$19.7 million National Men’s Health Strategy

The Liberal National Government will today launch the National Men’s Health Strategy 2020-2030 with more that $19 million to guide action over the decade to improve the health and wellbeing of every Australian man and boy.
We will release the National Men’s Health Strategy, which sets out a national approach to improving health outcomes for all men and boys in Australia, particularly those at greatest risk of poor health.
On the whole, Australian men and boys enjoy long, healthy lives, with a current average life expectancy of more than 80 years, the eighth highest in the developed world.
Despite this, Australian men and boys face challenges in their health and wellbeing. They die earlier than women, and more often from diseases that can be prevented. Aboriginal and Torres Strait Islander men live significantly shorter lives than other men.
The Strategy is forward looking with a clear blueprint for actions on the five priority health issues affecting men’s health:

  • sexual and reproductive health and conditions
  • mental health
  • chronic conditions
  • injuries and risk taking
  • healthy ageing.

Important health issues for men include infertility, coronary heart disease, prostate cancer, overweight and obesity, diabetes, bowel cancer, lung cancer, injuries, mental health and suicide.
We are pleased to announce $3.8 million for research into the causes and prevention of male infertility, a disease recognised by the World Health Organisation. It is estimated to affect one in six couples, causing significant suffering to thousands of Australians.
To date the vast majority of resources expended in research and treatment have been focussed on female infertility yet in couples seeking infertility treatment in Australia, male infertility is recognised by clinicians as being an equal contributor to couples being unable to achieve parenthood.
We are also pleased to announce $3 million in funding to Andrology Australia, through to June 2021. This will allow them to continue to deliver high quality education and training programs for health professionals and information for men on a range of reproductive health issues.
In addition, the Liberal National Government is providing continued and expanded funding to support the Men’s Shed movement ($11.2 million over 4 years). The funding consists of the following:

  • Funding to men’s sheds through the National Shed Development Programme will be continued, and increased to $1 million per year for years ($4 million over 4 years). These grants enable sheds to apply for funding twice a year to assist with health and wellbeing activities and events, shed improvements and tools and equipment
  • $1.5 million to fund regional coordinators at the grassroots level in each state and territory which aims to provide direct assistance in men’s shed
  • $3.6 million to the Australian Men’s Shed Association in supporting to support Sheds at a national level
  • $2 million to equip every Men’s Shed in Australia with a portable defibrillator
  • $100,000 to establish a web based platform ‘Men’s Shed Exchange’. This platform aims to encourage the broader shed community to contribute ideas on how to attract and retain membership and participation and how to stage regional events. Andrology Australia will host the portal.

Health and medical research is one of the four pillars of the Government’s Long-Term National Health Plan.
Our Government’s strong economic management ensures the continued record investment into vital health initiatives.
$1.5 million over three years will be available to implement various key actions from the Strategy to support health promotion initiatives and health literacy, improve health professionals’ knowledge and a literature review and development of strategies to increase men’s and boys’ engagement with the health system.
Further research investment includes:

  • The Australian Prostate Centre, Victoria, is receiving $600,000 to support prostate cancer research
  • The Australian Prostate Cancer Research Centre – NSW, at the Garvan Institute, is receiving to $437,535 to support prostate cancer research through safeguarding their biobank and databank
  • The Australian Longitudinal Study on Male Health (Ten to Men Study) which examines social, environmental and behavioral factors of males aged 10-55 years. One of the themes the study is investigating is barriers to accessing healthcare and men’s attitudes to their own health, which may identify cultural or social barriers. The next stage of this research will be undertaken by the Australian Institute of Family Studies in 2019/20.

Today’s announcements add to the Liberal National Government’s strong record on men’s health.
In last week’s budget, our Government invested an additional $31 million to more than double the number of Commonwealth funded Prostate Cancer Nurses from 28 to 62 by 2022-23.
Earlier this year we announced $10 million in an advertising blitz to boost participation in the free and life-saving National Bowel Cancer Screening Program. By the end of 2019 all Australians aged 50 to 74 will be invited to screen.
Bowel cancer is the second most common cause of cancer-related death in Australia with 17,000 people diagnosed each year. Bowel cancer is the second most common cause of cancer-related death in Australia with 17,000 people diagnosed each year and is more common in men, with one in 11 developing bowel cancer before the age of 85.
Participation in the screening program is also lower for males (39.4% compared to 43.2% for females)
Tragically, deaths by suicide in Australia occur among males at a rate three times greater than that for females and that is why we are providing $114.5 million for a trial of walk-in integrated Adult Community Mental Health Centres at eight locations nationally; and $11.5 million for the National Mental Health Workplace Initiative to assist businesses to create mentally health workplaces.
On the PBS, the following medicines specific to male patients have been listed since 2013:

