The Australian Medical Association has released its alternative to the budget’s controversial $7 Medicare co-payment plan that would protect pensioners and children, but raise only $60 million in revenue compared with government’s $3.5 billion.
Under its plan, a minimum $6.15 co-payment would apply to all patients but the government would pay for concession card holders and people under 16.
There would also be no obligation on GPs to charge the co-payment for Medicare-funded chronic disease services, health assessments and mental health items. Residential aged-care visits and home visits would also be excluded.
The AMA $6.15 co-payment – which is the same as the current bulk billing incentive - would be indexed annually, unlike the government’s $7 one, which is not to be indexed.
The AMA strongly opposes the government’s proposed $5 cut in the Medicare rebate for GP services, pathology and diagnostic imaging. The government says it would put the $5 into a new medical research fund, leaving $2 of the co-payment to go to the doctor.
Doctors would be better off by $6.15 a service under the AMA plan, compared with $2 better off under the government proposal.
Speaking at a forum in Melbourne organised by the Centre for Economic Development of Australia, health minister Peter Dutton said the plan would be a windfall for doctors and wipe out 97% of the government’s proposed savings.
AMA president Brian Owler said the association was not opposed to “well designed and well-intentioned co-payments”. About 20% of GP visits currently attracted co-payments, on average more than $7, he said.
But he condemned the government plan as bad for patients and practitioners and bad on policy grounds – it was unfair and potentially harmful to the health of the most vulnerable people.
The AMA plan “retains protection for vulnerable patients in society including those in aged care, those on pensions, or the unemployed. It also protects young families by providing protection for children”.
He admitted the savings would be “modest” but said the AMA was “not about to support any plan that takes money out of general practice”. What small savings there were would come from an estimated 1% drop in usage, and from some patients not being charged the co-payment by their doctor who would still receive the lower rebate.
Owler said that linking the cut to the Medicare rebate to the Medical Research Future Fund “was always an inappropriate link. While we support research, we cannot support a measure that takes funding from primary care and puts it into tertiary level research”.
He said if the government wanted a sustainable system it must invest in general practice for prevention and chronic disease management. If the government wished to keep the medical research fund, “it may need to be accumulated over a longer term or be delivered from alternative sources”.
“Professor Owler is a strong advocate for his colleagues and as the head of the AMA that is his job and I note the current proposal put forward by the AMA with regards to the $7 co-payment, will result in a windfall for doctors while wiping out 97% of the government’s estimated savings,” Dutton said.
Both Prime Minister Tony Abbott and Treasurer Joe Hockey defended the government’s plan in comments today.
The government has had the AMA alternative for three weeks.
The Greens, Labor, and the Palmer United Party have all been highly critical of the $7 co-payment and said they will oppose it in the Senate.
The co-payment is not due to start until mid next year and Dutton is stressing that there is no hurry to get a resolution.