Sunday, November 30, 2014

The Government Has A Very Bad Week and The Medicare Co-Payment Is Right In The Middle!

There has been a lot going on in Federal Politics this week - to say the least. We have had the ABC funding cuts, confusion on the fate of the Medicare Co-Payment, issues with canoe construction, barnacle clearing becoming more like a keel hauling and to top it off the Liberals being kicked out of Government, after only one term in Victoria.
It would be hard to argue the Government has not been losing a fair bit of paint over all this.
Here are the two of the more seminal articles on the Co-Pay.
First we have:

GP co-payment plan hangs in the balance as government insists it is not dead

Reports that Coalition may seek to impose $7 payment by regulation to circumvent Senate opposition
Uncertainty surrounds the federal government’s proposed $7 GP co-payment, after reports it was to be abandoned.
Speaking on ABC radio on Thursday morning, the leader of the government in the Senate, Eric Abetz, insisted the policy was not dead.
“The government’s policy on the GP co-payment remains,” Abetz said. “It is good policy.”
The government announced the co-payment in the May budget, but has yet to introduce legislation because of opposition from Labor, the Greens and crossbenchers in the Senate.
A spokesman for health minister Peter Dutton also dismissed the reports as media speculation, but Tony Abbott refused to say if the co-payment had been shelved.
Speaking to reporters on Wednesday night the prime minister would say only that the charge was “an important reform”.
Lots more here:
Second we have this:

Government sends mixed messages over future of $7 GP co-payment

Date November 27, 2014 - 9:17AM

Lisa Cox

Confusion reigns over the future of the unpopular GP co-payment amid suggestions it will be shelved or that the government could seek to bypass a hostile Senate to introduce some version of the policy through regulation.
The Australian Medical Association (AMA) has called on the government to declare its position, noting that Health Minister Peter Dutton had this week ruled out the possibility the government would bypass the Senate because it had legal advice indicating it could not introduce the fee without legislation.
But on Thursday morning, Mr Dutton told reporters in Canberra he would not "rule things in or out" and the government was "determined to make Medicare sustainable".
In an interview with Radio National on Thursday morning, the government's leader in the Senate Eric Abetz also refused to speculate "as to different methodologies that might be employed" to introduce some form of GP fee.
Fairfax Media and other outlets reported on Thursday that Prime Minister Tony Abbott has privately conceded defeat on the unpopular fee proposal and will shelve the policy before the end of the year. 
AMA president Brian Owler said "it would nice to have certainty from this government about what they're doing".
"Clearly there are a number of messages coming from the Prime Minister's office but then we've got Eric Abetz out there this morning defending the policy," Dr Owler said.
"It would be nice to just have a clear announcement from the government and then we could move on and have a more complex and nuanced discussion about health policy."
Dr Owler said he did not believe the government would attempt to bypass the Senate.
More here:
What seems to have happened is that as part of the of the de-barnacling process the Prime Minister’s Office briefed the press that the GP Co-Payment was off the table - but seemingly did not tell most other senior minister. They have become very annoyed and pushed back.
My feeling is that the Government is desperate to get a ‘price signal’ into Medicare and is now trying to work out what the best way to do this is - without causing huge political ructions as they have so far.
What has been missed in all this - excluding the outrage from Labor and the Greens and a few others - is the implementation complexity of this sort of co-payment as far as GP system providers are concerned. This is especially so regarding how you cap the impact to only the first 10 co-pays each year and exclude some from paying at all.
It seems unlikely the present proposal will now pass the Senate - which means the next chance will be in February, 2015. This is simply not long enough to develop, test and implement systems - especially when there is no legislation that provides clarity as to what is needed at the GP front desk!
To me this, at best, needs to be deferred by a year - if it indeed goes ahead at all. My view is that it is just bad policy but I am sure they won’t give a hoot what I think! I just want to see reasonable treatment of the GP System providers - not as we have seen meted out in the past by DoH and NEHTA. 

Equally I also think the Pharmaceutical Benefits Scheme Co-Payment increases are getting a bit out of had with those without a Senior's Health Care Card having to pay over $40 for each prescription. Seems like a pretty big hit for those on regular prescription medicine. The increases have been rather under the radar as compared to the Medicare Co-Payment. 
David.

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