Aged care spared government’s GP co-payment

While acknowledging the exemptions for aged care residents and children, consumers, doctors and nurses have broadly criticised the government’s latest policy.

Residents of aged care facilities will be among those exempt from the Federal Government’s new $5 GP co-payment plan, to be introduced for all non-concessional patients aged over 16 from 1 July 2015.

The government yesterday announced it was amending its fraught GP co-payment policy, first set out in the Budget in May.

While some media yesterday erroneously reported the government had “dumped” the scheme, Prime Minister Tony Abbott announced that the Medicare rebate paid to doctors would be reduced by $5. Doctors could choose to recoup that rebate reduction by charging patients a co-payment, or continue to bulk bill non-concessional patients – but at their own expense.

Along with aged care residents, those excluded from the co-payment include pensioners, Commonwealth concession card holders, all children under the age of 16, veterans funded through the Department of Veterans’ Affairs, and pathology and diagnostic imaging services.

The government said the co-payment would contribute $3 billion to the Medical Research Future Fund to fund “the research needed to find cures to the health problems of today.”

Reaction to the tweaked GP co-payment plan was swift – and broadly critical.

Council on the Ageing Australia welcomed the exemptions for pensioners, veterans and aged care residents, but warned that there were a significant number of older Australians who did not meet the exemption criteria and could “fall through the cracks.”

“There should not be price impediments to any older Australians, or Australians generally, accessing primary healthcare,” said chief executive Ian Yates.

“People should be encouraged to access primary healthcare as soon as they have a health issue, to stop its escalating and creating both health risks and additional costs of higher level services.

“There is no sign the government is looking at tackling the supply and pricing of specialist and tertiary level medical services”

The Public Health Association of Australia (PHAA) said the “optional co-payment” would force GPs to “do the dirty work of the government.”

“Either they lose $3 billion from their own pockets over the next three and a half years or drag it from the wallets of the bulk of their patients,” said Michael Moore, chief executive officer of PHAA.

“This is simply unacceptable. The message has been clear; the criticism widespread. A universal health care system is one that provides appropriate access to the community without distinguishing on the grounds of ability to pay”.

Echoing the PHAA, the Consumers Health Forum said that patients would inevitably pay for the cuts to Medicare rebates.

CEO Adam Stankevicius said the government was “turning GPs into its bagmen for the death of universal health care.”

“It will be patients who will suffer, as many doctors will have no option but to demand the $5 from patients. It will be the chronically ill, families and the elderly not covered by concessions, who will be hit hardest.

“While pensioners and other concession patients, children and veterans may still be covered by bulk billing, the squeeze on doctors’ income could well see a dramatic downturn in their ability to continue bulk billing which currently benefits more than 80 per cent of cases,” said Mr Stankevicius.

The Australian Medical Association described the new policy as a “mixed bag”.

AMA president Associate Professor Brian Owler welcomed the exemptions for concession card holders, children and aged care residents, but was disappointed that rebates for GP services for everyone else would be cut by $5.

“This comes on top of a freeze on Medicare patient rebates until July 2018. This means that, by 2018, Medicare rebates for many services will have been frozen for almost six years, while inflation continues to rise.

“At a time when general practice is in need of significant new investment to cope with an ageing population and more people with chronic disease, today’s announcement represents a disinvestment in quality general practice,” Associate Professor Owler said.

The Royal Australian College of General Practitioners (RACGP) said it was disappointed the government had proposed the $5 cut in Medicare rebates for standard GP consults, but welcomed the exemptions for pensioners and children.

The Doctors Reform Society labelled the Medicare rebate cuts as a “kick in the guts to working Australians.”

“We doctors do not want patients to avoid seeing us with what to them might appear to be minor complaints but are really signs of serious disease,” said the group’s Dr Tim Woodruff.

“This puts the pressure on doctors to decide who are the ‘deserving poor’ and forces doctors to cross subsidise care if they do want to bulk bill a non-pensioner.”

The Australian Nursing and Midwifery Federation criticised the policy and said that doctors should be given the freedom to make good clinical decisions “instead of worrying about who should be charged additional fees.”

“The announcement today will still increase an individual’s out of pocket costs which will hurt everyday Australians and signal the end of Medicare,” said ANMF Federal Secretary, Lee Thomas.

Other groups welcomed the use of the co-payment to pay for the government’s $20 billion Medical Research Future Fund (MRFF).

The Medical Research Future Fund Action Group endorsed “the funding mechanisms” set out in the amended policy.

MRFF Action Group Chair Peter Scott said this was a crucial step to overcoming the current deadlock, enabling the MRFF to be funded to the scale and timeframe that was proposed in the May budget.

Similarly, Research Australia welcomed the government’s re-commitment to the MRFF.

“The health and medical discoveries the MRFF will uncover will improve the treatment and management of disease, and improve the quality and efficiency of the healthcare system,” said Elizabeth Foley, CEO, Research Australia.

“The MRFF is one of the most significant health and economic policies in our nation’s history, and political partisanship should be set aside when important matters of national interest like this are being considered.”

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