AMA Transcript - Medicare co-payment

ELEANOR HALL: The Federal Health Minister Sussan Ley appears to have raised the prospect of a two-tiered Medicare co-payment, as she continues negotiations to come up with a plan C for changes to bulk billing.
The Minister has suggested the Government could ask patients to pay something if they can afford to.
The Australian Medical Association has told The World Today that the Minister hasn't raised her idea with them. 
In Canberra, Alexandra Kirk reports.

ALEXANDRA KIRK: The $5 co-payment plan remains on the table, though many expect the Government will eventually drop it.

The Health Minister Sussan Ley is continuing to consult the medical profession in a bid to come up with an alternative that has their support after the Prime Minister acknowledged it wasn't politically smart to pick a fight with doctors.

The Minister's scheduled to hold another meeting this afternoon. This morning on ABC radio she explained her latest thinking.

SUSSAN LEY: Now, my intention is that we all agree on a methodology that says if you can't afford to pay anything you can continue to be bulk billed. It is there to protect the vulnerable.

If you can pay a little bit more, then we'll ask you to do that, and if you're a higher income bracket again, you might have to pay something extra again.

So, it's not a rewriting of what happens now in many senses, it simply recognises that those bulk bill consultations, which are effectively funded by the taxpayer, that's who funds Medicare, the national insurer, are, if we're not careful, going to end up costing the health budget and creating an inefficient system.

ALEXANDRA KIRK: The head of the Australian Medical Association, Brian Owler, says it's hard to know what the Minister means, and says it hasn't been discussed with his organisation in those terms.

BRIAN OWLER: Look, that's I think the first time I've heard anything put into those words. I suspect the idea about a two-tiered system is really taking some of those words a little bit too literally.

I think I can only surmise that the Minister was talking about the ability of people to make a contribution based on their incomes and their personal situation, but actually trying to formalise that, I think, would be very difficult, and that's not something that we've discussed with the Minister.

ALEXANDRA KIRK: Associate Professor Owler says in some ways it reflects what happens now. 

BRIAN OWLER: There are situations where people do use differential billing systems, the GPs use different payments for different groups of people, but in terms of proposals that are being put forward, we're not aware of any proposal that would have a two-tiered co-payment.
I think what we need to do is make sure that there is that discretion there for the GP who knows their patient and is in the best position to judge the service that they're providing to those patients.
For instance, many times when people are having a long course of treatment, they may decide to bill for the first treatment, but then decide to bulk bill for subsequent treatments under that course of management.

ALEXANDRA KIRK: Doctors would want to keep that system in place?

BRIAN OWLER: I think it's really important to acknowledge the flexibility that's there in the system.
When GPs do have that flexibility they are in a position to judge the value of the services they're providing, but also in many instances the propensity of the person to provide some sort of contribution to the value and the cost of providing that service.

ALEXANDRA KIRK: Ahead of his meeting with the minister this afternoon, the head of the AMA says it would be helpful if the Government took the freeze on indexation of the Medicare rebate off the table, as well as any cuts to the Medicare rebate. 

BRIAN OWLER: I've also written to the Prime Minister, I think it's very important that he clear up the uncertainty around the proposals that are on the table. I think it's much easier to have a conducive, much more conducive discussions when you're having, when you don't have those things hanging over the heads of GPs and patients.
And so hopefully we'll be able to get those off the table and hopefully come up with something that provides better general practice, and that looks after the health of the community much better as well.

ELEANOR HALL: That's AMA President Dr Brian Owler, ending that report from Alexandra Kirk.

18 February 2015

CONTACT:        John Flannery                      02 6270 5477 / 0419 494 761

                            Odette Visser                      02 6270 5412 / 0427 209 753