  • Xtandi for prostate cancer. Treating over 900 patients and saving them over $9500 per year.
  • Lucrun for prostate cancer. Treating over 2500 patients and saving them over $4200 per year.
  • Testogel for male androgen deficiency saving patients over $700 dollar a year.

Since 2013, the National Health and Medical Research Council (NHMRC) has provided over $102 million in funding for Men’s health research. This includes nearly $14 million for clinical trials for Men’s health.
Through the Medical Research Future Fund’s (MRFF) Accelerated Research Initiative, the Movember Foundation is being funded up to $6 million over three years (2018/19 – 2020/21) to support the Australian Prostate Cancer Research Centres development of prostate cancer research.
We would like to thank Andrology Australia, the Expert Advisory Group, participants in the forum and those who provided online feedback in helping to shape this important piece of work.

LABOR TO BACK ROCKHAMPTON AIRPORT’S PUSH FOR INTERNATIONAL FLIGHTS

A Shorten Labor Government would kick off the process of opening Rockhampton Airport to international aviation, looking to supercharge growth of the Central Queensland economy.
An incoming Labor Government would invest $1 million to develop a business case to determine the viability of upgrading Rockhampton Airport’s status to that of a Regional International Gateway.
It would connect Central Queensland producers to the lucrative markets of Asia, creating huge opportunities for high-end agricultural exports.
The change would also provide a direct international tourism gateway to the region’s magnificent tourism assets, including the southern end of the Great Barrier Reef to the north and east and the Sandstone Wilderness to the west.
Most importantly, upgrading the Rockhampton Airport would boost economic activity and jobs growth right across the region.
Regional International Gateway airports require the capacity to deliver international airport services including customs and immigration.
The business case is a crucial first step that will examine the cost of expanding such facilities at Rockhampton, as well as the economic benefits of opening the region to the world.
Airports at Townsville, Cairns, the Sunshine Coast and Toowoomba are already designated Regional International Gateways.
It is beyond time that we look at the potential for Rockhampton Airport to join the international aviation community.
Over nearly six years of cuts and chaos,the Liberal National Party has been too focused on infighting to pay serious regard to regional economic development.
By contrast, Labor has a plan to assist every region in the nation to achieve its full economic potential through investment in critical rail and roads as well as support for tourism, aviation and economic diversification.
Labor’s plan for the Rockhampton Airport builds upon existing commitments for Central Queensland including $800 million for the Rockhampton Ring Road, $25 million for the South Rockhampton Flood Levee and $15 million to upgrade the Capricorn Highway.
Owned and operated by the Rockhampton Regional Council, the Airport is a major Australian regional airport, with flights to Brisbane, Mackay, Townsville, Cairns and the Gold Coast. Approximately 650,000 passengers pass through its terminal every year.

Waters and Bandt announce plan to create clean energy jobs for Qld

47,570 full-time jobs a year would be created in Queensland under the Greens plan to rapidly transform Australia’s energy system to renewables by 2030.
Greens energy spokesperson Adam Bandt MP said: “coal is the world’s biggest cause of climate change and Australia is the world’s biggest exporter of coal with 80 per cent of what we dig up being sent overseas to be burned. Unless we phase out coal, we can’t deal with climate change and the Greens are the only party to have a plan to do it.”
Queensland Greens Senator Larissa Waters said Queenslanders needed and deserved real jobs that last – not fake jobs and false promises like those made by Adani – which the Greens Renew Australia 2030 plan would deliver.
“We’ll build a clean energy export industry to replace the dying coal industry which will create jobs right here in Queensland. Our fully-costed plan will take our energy system from one of the oldest and dirtiest in the world, to one of the cleanest and smartest.
“We’ll support coal workers and their communities with a $1billion transition fund to ensure no Queenslander is left behind. Our plan will also lower energy costs for households and businesses and drive fossil fuels out of the economy.
“Right now, giant, multinational coal and gas companies are extracting our resources for free, polluting local environments and paying no tax. They get away with it because the Liberal and Labor governments take their dirty political donations – $5million over the last four years – and then do their bidding at the expense of everyone else and the planet.
“The world economy is changing and it’s time to turf the coal huggers out and for Australia to become the renewable energy superpower the global market is ready for.”
The climate and energy plan includes:

