Some months ago, I wrote that the original design of Medicare had a fundamental defect. Alas, Labor's $8.5 billion injection - instantly matched by the Coalition - does not fully address it.

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A good start but not visionary enough. It is another example of Medicare telling us a great deal about Australian politics and Australian politicians, and it will do so again this election.

The original defect in Medicare was that it paid GPs only a percentage (usually 75 or 85) of the scheduled fee if they "bulk-billed" - that is charged the patient nothing. But if governments want to give GPs an incentive to bulk-bill, the payment to the GP should be, say, 115 per cent of the scheduled fee and that non-bulk-billing GPs would get only, say, 85 per cent. A carrot and a stick.

The reasoning behind the original scheme was that, because GPs were saving on administration, they should accept a lesser fee. But in these days of electronic transfers and computer accounting it makes no sense at all. The administration costs of charging the extra 15 or 25 per cent is negligible. And why you are at it, why not charge even more. That is what the GPs have been doing.

The Coalition believes people should look after themselves and that the private sector is more efficient. So Medicare should undermined whenever they think they can get away with it electorally.

Labor believes in the universality of free health provision because it is for the common good.

Labor's $8.5 billion to apply bulk-billing incentives to every patient is a move towards restoring universality, which successive Coalition governments undermined - bribing, scaring, and blackmailing people into taking out private insurance; pushing Medicare as a mere safety net; and reducing GP payments by not indexing properly so GPs have been forced to abandon bulk billing wherever possible.

Labor's $8.5 billion will now provide incentives to bulk........

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