Ask the Squiz: Bulk billing, White House renos, and netball’s Olympic goal

Ask the Squiz

We’re back with another edition of Ask the Squiz, where we answer your questions about what’s been in the news. This time, we’re getting you across:

• the recent incentives for bulk billing

• why there’ve been bulldozers at the White House

• and we’ll step you through netball’s chances of making it into the Brisbane Olympics…

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Listen time: 16 minutes

Medicare changes and incentives for bulk billing

Eliza wants to know about the recent Medicare changes. There was a lot of focus on bulk billing, and her question is: Why wouldn't GPs sign up to bulk billing, and why is it an opt-in thing?
There’s a lot in that question, so let’s start at the beginning… Medicare is one of the 3 pillars of our health system (the others being the Pharmaceutical Benefits Scheme and public hospitals). It guarantees all Australian citizens and permanent residents access to a wide range of health and hospital services at a low or no cost. And a big part of that is a subsidy for consultation fees when you visit a General Practitioner (GP).

How much does Medicare cost each year?
About $30 billion a year - and about a third of that goes towards those GP consultation subsidies. This is where we come to bulk billing… It’s when the GP clinic - the healthcare provider - charges the full cost of your visit to the government (so, to Medicare). If that’s the case, the GP accepts the Medicare benefit as full payment for the service, so patients aren’t out of pocket. 

Why do some doctors charge more?
It’s a key tenet of our health care system that Australians, particularly low-income Aussies, can visit the doctor at no cost. But that’s up to doctors - they can choose how they want to charge their patients. As a patient, if you don’t want to pay extra, you can search for your closest bulk billing doctor and go there instead. 

How many doctors bulk bill patients?
The latest numbers published by the federal Health Department put our national bulk billing rate at 75.7%. You might be surprised by that if you’ve been paying extra to see a doctor. There are numbers on that too - the average out-of-pocket payment is $45 for a GP visit…

So, what changes are the federal government looking to bring in?
Health Minister Mark Butler has a target bulk billing rate of 90% of doctors by 2030… This is why it’s been in the news - Butler says the Albanese Government is making the "largest single investment in Medicare since its creation over 40 years ago". They’re doing that with expanded bulk billing incentives, particularly through the Bulk Billing Practice Incentive Program (BBPIP). 

What does that involve?
It’s an additional financial incentive to general practices that commit to bulk billing every eligible service for every Medicare-eligible patient. Essentially, it’s an extra 12.5% incentive payment on top of the standard Medicare Benefits Schedule (MBS) benefit for all eligible services.

What is it going to cost?
It’s priced at $7.9 billion over 4 years. The idea is that it will boost the number of fully bulk billing practices from around 1,500 to approximately 4,800 nationally. Those clinics will be required to put a sign at the front of their clinic that they are a ‘Medicare Bulk Billing Practice’. 

What has the reaction been?
The AMA, which is the doctors peak group, have given a cautiously optimistic response to the government's bulk billing package. They welcome the increased funding as a positive first step, but also express significant concerns that it doesn’t go far enough to address the fundamental issues within the Medicare system. 

What sort of issues?
The main one, they say, is that even with the increased payments, it doesn’t cover the actual rising costs of running a general practice (staff, rent, utilities, insurance). And that means some practices will still be unable to extend bulk billing to all patients.

Why is the plan an opt-in proposition, as opposed to compulsory?
It’s actually the Australian Constitution that prevents the government from imposing "civil conscription" on medical services. Essentially, it means that the government cannot legally mandate that doctors provide free services or that they can only charge a government-determined fee. 

So, there’s a bit to go to convince all doctors to sign up?
Yep - we’re bound to see more of PM Anthony Albanese and his Medicare card out and about for the cameras while the government strives to hit its target number of bulk billing GPs.

The White House gets a makeover…

Our second question comes from Jono, who asks: What's the deal with US President Donald Trump knocking down the East Wing of the White House? Is he allowed to just do that?
In case you missed this in the news, Jono’s talking about photos that went viral recently of demolition work at the White House in Washington DC. So, let’s begin with some facts… The East Wing was originally built back in 1902. It was expanded in 1942, and it housed the Office of the First Lady, the visitor's entrance, and a family movie theatre. 

What’s replacing it?
A new, privately funded, 90,000-square-foot ballroom - so 8,361 square meters - and it’s a project spearheaded by US President Donald Trump. 

I didn’t know he was into ballroom dancing…?
We’re not sure that’s the aim - although he’s been known to bust out a move or 2 on tour… The idea is that the new ballroom will accommodate major events and state dinners. At the moment, large tents have to be erected on the South Lawn to host these events, due to space limitations.

When will the reno be finished?
The hope is to complete the new East Wing well before January 2029, which is when Trump’s term will end. Many people have found it an alarming sight, but the other thing that’s raised eyebrows is that the project is being funded by private donors and Trump himself…

Who are the donors?
They include major tech and defence companies. Just a note on that - the use of private donations for White House upkeep and preservation isn’t unusual. The issue is the use of corporate funds for a large, new construction project without full public transparency or standard review processes. 

