live in the regions, there are the added costs of travel and accommodation. Every year, 300,000 Australians who need radiology just don’t get it because they can’t afford it. That’s 300,000 of us. We’re a smart country. We’ve got the best healthcare staff. We are a rich country. We’re a generous country, and we are better than the statistics I read out.
If someone you love has cancer, you’d sell the roof over your head. If it would help, you’d sell the shirt off your back. But should you have to?
Our fellow Australians pay their taxes to Canberra. You pay your Medicare levy. If I’m I elected Prime Minister, I’m going to make sure that the healthcare system is there for you when you need it most.
So tonight I’m announcing the most important investment in Medicare since Bob Hawke created it: Labor’s $2.3 billion Medicare cancer plan.
To my fellow Australians, I’ll explain what that would be used for. First, if we win the election, we will invest $600 million towards eliminating all of the out-of-pocket costs for diagnostic imaging.
Over four years this will mean six million free cancer scans funded by Medicare—CT scans, PET scans, mammograms, X-rays and ultrasounds—reducing the out-of-pocket costs for cancer patients from hundreds of dollars to zero, and this will apply to MRIs too. Today only half of the MRI machines—that amazing technology—in Australia are covered by Medicare.
People in the bush and the regions often have to drive hours or pay thousands. If we win this election, not only will we provide new MRI machines to communities where they are needed most; we’re going to change the game. We will guarantee that every single MRI machine which meets national standards is covered by Medicare for cancer scans, full stop.
The second part of our plan is to deal with the cost of seeing a specialist. As anyone knows, treating cancer relies on a marvellous team of experts: medical oncologists in charge of your diagnosis and ongoing chemotherapy and immunotherapy, surgeons performing your operations and monitoring your recovery, radiation oncologists designing targeted radiation therapy plans to destroy cancer cells. These appointments are part of your weekly routine, often for years. There are the trips, the waiting, the treatment, the recovery—thousands of dollars.
A new Labor government will invest $433 million to immediately cover specialist consultations for cancer patients. What this means over the next four years is that an additional three million appointments will be bulk-billed with no out-of-pocket costs, reducing what you pay from hundreds of dollars to zero.
The third part of our plan is our affordable medicine guarantee. Every drug recommended by the independent experts will be listed on the Pharmaceutical Benefits Scheme—not just cutting the cost of your treatment; cutting the cost of your cancer medication too.
Cancer is a curse. I wish I could stand here tonight and guarantee that we’ll find a cure for each cancer. No politician can give that promise. We will continue to support our scientists in their work. We’ll invest in the research and the clinical trials. Until the day that we find a cure,
I promise the men and women of Australia this: under Labor, if you’re battling cancer, you focus on getting well without worrying about going broke. I can promise you that, if you’re in the fight of your life, a Labor government will be alongside you every step of the way.
To summarise what our first four years of Labor’s Medicare Cancer Plan means for Australians: up to six million free cancer scans, three million free appointments with specialists and an affordable medicine guarantee.
This is our vision for the future. This is our vision to build Medicare. We can pay for it and we can deliver it because of our reform decisions. We choose our healthcare system over bigger tax loopholes….
Labor cancer care investment a game-changer
Statement by Australian Healthcare and Hospitals Association
‘The $2.3 billion investment pledged by Labor to address out-of-pocket costs for people with cancer is a much needed response to the significant costs many people are confronted with when they are diagnosed with cancer,’ says Australian Healthcare and Hospitals Association (AHHA) Chief Executive Alison Verhoeven.
‘Too many Australians have experienced significant financial difficulty and unexpected costs as they seek treatment for cancer.
‘We are a country which prides itself in our research capabilities, and a strong health system, but when treatments and tests are unaffordable, those strengths provide little comfort.
‘Medicare has served Australians well for 35 years but out-of-pocket costs are growing significantly, causing increasing inequity and hardship for too many seriously ill people.
‘While the Coalition’s review of the MBS and efforts to improve transparency about the costs of care have been welcome initiatives, the bold investment in cancer care pledged by the Opposition Leader in his Budget reply speech is a real game-changer which will potentially benefit the many Australians who are diagnosed with cancer.
‘If this investment goes ahead, we must ensure it is aimed at achieving real value for patients – and does not generate unnecessary and low value care.
