40 Years on: A quick look at Medicare's long history

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In the 2023 United Nations World Happiness Index, Australia was ranked the 12th happiest country globally. The World Happiness Index is a global ranking of the United Nations' countries according to surveys taken from averages in the population. For Australia to come 12th is no mean feat, and for us to come 12th in the world is a testament to our quality of life in this country.

Despite recent hardships, it's not difficult to see exactly why Australia ranks so highly. Our student fee help scheme means that anyone can study a grad cert in nursing, or a masters in engineering without needing to pay any upfront fees. We boast one of the most diverse populations in the world, we are home to a passionate and celebrated arts culture, and we have one of the most renowned healthcare systems of any developed nation.

This year, Medicare, the healthcare service that has helped 33.9 million people since 1984, turns 40 years old! In honour of this, we thought it only prudent to cast our eyes back and look at where Medicare began, and how it got to where it is today.

Pre 1984 Australia had some private health insurance but the system lacked efficiency. Without bulk billing, and upfront medical fees, some doctors and hospital visits could practically bankrupt the average Aussie. We needed a solution. People were avoiding going to the doctor, many of whom had chronic, and life-threatening conditions that demanded treatment.

The process started with Gough Whitlam. After becoming the opposition leader in 1967, the public debate around a public health insurance system in Australia renewed. This became the centre of Whitlam's campaign for the office of Prime Minister. He promised to introduce a public health insurance scheme if the Labour government won the following election. The promise rang true, and Whitlam was voted Australia's Prime Minister in 1972.

Medicare was initially introduced as Medibank in 1975. The process of introducing a new bill to Australian law is a lengthy process, but Whitlam's government was blocked twice by the Senate leading to further delays. Eventually, the bills were passed on August 7,1975 and Medibank came into effect in July of that year. It was changed to Medibank Mark II in November 1975 when Prime Minister Malcolm Fraser made several amendments to the scheme, including hospital funding, benefits, bulk billing, and private health insurance rebates.

Despite some early successes, the newly found Medicare still suffered from fierce opposition.

When Medicare was introduced in 1984 some of its strongest opposition came from an unlikely source: doctors. The Australian Medical Association (AMA) believed that Medicare represented an intrusion on the doctor-patient relationship and that doctors would have to contend with government interference in the course of their duties.

In their opposition to Medicare, the AMA cited flaws in the UK's NHS (National Health Service), concerned about similar problems in Australia. The AMA was also backed by the Liberal government, which had always been strongly opposed to the national insurance scheme, In 1987, opposition leader John Howard, said:

"The Government should have taken a knife to the expensive, failed Medicare system. Medicare has added between $3 billion and $4 billion to the Federal Budget. Medicare is one of the great failures of the Hawke Government."

Howard was quickly proven wrong, however, as 45 per cent of medical industry professionals engaged in bulk billing, increasing to 55 per cent over the next five years.

After Medicare's introduction it became clear that, despite the cost, the benefit to the people was astronomical and utterly priceless. Medicare was continuously improved on and now it is famously one of the most famous national healthcare schemes in the world.

40 years on and Medicare is still providing relief from medical expenses all over the nation. Despite dropping bulk billing rates across the country, the fact remains that Medicare is a right and a necessity.

Despite their early displeasure with the system, Dr Tony Bartone, president of the AMA, did eventually concede that:

"Universality of access is a fundamental right and a fundamental equity issue from that point of view, the AMA welcomes the history and the evolution that has led to today,"

Thankfully, Australia still has our Medicare. This system stopped people going bankrupt after a visit to the doctor's office or a hospital stay. While Medicare doesn't make accessing treatment and care free, it does make it affordable, and for many people this is all they need for now.

In a perfect world medicine and medical care would be free for all, but we don't currently have a perfect world. Yet with 40 years of Medicare behind us, and a populace that recognises the real value of this scheme, the future for an Australia where anyone can receive the treatment they need is looking bright.