The Proposed $5 fee to visit GPs/Emergency Rooms

[Run n Spread]

As per the title the proposed move invloves charging $5 to visit GPs/emergency rooms that will not be covered by Medicare. The reason given is to reduce the demand on free services and cut waiting times.

What has left me uneasy on this and is worth the discussion is the principle of the matter. I am well aware that it is only $5, people shouldn't rock up for just anything etc etc but I am slightly uneasy on this for a number of reasons as well as the principle it involves.

1) Most GPs don't bulk bill anyway and do so only in exceptional circumstances. The vast majority of people who visit GPs already pay a partially nonrefundable fee. Thus in the vast majority of cases this is merely a $5 add on.(Average GP charges say $70 with about $34 refunded I think).

2) Long term the fee will increase exponentially. It will not be $5 forever. So 10-20 years down the track when whatever excuses have been used to jack the rates up there is no free medical cover. Hence the principle. Australia either believes in a medicare system and free medical coverage in case of emergency or it doesn't. If it is viewed as a private matter all well and good but then there should be a reduction of taxes as well.

3) There seems to be a trend emerging of proposed new taxes i.e. increased GST and fewer services i.e. Lowering medicare, increased privitisations. So less bang for our tax buck. Governments of all persuasions actually need to start delivering on all their talk rather then continue to stick their hands in everyones pockets at the first sign of trouble/unease. Leads to lack of confidence imo as it radiates panic.

 

[skipper kelly]

Unless I'm reading the figures incorrectly it appears that bulk billing is more prevalent than you state.

"In 2012–13, the percentage of GP attendances bulk-billed varied across Medicare Local catchments and across peer groups, ranging from 55.0% in the Australian Capital Territory to 96.1% in Western Sydney."
http://www.myhealthycommunities.gov.au/national/mbs0011

 

[Pessimistic]

Western sydney ?

Make it $10

 

[TheMase]

What about keeping it 'free' but allowing x amount of visits per year for the standard Medicare levy but the levy rises if the amount of visits exceeds x (whatever the figure per person / family might be).

Should be pretty easy to do nowadays given your Medicare info is linked through ATO.

Would mean people can avoid the extra payment by being a bit more realistic (selective) for the times and reasons they go to the doctor.

Could be one health check per year and 2 visits or something per person. Which clears the way for preventative capacity as well as a reasonable coverage (with vaccinations etc being exempt).

Just musing.

 

[Admiral Byng]

What about keeping it 'free' but allowing x amount of visits per year for the standard Medicare levy but the levy rises if the amount of visits exceeds x (whatever the figure per person / family might be).

Should be pretty easy to do nowadays given your Medicare info is linked through ATO.

Would mean people can avoid the extra payment by being a bit more realistic (selective) for the times and reasons they go to the doctor.

Could be one health check per year and 2 visits or something per person. Which clears the way for preventative capacity as well as a reasonable coverage (with vaccinations etc being exempt).

Just musing.

Musings sound fine at first, but whatever limits are set means extra admin costs. What if Joe Bloggs has made three extra visits to his GP over his quota? Who keeps track of it, who audits it, who writes a letter to Mr Bloggs demanding payment? What if Mr Bloggs starts the year seeing one doctor, then after he uses up his quota he goes to a different clinic the next time, who keeps track of that? I think there needs to be some degree of practical consideration built into it.

From a public policy point if view, it is better to have a slight degree of over-servicing in health rather than any degree of under-servicing. I don't think we could ever design a system that hit it absolutely spot-on.

 

[TheMase]

Musings sound fine at first, but whatever limits are set means extra admin costs. What if Joe Bloggs has made three extra visits to his GP over his quota? Who keeps track of it, who audits it, who writes a letter to Mr Bloggs demanding payment? What if Mr Bloggs starts the year seeing one doctor, then after he uses up his quota he goes to a different clinic the next time, who keeps track of that? I think there needs to be some degree of practical consideration built into it.

From a public policy point if view, it is better to have a slight degree of over-servicing in health rather than any degree of under-servicing. I don't think we could ever design a system that hit it absolutely spot-on.

I guess my point would be it would be digital records. There would be no chasing as the payments would be recorded against your Medicare record (you get your card swiped each time as you do now) and at tax time this information is available online (as it is now when you load under your tax file number). You then get taxed accordingly if you were above your quota (automatically).

The administration costs could be limited (could be wrong, I am no expert) if: the Medicare card records the amount of visits (and contains your dependents for calculation of the family quota), this is compared against your information when you enter with tax return (a lot of which is now auto generated) determines what % of levy you are charged if you went over. Therefore you'd either get a tax return if you offset enough or don't break the quota, or you would pay money owing to the ATO just as you do now.

 

[Pessimistic]

Its all well and good but theres more other pressures to go to the doctor these days

Victorian government now impose $70 fines for more than five days off school for pupils. Only a matter of time before doctors notes are required by yet another self serving beaurocracy

 

[Cap]

It is a great idea and over due.

 

[ClokesShankedIt]

It is a great idea and over due.

Well, it's not a great idea. An addition of a fee to public health is not ideal but we voted ourselves into debt over the last two elections so we are going to need to accept this sort of thing

 

[Cap]

Well, it's not a great idea. An addition of a fee to public health is not ideal but we voted ourselves into debt over the last two elections so we are going to need to accept this sort of thing

I think it is a great idea.

It gives a value to the service people are getting. I know my local GP is nigh impossible to get a booking because people have simply put in reoccurring appointments regardless of if they actually need them, I've heard the story in many places.