‘’As renowned renowned breast cancer surgeon and commentator Professor Christobel Saunders, AO, says in the April 2019 edition of Australian Health Review (AHR), the time to implement value-based healthcare—patient outcomes divided by the cost of achieving those outcomes—is now. Labor must take the lead on this if it wins government and has the opportunity to implement this pledge,’ says Ms Verhoeven.
The Australian Healthcare and Hospitals Association is the national peak body for public and not-for-profit hospitals, Primary Health Networks, and community and primary healthcare services.
Labor’s Medicare boost for cancer care a tremendous step
Consumers Health Forum statement
The Labor pledge to introduce a $2.3 billion Medicare boost for cancer care is a tremendous response to what has become a heart-wrenching dilemma for too many Australians: high out of pocket costs for cancer treatment.
“The big increase in funding for diagnostic imaging, oncology, surgery and medications for cancer patients, is an important acknowledgement of the need for higher payments if Medicare is going to continue to ensure access to quality health care for all Australians,” the CEO of the Consumers Health Forum, Leanne Wells said.
“The Consumers Health Forum has in recent years highlighted the erosion in equitable access to health care created by rising gap costs, culminating in our Out of Pocket Pain report* last year which showed that many cancer patients were facing bills of $10,000 a year or more.
“Opposition Leader, Bill Shorten, has said the Labor Medicare Cancer Plan will provide millions of free scans, millions of free consultations and cheaper medicines for cancer patients.
“An important feature of these changes is that the increased Medicare payments to radiologists and specialists will be available on the basis that patients are bulk billed.
“The focus on cancer is a worthy and understandable initiative. We would hope that it will provide the platform for comparable measures to support patients receiving treatment for other conditions.
“For instance, joint replacement and cataract surgery, both life-changing procedures for many thousands of patients, routinely come with very high out of pocket charges and are subject to long waiting times in public hospitals.
“It is vital that Labor’s promised funding for public hospitals makes significant allowance for more resources for elective surgery and specialist outpatient clinics.
“We trust that further announcements from Labor will also include support for much-expanded primary health services and for a realistic national preventive health strategy,” Ms Wells said.
* https://chf.org.au/sites/default/files/20180404_oop_report.pdf
ACOSS welcomes Labor’s commitment to funding services over high-end tax cuts but people on Newstart again left behind
ACOSS welcomes the Opposition’s commitment tonight to give priority to funding essential services over big tax cuts for people on higher incomes but remains deeply concerned about people on Newstart again being left behind.
“We welcome wholeheartedly the major commitments tonight from the Opposition on the NDIS, support for people fighting cancer, and funding for TAFE and apprentices,” said ACOSS CEO Dr Cassandra Goldie.
“We also welcome the Opposition’s renewed commitment to remove the Government’s tax cuts for higher income earners that will otherwise cost $20 billion per year.
“ACOSS maintains the view that now is not the time for tax cuts whilst gaps exist in our essential services. For people on modest incomes, providing universal access to health, education and early childhood education is a higher priority.
“People on the lowest incomes do not benefit from tax cuts. One third of households don’t benefit from tax cuts at all because their incomes are too low to pay income tax.
“People on Newstart are again being left behind. While Labor has committed to a review of Newstart should it win government, we do not need a review to know that Newstart is not working.
“We urgently need to increase Newstart by $75 per week. We must provide immediate relief to people to get through tough times and into suitable employment. An immediate increase to Newstart would also provide the most effective boost to consumer spending at a time when local economies need it, including in regional areas.
“The most effective way to tackle the worst poverty is to increase Newstart so people can cover the basics while they look for paid work,” Dr Goldie said.
Welcome from Breast Cancer Network Australia
Breast Cancer Network Australia (BCNA) welcomes the Federal Opposition’s pledge to reduce out-of-pocket costs for Australians with cancer.
The $2.3 billion Medicare Cancer Plan announced by Opposition Leader Bill Shorten in his Budget reply proposes to reduce costs for patients from the moment they are diagnosed with cancer. The plan includes dramatically increasing the number of bulk billed imaging services, including MRI, and reduced out-of-pocket costs for specialist appointments.
The development of Labor’s Medicare Cancer Plan has been informed by two BCNA reports, The Financial Impact of Breast Cancer (2017) and State of the Nation (2018), both of which shone a spotlight on the significant out-of-pockets costs people with breast cancer are facing around the country.
“We are pleased to see that the Opposition has listened to the stories of people with a personal experience of breast cancer and put a plan in place to reduce the financial toxicity that we know can have a huge impact on women, men and their families,” said Breast Cancer Network Australia CEO Kirsten Pilatti.
