Tuesday, December 09, 2014

The Abbott Government Had Gone Mad On The Medicare Co-Payment.

Just announced:

If not a child or pensioner etc. you will have your Medicare Rebate dropped by $5.00

The GP can charge an 'optional' co-payment or take a paycut.

BTW they have to now spend more time with the patient as well.

Their income will take a major hit, to say the least. Most GPs are not rich so what we will see is a huge increase in the out of pocket expenses for most!

Guess how this will play out!



Anonymous said...

Unless a GP is bulk billing everyone, people already pay a 'co-payment', sometimes up to $50 per visit, so now the GP says 'Attention valued patients, our fees are increasing by $5, unless you are a pensioner, child or concession card holder'.

Australia doesn't have free healthcare, we pay for it in the levy. But the levy isn't covering the bill that is increasing rapidly. It's either $5 here and there or a few hundred in an increased Medicare levy.

Dr David More MB PhD FACHI said...

The issue with all this is that the plan saves the Government $3.5B or so over a few years.

Guess where that will come from. Almost certainly from all our pockets.

For a Government which is meant to be increasing support for General Practice for a range of very good reasons this is a travesty!


Anonymous said...

Taking money off doctors won't encourage them to use the PCEHR, quite the reverse.

Someone not's thinking very hard, and I know who that might be.

I heard Minister Dutton say on the radio this morning he didn't want things to "revert back to Labor"

Revert back is a well known tautology and indicates a lack of education. What's even worse is that it's not the first time and it's on his own web site:

What hope is there when such uneducated people try and run complicated things like health????

Anonymous said...

well, at least this will help abbott to show that he is oblivious to public health- and we already pay the highest 'copayments' for drugs- and just watch him fail to negotiate the pharma prices down like NZ-- they are hit mates.. we the people are certianly not. this is just a move towards privatising health care(again for his mates). USA dysfunctional 'health' care here welcome. this i the first move .. watch for the next. Forget the medical research fund, it is a fantasy..and of course you can rely on Abbots word? No?

Bring on a double dissolution. ASAP

Anonymous said...

I think some of the comments are a bit over the top. Anyone with a financial issue has a health care card and a loaf of bread is close to $5 and I don't see people saying they can't afford bread. Paying $5 to see a doctor is very affordable and I have heard that the numbers dropped off when the co-payment was mentioned and not implemented. If you are not worried enough about your health to spend $5 then you probably don't need to see your doctor.

As for the PCEHR everyone will be much safer if its not used!!

K said...

Anonymous @ December 10, 2014 4:33 PM clearly doesn't have to count every dollar, and he doesn't have to choose to go without bread for the week so he can go to the doctors. Perhaps he might think differently if he did. Or perhaps anonymous really thinks that anyone who's money is this tight has a healthcare card - does anyone have numbers on this?

Enrico Coiera said...

Here is how I understand the rationale for a co-pay in primary care.

The argument that we need a price 'signal' to control costs in medicare assumes that GP visits are substitutable consumer items, just like apples, oranges or indeed, a loaf of bread. If I don't buy my bread today I can always buy a very similar item tomorrow - if I really am hungry.

Except that they GP visits are not substitutable commodities, and first year university economics is not sufficient to understand what is going on.

Yes, a co-payment will cause some unnecessary visits to not happen.

A co-payment will also cause some necessary visits to either be delayed, or not occur.

Here's the thing. Consumers, not being doctors, are not expert in deciding which category their visit will fall in.

So, for those who need to see the doc, but delay, the downstream cost will not be the same as the cost of the initial visit. One GP visit is not identical to another.

Think about this. A woman presents for a possible lump, its cancer, she gets a lumpectomy, then radiation and is cured. Or she delays 3 months, but now has nodal involvement (or worse). The difference is not the cost of the visit that was missed.the delayed care runs into the $100,00 in additional costs. Not to mention the impact on the patient and their family and (lets keep it economic) their contribution to the nations' productivity. The two visits - early and delayed - are not substitutable for each other.

As far as I know, all international experience on co-payments shows that the cost of care delayed swamps the cost of the unnecessary visits deferred.

So it appears to be bad economics to have a co-pay. If you want to save some $, then maybe negotiate a better deal for drugs on the PBS, have a better approach to end-of -life care, or stop subsidising running shoes in the private health funds.


Bernard Robertson-Dunn said...


Politics, economics and health are very different disciplines.

As you have pointed out co-payment is bad economics and bad health. IMHO, that's because, like the PCEHR, co-payment is all about politics.

If they really wanted good economics and health outcomes, they would spend more on helping people achieve better health, not by reducing the amount spent on managing and alleviating sickness.

And one way of achieving better health is by restricting the promotion of bad nutrition. But that would mean taking on some large corporations - which brings us back to politics.

Dr Ian Colclough said...

Ahhh yes Enrico but that $5.0 was for one visit to the lady's GP. He sent her off for a series of pathology and imaging tests and they too each incurred a $5.0 co-payment.

She said she couldn't afford that so he referred her to the public hospital. The hospital did a series of pathology and imaging tests and it didn't cost her anything.

The end result,much to the joy of Canberra was a net cost shift from Federal to State - but Mr Dutton hasn't made any mention of cost shifting. I wonder why.