So, the demolition of the East Wing occurred without advance approval or public comment from the relevant oversight bodies, such as the National Capital Planning Commission and the Commission of Fine Arts?
Yep… And just to be clear, the Trump administration says that approval wasn’t needed for the demolition phase, only for the construction of the new ballroom. And they’ll soon submit plans to the NCPC now that the demolition is complete. 

What’s the ballroom going to be like?
That’s another point of contention. The proposed interior renderings of the ballroom are said to be in the gilded, opulent style that Trump prefers... People are pointing to the Grand Ballroom at Mar-a-Lago, President Trump's private club in Florida, as a style reference.

Does it go with the White House?
We say ‘to each their own’ when it comes to decorating. But the point is that this is the White House we’re talking about, and there’s criticism that Trump’s style might not be the most appropriate for that building of national importance. Trump’s people say the new build will go through a public process, but Trump tends to have form on getting his way…

Netball’s push for the Brisbane 2032 Olympics

Annie has asked us about the chances of netball being in the 2032 Olympics…
Netball has never been an Olympic sport, but the World Netball Foundation is currently running a campaign called Back the Bid, where it’s attempting to get it into the 2032 Brisbane Olympic Games program. 

Why isn’t it an Olympic sport?
There are lots of rules around this… While netball is a sport that’s recognised by the International Olympic Committee, that alone isn’t enough to get it into the Games - Tenpin Bowling and Chess, for example, are recognised sports, but not Olympic ones.

How do sports get into the Olympics?
There are quite a few hoops to jump through… The International Olympic Committee (IOC) takes 35 different criteria into account when analysing a sport. There’s a bunch of technical detail, but when it comes to netball’s inclusion, there are two main sticking points: popularity and participation.

What’s the deal - isn’t it popular?
The International Olympic Committee wants any new sport in the Games to be popularly played across a range of countries and continents. Netball is a big sport in the Commonwealth, but it isn’t as popular in other parts of the world.

Is this the first time netball has had a go at being included in the Games?
Nope… There were efforts to get it into the Tokyo Games, but it didn’t have much luck because netball doesn’t have a profile in Japan, and the same goes for Paris and the next Olympic Games, LA in 2028.

What are the numbers like?
According to the website netball.com.au, it’s played by more than 20 million people in 117 countries. And because the Brisbane Olympics will be in Oz where netball is hugely popular, this is considered the sport’s best chance of getting into the Games.

Does the host country get a say in which sports get a run?
Yep… As almost every Australian knows by this point, thanks to Raygun, breaking was one of the new sports introduced in Paris - partly to appeal to a younger demographic … It won’t be back for Los Angeles in 2028, but baseball, softball, lacrosse, and flag football - popular sports in North America - will be. And also, cricket… 

That’s unexpectedly good news for cricket fans… Any other issues with netball’s inclusion?
Yep… There’s a gender equity problem. Netball is vastly more popular across the world amongst women, while men’s participation rates are very low, especially outside of Australia. If Netball does make it into the Brisbane Games, it would likely be only played by women. 

Are there any other Olympic sports that work like that?
Only a few Olympic events have either solely male or female participants, and they’re dwindling. Some examples are Greco-Roman wrestling, one-person dinghy for men, synchronised swimming, and rhythmic gymnastics for women. So netball would be an outlier.

What’s the argument for including it?
The sport is aiming to encourage male participation in the game and help it to grow. The Back the Bid campaign also points out that netball is so popular in Australia, we already have the infrastructure for it, so it wouldn’t cost any extra dosh. 

When will we find out if they’re in?
Normally, decisions on which sports are included in the Olympic Games are made 7 years in advance, but Brisbane is an unusual case. This time around, the decision will be made 6 years in advance, at an IOC meeting in 2026. 

What will happen at the meeting?
The IOC specifically said that the “Brisbane Organising Committee will have the opportunity to propose one or more additional events from new sports, once the initial sports programme is finalised”. 

So there’s still time?
It’s here if they need…

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Onto our Recommendations…

Reading: Here’s a helpful piece from the ABC about the changes to Medicare that have now kicked in around the country… 

Reading/Watching: This explainer from The Guardian gives a good overview of the White House East Wing demolition, and here’s SNL’s irreverent take on it, featuring Miles Teller…

Tapping: Here’s a link to World Netball’s Back the Bid campaign if you’d like to read a bit more about it.

Keep your questions coming…

We're interested in questions from Squizers so we can drill down on what you want to know more about.

We’ll be back with another Ask the Squiz in the first week of December - so if you’ve got a question you’d like answered about the news, send it through to [email protected] or leave us a voice memo here and we’ll answer it then. Stay tuned…

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