  • 100% renewables by 2030 including support for households and business solar and batteries and the establishment of renewable energy zones
  • A new public energy retailer Power Australia and re-regulation of electricity prices
  • Phasing out the burning and export of thermal coal supported by a $1 billion transition plan for workers
  • The building of a solar export industry based on hydrogen and direct exports to Asia
  • Doubling energy productivity and a reduction in pollution across the economy driven by industry programs, a energy efficiency target and a carbon price
  • A shift to electric cars with the phase-out of petrol car sales
  • Support for farmers to drawdown carbon in the land

The plan will create 180,000 new jobs nationally and drive Australia towards zero-net emissions by 2040.
Read the full plan: greens.org.au/platform/renewables#repower

Use the 'special relationship' to stop Assange extradition: Di Natale

Australian Greens Leader and Foreign Affairs spokesperson Dr Richard Di Natale has called upon the Australian Government to swiftly intervene to ensure that Julian Assange is not extradited to the United States.
“This arrest is a dark day for press freedom around the world,” Di Natale said.
“Regardless of what you think about Assange as an individual, he is facing extradition to the US on charges relating to his work to shine light on potential war crimes – an act that won him Australia’s highest honour for journalism.
“Seeking to punish Assange for exposing evidence of US atrocities in Iraq and Afghanistan would put a chilling effect on moves towards open and more transparent democracy.
“This is not a simple case of someone breaking local laws while overseas. If extradited to the United States, Assange will be on trial for alleged crimes he committed while not even in the country. Foreign nations must not be able to extradite and charge journalists who have exposed their wrongdoing. It sets a terrible precedent and would be a disaster for the free press.
“Australia must do more than simply provide a tokenistic offer of consular assistance. I call on the Foreign Minister to make the most of our so-called special relationship with the United States to ensure that Assange is not extradited to the US”
“It’s time the ALP showed some courage and stood up for a more open and transparent democracy instead of again falling into line behind the Coalition.”

STEELE-JOHN: The Greens (WA) are ready to roll out on climate change election

Australian Greens Senator for Western Australia Jordon Steele-John has welcomed the official start of the election campaign, declaring the Greens (WA) have never been more prepared to deliver a genuine, progressive alternative to the major parties.
Senator Steele-John is up for re-election at the 2019 Federal election and he is The Greens (WA) lead Senate Candidate, and lead Spokesperson throughout the election campaign. 
“We’ve never been more ready. We have a positive plan for Western Australia that will create a better future for all of us and we’ve been out in the community talking to voters about it since day one!,” Steele-John said.
“This election is being decided on climate change. Only the Greens have a plan that is based on science, not politics; a real plan to tackle dangerous climate change and transition away from coal to a jobs-rich, 100 per cent renewable economy by 2030.
“The Liberal and Labor parties won’t take the action we need on the climate because they are too compromised by the millions of dollars they take from their big donors in the coal, oil and gas lobby. The Greens don’t take big corporate donations, our campaigns and therefore our policies that we take to Parliament, are entirely people-powered and focused.
“Over the next 37 days, we’ll be outlining our comprehensive plan to turn Western Australia into a renewable energy superpower. Northern parts of our state have some of the world’s best solar and wind energy resources that are also co-located closely with growing economies in our Asian region neighbours. This transition phase would create tens of thousands of jobs across the economy in the process.
“Neither major party has a plan to end the digging up, burning and exporting of coal, which is the biggest single contributor to climate change worldwide. If you don’t have a plan to transition out of coal you don’t have a plan to tackle climate change, it’s as simple as that.
“I’ve been out talking to voters across WA from Busselton to Broome, Albany to Kalgoorlie, from Rockingham in the South to Joondalup in the North, and the message is crystal clear; people want to send to the major parties a message that we need stronger action on climate change!
“We also have a bold social plan to make tertiary education free, build a home for all, raise the rate of newstart and the minimum wage to help people out of poverty, and ensure justice for disabled people by ensuring the Royal Commission is what disabled people need, not what the bureaucrats want it to be. Without Greens in our Parliament there’s no progressive voice to hold a Shorten Labor government to account.
“Here in Western Australia we are fighting to hold off our Senate seat from One Nation – that is the scary truth – and to see positive swings towards the Greens across Perth, Swan and Fremantle because we know these electorates care about issues like climate change.
“Across the country, it’s clear that people want a plan to prevent the breakdown of our climate. Only the Greens have a plan to transition out of coal and into renewables, and at this election you help make that change a reality.”

