Bridie Jabour theguardian.com, Friday 16 May 2014
Medicare changes are a 'nightmare', says AMA president, who says the new system is 'complex and obtuse'
AMA president Steve Hambleton: Medicare changes 'impact on people who have very low incomes.' Photograph: Dave Hunt/AAP
Doctors will be financially penalised $11 for bulk-billing concession card holders and children under the government's proposed changes to Medicare.
The Australian Medical Association says small medical practices could lose up to 25% of their income if they continue to bulk-bill.
AMA president, Steve Hambleton, said: “The government is replacing a very straight, a very simple, very clear system with a very complex, very obtuse co-payment system which requires new software,” he said.
Hambleton said the policy would hit the most disadvantaged the hardest including low-income earners, Aboriginal and Torres Strait Islanders and people with chronic illnesses.
“It’s a nightmare,” he said.
Currently doctors receive a $36.60 rebate from the government for each patient they see, which will be reduced to $31.60 under the new system. In metropolitan areas doctors receive a $6 low-gap incentive payment when they bulk-bill concession card holders and children under 16.
Under the new system doctors will only receive the low-gap incentive if they charge the co-payment. So instead of receiving the $42.60 they currently get for bulk-billing a disadvantaged patient, they will receive $31.60. If they charge the co-payment they will get $44.60 for treating a disadvantaged patient.
Hambleton said bulk-billing doctors were facing losing 12-25% of their current income if they do not adopt the co-payment when it is due to come into effect next July.
“Can a small business operating in the community accept a 25% reduction in revenue? Highly unlikely,” he said. “...it’s highly unlikely doctors will bulk-bill.”
Hambleton said doctors were not consulted about co-payments by the government and they would also lose money unless the patient had the $7 co-payment at the time of consultation as sending out an account would eat it up.
“You’ll be saying to a patient for example, I think have an ear infection, go and get a sample and they’ll be saying 'I’m not getting the test'. It’ll be $7 for the doctor, $7 for the pathologist and another $7 if they need an x-ray, and the patient says they’re not getting it.”
He added: “I’m not talking about people who are wealthy, they already pay. This impacts on people who have very low incomes.”
Hambleton has been a GP for three decades and while he has only taken on limited patients in the past five years, he said he rarely saw a patient who did not need to see a doctor in his practising career.
“If people are worried about something and they come into discuss it, whether it turns out to be serious or not, them being worried about it makes a legitimate visit,” he said.
“Doctors can also take the opportunity to ask them about general health, do a blood pressure check, discuss their weight. What a good GP does is opportunistic health checks. Very few people come to the GP for a band-aid.”
Treasurer Joe Hockey defended the policy on Thursday morning by saying the cost of a co-payment was cheaper than “a couple of beers”.
Health minister Peter Dutton said the government were only asking for a “modest” contribution from people for their health care.
“It [the budget] introduces unprecedented investments in medical research, along with new, tough but fair, ways to finance and sustain health care in the years ahead,” he said in a speech to the Cancer Council in parliament on Thursday.
The government will also start charging $5 more for each prescription for general patients and by 80 cents for concessional patients.
“Fundamentally, the budget continues to protect those who are least able to look after themselves. We are not undermining the health safety net. We are making it stronger and fairer,” Dutton said.
Labor are voting against the co-payment in the Senate, labelling it a “GP tax”.
“Australians are sick of politicians breaking their words, no more weasel words. This is an attack on Medicare. Tony Abbott is a clear and present danger to the universally accessible health care system of this country. Labor will not support taxes on Medicare, full stop,” opposition leader Bill Shorten said on Thursday.
“Labor believes in Medicare. We believe that in this country, no matter what your circumstances, if you are sick you should able to go to the doctor and not pay tax. We believe for this and we will fight and fight and fight to defend Medicare.”
Bulk-billing poorer patients will cost us $11 a time, doctors warn | World news | theguardian.com
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