AMS flags alternate GP co-payment model

A GP co-payment model that promises to protect the vulnerable in our society, encourages quality care and the management of chronic disease while also sending a price signal for non-concession patients was flagged by the Australian Medical Society yesterday, (Thurs) as a more workable answer to the dilemma surrounding the cost of healthcare in this country.

Doctors in rural and regional areas, however, while not stampeding to pledge their support for the scheme, have greeted it with cautious optmism.

"The impact that any co-payment system may have on rural communities, rural doctors and rural medical practices needs further consideration," said Dr John Hall, the vice-president of the Rural Doctors Association.

"There are still a lot of issues we need to work through, as the unique circumstances of rural practices are often overlooked when assessing the potential impact of changes to the overall health system."

Presented as an alternate model to the government's controversial contribution scheme first touted in the May Budget, the AMA says its blueprint will exempt the disadvantaged members of our communities from the extra cost burdens of health care.

Like the Government's plan, this proposal has a Medicare co-payment too - $6.15 compared to $7 - but here the Government would pick up the tab for concession card holders and patients under 16 years of age.

It is, says AMA President, Assistant Professor Brian Owler, a "health policy, not an economic policy".

"Our model is based on the realities of day-to-day medical practice, and our objective is to provide higher quality primary care for all Australians," Prof Owler said.

"Under our model, there will be no cut to the Medicare patient rebate, and there is an incentive for general practices to collect the co-payment.

"The AMA co-payment model allows GPs the opportunity to spend more time with their patients, provide preventive health care and chronic disease management, and place a value on the essential service they provide."

The AMA has been voraciously opposed to the Government's scheme which not only applies a $7 co-payment to the vast majority of Medicare funded general practice, pathology and diagnostic imaging services but also ensures a cut in rebates and a marked increase in compliance costs.

Prof Owler said that although they had not opposed the Government's leaning towards co-payment, the AMA could not support the idea of forcing the disadvantaged to pay it.

"We had to reject the proposal under the Budget because of the implications for vulnerable patients, the lack of protection and safety net for them," said Prof Owler.

"And the implications for some practices, particularly in disadvantaged areas, and because it does go against some of our health policies in terms of encouraging prevention and chronic disease management. That is the issue that we have with the government's proposal and so, they're some of the things that our proposal tries to address."

The AMA presented their alternate plan to the Government some three weeks ago but have yet to hear anything back prompting them to release their scheme into the public arena.

Treasurer Joe Hockey played down concerns yesterday saying he had met with the AMA and was glad they supported the co-payment.

"If we want to have a sustainable Medicare system we are asking Australians to make a contribution along the way because ultimately nothing can be for free," he said.

"We can't build roads, we can't create jobs unless we all make a contribution in one form or another. Now, we are always prepared to have sensible discussions with sensible people about making sure that those most vulnerable are properly taken care of, of course we want to do that. But also, we want make sure what people have today is affordable in the future."

The AMA's proposal did not find much favour with Labor with Shadow Treasurer Chris Bowen saying they would not support a co-payment of any kind.

"Our principles tell us that your wealth should not determine your health and that the health of any of us should be the concern of all of us," he said. "I have made clear matters of principle and that principle is that there should be no co-payment or no charge to go to the doctor and any compromise still leaves a charge to go to the doctor, and not one we would support."

AMA's Alternate Plan

  • Co-payments of $6.15 for non-concession patients
  • No cuts to Medicare rebates for patients
  • Protection of disadvantaged patient groups
  • No 10-visit threshold for concession card holders
  • No obligation on GPs to charge a co-payment for Medicare-funded chronic disease services, health assessments and mental health treatment items
  • All co-payments would be included in determining whether or not the Medicare safety net has been reached
  • Reducing compliance burden on practices