AMA Transcript - The Government dumps GP co-payment

BRIAN OWLER: Alright, well thank you for coming out this afternoon. The AMA obviously is very pleased that the $5 cut to the Medicare rebate has been taken off the table. This is the so-called optional $5 co-payment. This is something that the AMA has been arguing against for some time. What we really need to be discussing in this country is how we actually invest in general practice. How we rebuild general practice. Because we all know that to have a sustainable health care system you have to invest in general practice. It's about keeping people well and keeping them out of more expensive hospital care.

Now, the only other elements of the second co-payment proposal that remains is of course the freeze to indexation, which extends out to 2018. Now, this is still a real issue not just for general practice but for specialist practice as well and it's a real issue for private health insurance participation, for our public hospital system, but also for the out of pocket expenses of patients and so I think there's a lot of work that we need to do there.

We're continuing to work very closely with the new minister, Minister Ley. She has shown a very constructive and consultative approach, and I thank the minister for her enthusiasm in getting across the portfolio, in visiting many GPs and other doctors around the country, and particularly for working closely with the AMA. We're committed to working as always with the Government to come up with better health policy because we know that when you work with doctors who are working at the coal face, we come up with better health policies and something that's going to be much more sustainable for our health care system in the future.

QUESTION: Prime Minister Tony Abbott says it's dead, buried, and cremated; Labor says it's still got a pulse. What's your diagnosis?

BRIAN OWLER: No, there's no doubt that it's dead and buried. It was of course dead from the moment that it was announced because it was never going to be supported, not only by the medical profession but of course by the crossbenchers. And that was very important. The Prime Minister and the minister also said that they would not take anything forward to the Parliament that didn't have the support - the broad support of the medical profession, and so it was really only a matter of pronouncing the death of the co-payment, but it has been dead for some time.

QUESTION: Do you think that the freeze - the continuation of the freeze will push down bulk billing rates?

BRIAN OWLER: For general practice, there's no doubt that over a four year period - they've already had a period of freeze, of course, delaying their indexation. But over time, their costs are going up. The costs of staff, their lease, their indemnity are all increasing over time, so if you freeze the rebate it means that there is less money to employ practice nurses. It makes it more difficult for GPs to do the sort of quality general practice that we expect and need in this country, and it's - the only way that is to either have shorter consultation times, which is something that doctors don't want to do, or you increase the rate of private billing.

So that is a risk for the future and I think that would be an issue also for practices in disadvantaged areas where private billing may not be an option. So I think we need to consider all of the practices, not just those in affluent areas but of course those in disadvantaged areas as well, and, of course, what it means for our patients at the end of the day. And I think having those practices, providing that important care in those disadvantaged areas, is very important because we know that the rates of disease in those areas are much higher.

QUESTION: The minister has essentially said that they're going to continue with the freeze on the rebate indexation until they can negotiate an alternative policy with the stakeholders, including doctors. What's your thoughts on that? Does that feel like you're being forced into accepting the freeze to come up with something else?

BRIAN OWLER: No not at all. I mean, the AMA and other health groups work every day to make our healthcare system more efficient. This is not something that we're being forced into, we're participating in a number of elements already and, in fact, every day doctors in our hospitals and in general practice are working to make sure that we reduce costs, to make out hospital system, our health care system, not only more efficient but also more effective for our patients. So, we see that as part of the role of not only the AMA but as being a doctor because at the end of the day, that's why we're in medicine. It's for our patients and to improve our health care system.

QUESTION: The Government has confirmed that Medicare rebate freeze will go ahead, is that ultimately going to have to be passed on to patients?

BRIAN OWLER: Well, that's the concern. For general practice after four years, I think the rates of private billing will increase and the rate of bulk-billing must fall. But also there are very significant issues around private health insurance schedules which will also be frozen in line with the NBS schedule and if that happens, it means that out of pocket expenses for many medical procedures will have to increase because the moment you go $1 above the private health insurer's schedule, the out-of-pocket expenses sky-rocket as the health fund only gives back then 25 per cent of the NBS schedule. So, that sort of complication in, I guess, in the policy has not been something that the Government has considered and it really takes doctors, those people working in the frontlines with their patients that can understand what implications that sort of change is going to have and that's why it's so important that the Government acknowledges that they need to work with doctors, work with health groups like the AMA in coming up with better health policies for our patients.

QUESTION: Is there anything that the Parliament can do to stop the freeze going ahead?

BRIAN OWLER: Well, at the moment it appears that the schedule that's there can remain and if it doesn't need to be changed or refreshed then it could actually just stay in place. But, obviously, we will work with the Government and we've already had very productive discussions with the Minister around ways that we might try and curtail the freeze to indexation. So, I think that issue is not at an end. We're still working very closely with the Minister and we'll be discussing this again later in the week when we meet with the Minister and the Prime Minister to come up with some solution. So - I mean, we're here not only to help the Minister but to also help the Prime Minister.

We want to help the Prime Minister and this government come up with better health policies, things that will make our health care system more sustainable and deliver better outcomes for our patients.

QUESTION: You've spoken about alternative payment models like blended payments, paying doctors a lump sum to treat a patient rather than being paid on a fee for service basis. How far along are you in those discussions with the Minister or how far advanced are your own proposals in that regard?

BRIAN OWLER: Well, let me first of all say that fee for service will continue to underpin the financing of the health care system for the foreseeable future, there's certainly no proposals to change that. But we do know that blended payments already have a role in general practice. If we look at the Department of Veteran's Affairs' CBC program, that actually is a blended patient - payment model for people with chronic disease and it works very effectively. There are models that are being discussed around private health insurers but also partnerships with federal and state governments and I think we need to be open to those sorts of long term structural reforms that deliver better health outcomes and do make our health care system more efficient but I think that is not part of the discussions around the co-payment issue at the moment. That is part of a broader, longer term discussion about how we have structural reform in general practice and our health care system in general and I think it's something that we'll continue to work on.

Thank you.

3 March 2015

CONTACT:        John Flannery                     02 6270 5477 / 0419 494 761

                            Odette Visser                      02 6270 5412 / 0427 209 753