I had written about this^ in this post
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UMelb - UMelb Medicine: Provisional Entry Questions and Discussion
Not sure if UMelb says guaranteed for the 99.0+ but if they do it's subject to passing the MMI, thus I suspect they could use a flexible MMI overall pass mark to regulate the number of passes. In effect making the MMI competitive for the ~50 FFP spots rather than pass/fail for the 99.9+ Chancellors.
It's not insurmountable. The HECS/FEE-HELP limit is $162k, after using $30k for the undergrad there's $132k to cover two of the 4 MD years. They need to find $130k own money for the final two years, not easy but possible with medium rich parents