Australian Greens ready for the climate change election

Australian Greens Leader Senator Richard Di Natale has welcomed the official start of the election campaign, declaring that the party has never been better equipped to offer a progressive alternative to the old parties.
“We’re ready. On May 18, we’ll give the Australian people a genuine alternative to the old parties, one that offers a positive plan for Australia that will create a better future for all of us,” Sen. Di Natale said.
“This is the climate change election. Only the Greens have a real plan to tackle dangerous climate change and transition Australia out of coal to a jobs-rich, renewable economy. The Greens have a plan that is based on science, not politics.
“The Liberal and Labor parties won’t take the action we need on the climate because they are too compromised by the millions of dollars they take from their big donors in the coal, oil and gas lobby. The Greens don’t take big corporate donations, so our only focus is what’s best for people.
“Over the next 37 days, we’ll be outlining our comprehensive plan to turn Australia into a renewable energy superpower, move to 100 percent renewables by 2030 and create more than 180,000 jobs across the economy in the process.
“Neither Labor nor the Liberals have a plan to end the digging up, burning and exporting of coal, which is the biggest single contributor to climate change worldwide. If you don’t have a plan to transition out of coal you don’t have a plan to tackle climate change, it’s as simple as that.
“You only need to walk through electorates like Macnamara, Kooyong or Higgins to see that people want to send a message to the Liberals that we need strong action on climate change.
“Our goal is to return our brilliant team of Senators: Nick McKim, Larissa Waters, Janet Rice, Mehreen Faruqi, Jordon Steele-John, Sarah Hanson-Young, and to re-elect Adam Bandt and continue to build our lower house representation. We’ll put all of our energy into making that a reality, and to put ourselves into a position to hold a future Shorten Labor government to account.
“This election you have the chance to join the Greens in building a future for all of us, and I’m so excited to be kicking off this campaign today in Macnamara with our positive, progressive plan to tackle the big issues facing all Australians.
“Across the country, it’s clear that people want a plan to prevent the breakdown of our climate. Only the Greens have a plan to transition out of coal and into renewables, and at this election you help make that change a reality.”

$9.2 million for childhood epilepsy medicines on the PBS

The Morrison Government is investing $9.2 million to make a life changing medicine for childhood epilepsy available through the Pharmaceutical Benefits Scheme (PBS), which will help them to control their seizures.
From 1 May 2019, the PBS listing of Vimpat® (lacosamide) will be extended to include treatment of intractable partial epileptic seizures for children aged four to 15 years, in combination with two or more anti-epileptic medicines.
These children suffer seizures that affect only one part of the brain and they experience inadequate seizure control with currently available anti-epileptic drugs. This medicine helps control brain chemicals which send signals to nerves, so that seizures do not happen.
Without the PBS subsidy, patients and their families would otherwise pay more than $4,700 per year for this treatment. They will now pay just $40.30 per script or $6.50 with a concession card, thanks to this listing on the PBS.
Epilepsy is a chronic disorder of the brain that affects people of all ages. There are approximately 14,000 children aged 15 years and under with partial onset seizures and this medicine will help 870 children per year who have trouble in controlling their epilepsy and seizures.
The Morrison Government is continuing to make life changing medicines available to Australians at affordable prices through the PBS. These treatments improve lives. Listing these medicines on the PBS means that these life-changing medications are no longer out of reach for many patients and families.
This listing builds on the $330 million investment in new medicines we announced in the Budget, in particular cancer medicines:

  • Ibrance® will be available on the PBS for the treatment of inoperable advanced metastatic breast cancer. Without subsidy, people would pay $55,000 per year.
  • Bavencio® will be available on the PBS for the treatment of metastatic merkel cell carcinoma, a rare and highly aggressive type of skin cancer. Without subsidy, people would pay $150,000 per year.
  • Besponsa® will be available on the PBS for the treatment of acute lymphoblastic leukaemia. Without subsidy, people would pay $120,000 per year.

