Introducing The Digital Medicare Wallet
“They say they didn’t do it to hurt me, but what if they did?”
The myth of expertise is holding the entire health system hostage.
We’ve mistaken credentials for competence.
We’ve confused titles with capability. And we’ve allowed professional protectionism to override patient outcomes.
But the truth is clear:
The system isn’t failing because we don’t have enough qualified people.
It’s failing because those people are locked in a structure that doesn’t let them operate where they’re most needed.
We don’t need more paperwork.
We need access.
And that’s where the Digital Medicare Wallet comes in.
Noting, the ideas in this piece should be read alongside standout professional body work such as this from the Australian Physio Association focussed on primary care reform.
Introducing the Digital Medicare Wallet
The Digital Medicare Wallet (DMW) proposes radical Medicare Reform via a decentralised, patient-led model for healthcare access.
It builds on what already exists (Better Access, CDM, GP care plans) and redistributes those funds into a flexible, accessible format:
• Every adult receives $2,000 per year in a Digital Medicare Wallet
• $500 of this can be used autonomously – no referral required
• This can be spent with any AHPRA-registered allied health provider (physio, psych, OT, EP, etc.)
• After $500 is spent, a GP or senior clinician is reintroduced to coordinate ongoing care and ensure clinical oversight
This model mirrors real-world logic:
• Patients already self-triage
• Allied health already delivers evidence-based care
• GPs are overwhelmed and can’t see everyone
• Early intervention works – but only when it’s accessible
Guardrails and Governance
This isn’t free-for-all medicine. It’s structured, safe, and modern:
• Only AHPRA-registered providers are eligible
• AI and screening tools (e.g. Orebro, K10, SF-10) guide early care
• Clinical variance dashboards flag risk, overuse, or misuse
• GPs still lead complex care, but they no longer block simple access
Currently Funded, Poorly Allocated
We don’t need new funding to make the Digital Medicare Wallet work — we just need to stop wasting what’s already there.
Right now, patients navigate a maze of care plans, consults, and gatekeeping just to unlock a few rebated sessions.
Here’s what Medicare already spends per person each year to access allied health and psychology — most of it on process, not treatment:
That’s over $2,000 already allocated.
The DMW simply packages it into something usable.
Outcome-Based, Not Identity-Based
The Digital Medicare Wallet dismantles the myth that only certain professions can be trusted to decide what patients need.
Instead, it says:
• Trust is earned through results
• Safety comes from structure, not status
• Value is demonstrated, not declared
Credentialism says: "You need to see a GP first."
The DMW says: "You can see who you need now — and we’ll check in later."
Designed for Reality, Not Tradition
The Digital Medicare Wallet isn’t theory.
It’s already reflected in:
• WorkCover models
• Private health schemes
• Employer-supported care
• The lived behaviour of patients every day
This system works because it reflects how humans actually access care.
And because it trusts clinicians to operate at the top of their scope, not beneath the weight of administrative bottlenecks.
We don’t need more control.
We need more competence.
We don’t need more oversight.
We need more outcomes.
And we don’t need to build something new.
We just need to unlock what already works.
A Post-Dualist System, Rooted in Trust
The philosophical underpinning here draws from the Teal model of organisational thinking (as described by Frederic Laloux).
Teal systems are decentralised, self-managing, purpose-driven, and built on trust, not control.
They are the natural evolution of 20th-century bureaucracy — and healthcare, perhaps more than any other industry, is overdue for that evolution.
A Digital Medicare Wallet isn’t just practical — it’s philosophical. It breaks free of outdated models like Cartesian dualism (the idea that mind and body are treated separately), and instead funds whole-person care through integrated, intelligent access.
It’s not a political identity. It’s a systems upgrade.
Stay tuned for our final piece, where we bring home the idea to decentralise medicare.
If you can't wait that long, read the entire series by downloading it in pdf form here.
Problem #3: Our current system is stuck using 20th century infrastructure to deliver 17th Century, Mind-Body Dualism.
BACKGROUND
Recently the Royal Australian College of General Practice (RACGP) took a big swipe at allied health professionals.
Arguing that allied health professionals should be operating inside their businesses OR effectively under the supervision of a GP.
This was a flailing fist from an ageing giant, one who knows that the sun is going down on the idea of the General Practitioner being the go-to for every form of healthcare.
The reality is that General Practice ideology – GP at the centre of care, sits in conflict with modern consumerism – Patients at the centre of care.
Private citizens have moved far beyond these narratives decades ago, and if we are asking to go back to the 1980’s, that’s just not going to happen.
But instead of looking backwards, why not look forward at what could easily be achieved by 2030, if we took a genuine reformist approach to Medicare.
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