The Financial Impact of Breast Cancer report found that women typically pay around $5,000 in out-of-pocket costs in the five years after their diagnosis, with the majority of this in the first two years. Twenty five per cent of women reported out-of-pocket costs of more than $17,200 during their breast cancer journey. The report also showed that women living in a rural and regional area can face additional costs if they need to travel long distances for treatment and stay overnight.
“Reducing the financial toxicity of breast cancer has been a major focus of Breast Cancer Network Australia for a long time – we have heard countless stories from women and men who have faced thousands of dollars in out-of-pocket costs after being diagnosed with breast cancer,” said Kirsten.
“As if being diagnosed with breast cancer isn’t stressful enough, women, men and their families then have to deal with the financial stress as they pay for ongoing specialist appointments, scans and medicines. If you live in a regional or remote area, these costs can add up further if you need to travel for treatment and follow-up care.”
BCNA has been working with Cancer Council Australia, Prostate Cancer Foundation and Canteen to advocate for change around the issue of out-of-pocket costs.
Historic commitment
The Royal Australian and New Zealand College of Radiologists
The Royal Australian and New Zealand College of Radiologists (RANZCR) applauds Opposition Leader Bill Shorten’s announcement in the budget reply that if elected Labor will significantly increase access to vital scans for Australian cancer patients. This announcement is part of their $2.3bn Medicare cancer plan.
Cancer patients require multiple visits to specialists, imaging and treatments and have shouldered significant out of pocket costs as a result. This has resulted in some patients delaying or missing out on essential tests such as MRI.
RANZCR President Dr Lance Lawler said “Cancer affects one in two Australians at some point in their lives and they must have timely and affordable access to the care they need. These patients require imaging at several stages of their cancer journey including diagnosis, staging, treatment planning and assessment and ongoing monitoring to look for disease recurrence.”
Australia has lagged behind other OECD countries in terms of access to MRI. This investment coupled with quality measures could position Australia as a global leader in the quality and appropriate use of imaging for cancer.
RANZCR has been advocating for increased access to MRI and it is a high priority for our members this election. We thank the Opposition for listening to the concerns of patients and clinicians and acting to address barriers in Medicare.
Cancer patients will now have a choice of any MRI machine close to where they live.
Dr Lawler said “This is the first time a political party has recognised the unfair and restrictive MRI licencing system and has committed to levelling the playing field for cancer patients”.
RANZCR also welcome the addition $433 million for specialist consultation with cancer doctors including radiation oncologists.
Labor Party fails to recognise vital role of general practice in every Australian community in Budget reply
Royal Australian College of General Practitioners
Tonight’s Budget reply saw Opposition Leader Bill Shorten committing to further investment in hospitals, the National Disability Insurance Scheme (NDIS) and significant support for cancer patients in managing out of pocket costs for expensive investigations and treatments.
President of the Royal Australian College of General Practitioners (RACGP) Dr Harry Nespolon said that while these supports are welcome, Labor’s Budget response is another missed opportunity for where the vast majority of care occurs – in the community.
General practice is Australia’s most accessed form of healthcare, with nearly 90% of all Australians visiting their GP each year. Despite this, funding for general practice represents only 7.4% of total government health spending.
Today’s Budget reply by the Australian Labor Party did not go far enough to ensure Australian patients have access to primary healthcare when they need to, not when they can afford to.
Dr Nespolon said he was disappointed to see another missed opportunity to recognise the value of general practice and properly invest in the preventive care provided by GPs.
“General practice is the most cost effective part of our healthcare system and more than two million Australians visit a GP every week, so it was disappointing not to hear the Australian Labor Party would commit proper investment in general practice patient services if elected in the upcoming Federal Election.
“We have seen some signs that our political leaders are starting to recognise the vital role of general practice in our healthcare system, such as Labor’s Federal Election promise to end the Medicare freeze. But unfortunately this recognition does not go far enough.
“This health policy fails the very people Labor seeks to represent.”
The RACGP is calling for catch-up funding to reset Medicare patient rebates.
“Until this happens, patients will still be paying more than ever for their healthcare,” Dr Nespolon said.
“Australian GPs and their patients need the government elected at this year’s Federal Election to commit its support to general practice, rather than further investing in expensive hospitals.
“Focussing on hospitals as the answers for the challenges in health is simply unsustainable.”
• Watch the full speech here.
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