These new and amended PBS listings will take effect from 1 May 2019. Patients will now be able to access all of these medicines for just $40.30 per script or $6.50 with a concession card. All were recommended by the independent expert Pharmaceutical Benefits Advisory Committee.
Unlike Labor, we are listing all medicines recommended by the independent medical experts. In 2011, when Bill Shorten was Assistant Treasurer, Labor stopped listing medicines because they ran out of money as a result of their poor economic management.
Since 2013, the Coalition Government has listed more than 2,000 new or amended items on the PBS. This represents an average of around 31 listings per month – or one each day – at an overall cost of around $10.6 billion.
Our commitment to ensuring that Australians can access affordable medicines, when they need them, remains rock solid.

Boosting Health Services in Tasmania

The Morrison Government is investing almost $92 million to support better health care for all Tasmanians, improving waiting times for elective surgery, boosting mental health and maternity services and increasing cancer diagnosis scans.
The Tasmanian Health Plan also provides greater support for Tasmanians in rural and remote locations while increasing a wide range of vital services, from GPs to hospital care and specialist health services.
Prime Minister Scott Morrison said this investment would improve the health of all Tasmanians.
“Our strong economic management means we can provide record investment in Medicare, public hospitals and medicines, delivering more doctors, more nurses and more services to Tasmanians.”
“We can deliver this record investment in health without raising taxes for hard-working Tasmanians.
“We will invest $34.7 million to reduce surgical waiting times by providing an additional 6,000 surgeries and endoscopies and for primary care support for Tasmanians in rural and remote locations through TazReach.”
$10 million will support the Menzies Multiple Sclerosis Flagship Program to improve the quality of life for the more than 25,000 Australians living with MS by conducting research into cures and prevention of the disease.
$10 million will be invested in a new residential eating disorder clinic in Hobart, to provide in-patient specialist care for people experiencing eating disorders.
Health Minister Greg Hunt said around one million Australians live with an eating disorder, which is a complex condition with a high mortality rate.
“This treatment option will be an Australian first, providing diagnosis and treatment of eating disorders across the state, through training, education and advocacy,” Minister Hunt said.
“Eating disorder patients will also benefit from our historic decision to provide Medicare benefits for up to 40 psychological and 20 dietetic sessions per person per year.”
$10.5 million will be provided for a new walk-in mental health centre in Launceston, providing an environment where people can receive psychological, counselling or other mental health services without a prior appointment.
The centre will cater for people in crisis as well as those at risk, providing an alternative to the hospital emergency department.
$3 million will fund two new diagnostic mammography units, one in Hobart and one in Launceston.
These new machines will ensure that Tasmanian women do not have to wait to obtain x-rays to check their breasts for cancer. Earlier diagnosis and treatment of breast cancer can save lives, especially for women over 40.
A further $400,000 will support upgrades to new birthing suites in Launceston General Hospital to better support women giving birth.
In Tasmania, funding for public hospitals will increase from $425 million a year (2018-19) to $525 million (2024-25) under a new agreement with the Tasmanian Government, which has primary responsibility for public hospitals.
This is in addition to the $730.4 million we provided to support Mersey Community Hospital.
Our Tasmanian Health Plan will result in new health initiatives, new infrastructure and new medical research, with real benefits for the people across Tasmania.