I'm also happy to have the charge at emergency (that being said, I don't want them to be not seeing someone because they don't have the $5 on them)

 

[Run n Spread]

I'm also happy to have the charge at emergency (that being said, I don't want them to be not seeing someone because they don't have the $5 on them)

What about in 20-30 years when someone doesn't have the $50-$100 on them? Sure it is $5 now but it won't be like that forever. Also the $5 is what the public are simply being sold. The hidden costs and move to a more user pays system I think is what is on the cards.

I guess my point is, are we comfortable to use to a user pays system/one that may require compulsory insurance when costs raise in the future? (Sure it is $5 for emergency/GPs but what will the fees be for the follow up care, appointments, treatment plans be? Most people in emergency don't just leave with no treatment). If so fine but it will be a very different system to what is in place now.

What I don't understand is Australia are moving to this direction when other countries are moving away from it?

 

[noddy]

Lol, amazes me how some people are accepting this as if it's a one of, this gets through with a meek response & the lemmings can expect more of the same.

Would be in favor of a slight rise in the medicare levy as long as that rise was only for health costs & not general revenue for the government to plunder, must also add that i'm no longer a tax payer & now have health care in my wallet.

 

[Power Raid]

What I don't understand is Australia are moving to this direction when other countries are moving away from it?

May be we will end up meeting somewhere in the middle?

 

[Power Raid]

Lol, amazes me how some people are accepting this as if it's a one of, this gets through with a meek response & the lemmings can expect more of the same.

Would be in favor of a slight rise in the medicare levy as long as that rise was only for health costs & not general revenue for the government to plunder, must also add that i'm no longer a tax payer & now have health care in my wallet.

May be the $6 is not a revenue raiser. May be it is to get people thinking do they really need the service

 

[CLUBMEDhurst]

Lol, amazes me how some people are accepting this as if it's a one of, this gets through with a meek response & the lemmings can expect more of the same.

Would be in favor of a slight rise in the medicare levy as long as that rise was only for health costs & not general revenue for the government to plunder, must also add that i'm no longer a tax payer & now have health care in my wallet.

Another step towards number 20 in the IPA's 75 point plan

 

[L_W_P]

So what about people who have to have regulation visits to the GP, as ordered by that same GP?

My old man has to see his GP once a week and a psychologist once a month as he has long term health issues related to alcohol.

Would he have to pay the extra $5 every visit, even though he isn't choosing to go? If the Dr didn't make the appointment and tell him to go then he wouldn't go. Could we see a situation where some greedy practices start over playing the symptoms of illness to get repeat business and thus an increase in this revenue?

 

[noddy]

May be the $6 is not a revenue raiser. May be it is to get people thinking do they really need the service

I have yet to meet anyone who gleefully goes to the Doctors just for the sake of it, surely the one hour plus waiting period would turn off most people.

 

[noddy]

Another step towards number 20 in the IPA's 75 point plan

Well depends on who/what the rise will benefit & it probably would have to be a partisan agreement in the first place.

 

[Admiral Byng]

May be the $6 is not a revenue raiser. May be it is to get people thinking do they really need the service

That will only work if it is actually people on lower incomes that are the ones over-using health services. The response from the medical profession over the last couple of days is that the data suggests that people in lower socio-economic areas already access health services less than the national average, and that the overuse tends to be in middle or affluent suburbs. If those figures are correct then putting a price signal on it isn't going to deter those already overusing health services because it won't be a burden for them to pay it. It's just going to force people who already underuse health services to access them even less. I can't see it being good public policy.

 

[Gough]

That will only work if it is actually people on lower incomes that are the ones over-using health services. The response from the medical profession over the last couple of days is that the data suggests that people in lower socio-economic areas already access health services less than the national average, and that the overuse tends to be in middle or affluent suburbs. If those figures are correct then putting a price signal on it isn't going to deter those already overusing health services because it won't be a burden for them to pay it. It's just going to force people who already underuse health services to access them even less. I can't see it being good public policy.

It seems to be a common theme amongst some who tread these boards that the lower your socio-economic status the more you are to blame for the alleged woes of this country.

 

[Gus Poyet]

Gee I wonder how many of the pro-carbon tax people are the ones most opposed to this fee.

 

[Admiral Byng]

It seems to be a common theme amongst some who tread these boards that the lower your socio-economic status the more you are to blame for the alleged woes of this country.

Yes, the stereotypical bludger is always a poor, uneducated layabout. Even when the facts don't support it, it's a hard mental image to let go of, unless the unions can be blamed for it.

 

[Gough]

Yes, the stereotypical bludger is always a poor, uneducated layabout. Even when the facts don't support it, it's a hard mental image to let go of, unless the unions can be blamed for it.

The modern Australian bludger is someone who is less deserving of their plasm screen than you are.

 

[CLUBMEDhurst]

Well depends on who/what the rise will benefit & it probably would have to be a partisan agreement in the first place.

Whichever way, it's an attack on the fabric of universal healthcare (although the out-of-pocket costs of healthcare have been on the march northward for a while now)

 

[Power Raid]

I have yet to meet anyone who gleefully goes to the Doctors just for the sake of it, surely the one hour plus waiting period would turn off most people.

Apparently is is not uncommon for the unemployed or retirees going to the doctors to have a conversation and companionship.

http://www.campaigntoendloneliness.org/blog/lonely-visits-to-the-gp/

http://m.scotsman.com/news/health/tenth-of-doctor-visits-by-sufferers-of-loneliness-1-3189796

I don't know how true the numbers are but it seems reasonable that it happens.