Health,age pension and unemployment benefits are now very large outgoings in the Federal budget.
To put things into perspective for the current federal budget out of a $464B spendathon $64.3B is assistance to the aged, while assistance to the unemployed and sick is just $10B. I highlight this as too often the media and politicians report about the unemployed as if they're a giant leech on society when they actually represent one of the smaller budget expenditures.
Health is $75B and one of the biggest drivers of health costs has been the blowout in medicare GP costs as the Govt continues to bring in overseas trained doctors to work in regional areas, but when their 5 or 10 years is up they move into a capital city. The number of doctors in Australia rose by 47% in the decade to 2014-15, around 2.5 times the 19% growth in the overall population. Much of this growth has come from OTDs (Overseas Trained Doctor), whose numbers have ballooned-out by a whopping 111% over this period.
A bit of a rant for the below, but I honestly don't think many of the political class quite grasp what's going on with the health budget.
The purpose of the OTD promotion policy was to get more doctors into under serviced areas, particularly RA 2-5 areas. As with most policy in Australia we've achieved the opposite with most of the extra OTDs, by 2014-15, practising in RA 1 areas. Of the total increase in OTDs (6,946) 4,520 were practising in RA 1 areas and 2,426 in RA 2-5 areas.
By June 2015, for all of Australia, OTDs made up 39.7 per cent of the workforce but received 49.8 per cent of total rebates. In RA 1 areas they made up 38.1 per cent of the total workforce and received 47.6 per cent of services paid for by Medicare. [OTD] numbers have been rising at up to 17.2 per cent per annum since 2010.
There is no end in sight. With supply well ahead of population expansion, the competition for patients is set to get worse. In the case of the recruitment of OTDs, the Government has taken no notice of the GP oversupply. It continues to allow employers to sponsor new OTDs to DWS locations. So, when OTDs leave, many are being replaced. In 2014-15 there were 1,132 OTD GPs sponsored on 457 visas and in the first six months of 2015-16, another 582. Also, the Australian Government has left GPs on the Skilled Occupation List of occupations that are eligible under the permanent-entry skilled migration program. Hundreds of OTDs are being granted such visas for service in DWS and hospitals each year.
It would be cheaper in the long run to offer better pay to for local doctors to move to regional areas than continue with the never ending importing of more doctors that will generally end up in a corporate bulk billing clinic and ensure the roughly 40% growth rate of pathology and radiology that occured over the 2004-05 to 2014-15 period.