LABOR TO BACK ROCKHAMPTON AIRPORT’S PUSH FOR INTERNATIONAL FLIGHTS

A Shorten Labor Government would kick off the process of opening Rockhampton Airport to international aviation, looking to supercharge growth of the Central Queensland economy.
An incoming Labor Government would invest $1 million to develop a business case to determine the viability of upgrading Rockhampton Airport’s status to that of a Regional International Gateway.
It would connect Central Queensland producers to the lucrative markets of Asia, creating huge opportunities for high-end agricultural exports.
The change would also provide a direct international tourism gateway to the region’s magnificent tourism assets, including the southern end of the Great Barrier Reef to the north and east and the Sandstone Wilderness to the west.
Most importantly, upgrading the Rockhampton Airport would boost economic activity and jobs growth right across the region.
Regional International Gateway airports require the capacity to deliver international airport services including customs and immigration.
The business case is a crucial first step that will examine the cost of expanding such facilities at Rockhampton, as well as the economic benefits of opening the region to the world.
Airports at Townsville, Cairns, the Sunshine Coast and Toowoomba are already designated Regional International Gateways.
It is beyond time that we look at the potential for Rockhampton Airport to join the international aviation community.
Over nearly six years of cuts and chaos,the Liberal National Party has been too focused on infighting to pay serious regard to regional economic development.
By contrast, Labor has a plan to assist every region in the nation to achieve its full economic potential through investment in critical rail and roads as well as support for tourism, aviation and economic diversification.
Labor’s plan for the Rockhampton Airport builds upon existing commitments for Central Queensland including $800 million for the Rockhampton Ring Road, $25 million for the South Rockhampton Flood Levee and $15 million to upgrade the Capricorn Highway.
Owned and operated by the Rockhampton Regional Council, the Airport is a major Australian regional airport, with flights to Brisbane, Mackay, Townsville, Cairns and the Gold Coast. Approximately 650,000 passengers pass through its terminal every year.

PUBLIC HOSPITAL CANCER WAITING LIST BLITZ

A Shorten Labor Government will slash waiting times for cancer treatment and surgery in public hospitals, with a $500 million investment in waiting lists across Australia.
When people are sick, the last thing they need is to sit on long waiting lists watching the clock for the treatment they need.
However, under the Liberals’ cuts to health and hospitals, waiting times for essential surgery and procedures have blown out.
Average waiting times for elective surgery have increased in every state and territory under the Liberals.
One in ten Australians will have to wait an average 47 days to get a breast lump removed or checked.
83 per cent of people who receive a positive result from the government’s bowel screening program don’t undergo a colonoscopy within the recommended time.
That’s why, as part of Labor’s $2.3 billion Medicare Cancer Plan, we will act to ensure that it is your Medicare card, not your credit card, that determines access to potentially life-saving surgery.
Labor will work with the states and territories to establish a National Partnership Agreement (NPA) on Cancer Care, to slash waiting times for surgery and consultations in Australia’s public hospitals. This investment is in addition to Labor’s $2.8 billion Better Hospitals Fund.
Labor’s public hospital cancer blitz will mean:

  • More Australians can receive free cancer care in public hospitals
  • Public waiting times will be reduced, forcing fewer patients into the private system
  • Downwards pressure will be put on private out-of-pocket costs through increased competition from the public system

Labor’s $500 million investment is equivalent to:

  • Almost 19,000 major breast reconstructions
  • Over 250,000 free colonoscopies
  • Almost 1.4 million free consultations with medical oncologists
  • Almost 1.8 million free consultations with radiation therapists or
  • Almost 2.9 million free consultations with cancer nurses or allied health providers

Public patients generally visit a specialist in an outpatient department for referral to surgery, radiation therapy or other procedures.
Long waiting times for these initial consultations can force patients into the private system, where they may face large out-of-pocket costs.
When someone is sick, they shouldn’t face the cruel choice of long public hospital waiting times or being forced to pay huge out-of-pocket costs in the private system.
Addressing inequality in our health care system is critical to addressing inequality in survival rates across the country – people living in rural and regional Australia and Aboriginal and Torres Strait Islanders wait longer for the treatment they need and have poorer health outcomes.
This investment is part of Labor’s $2.3 billion Medicare Cancer Plan – a plan to make sure it is your Medicare card, not your credit card, that determines your access to health care.
Our Medicare Cancer Plan will deliver cheaper cancer scans, cheaper cancer specialist consultations and cheaper cancer medicines.
The Medicare Cancer Plan will cover an additional 2,000 specialist consultation a day –  with no out-of-pocket costs.
For people who need a cancer scan – every MRI machine, in every postcode, will be eligible for Medicare.
For CT scans, X-Rays, mammograms, PET scans – this plan will cut out-of-pocket costs and provide up to six million free scans.
We can pay for our plan because we are making multinationals pay their fair share and closing tax loopholes used by the top end of town.
We’re prioritising health and hospitals – making sure Australians have access to the best medicines and care, because we’d rather have the world’s best health system not the world’s best tax loopholes.
Labor will invest in cancer care, we’ll fight for Medicare and we will always make sure it is your Medicare card, not your credit card that determines access to health.