The Liberals’ $7 GP fee is designed to undermine Medicare as a universal health system and entrench the principle of user-pays in health.
The Liberals think a comprehensive and well-funded health system is a luxury that should be only accessed by those rich enough to pay for it. Their $7 co-payment for GP visits, blood tests and x-rays goes alongside a $5 increase in the amount we have to pay for prescriptions, and a $15 billion cut from the hospital budget over ten years.
Abbott is forcing through the co-payment by cutting the Medicare rebate GPs get for each bulk-billed visit by $5. This means doctors lose $5 for every patient they refuse to charge the co-payment. If the patient is a concession card holder they also lose a $6 government incentive payment to bulk-bill those on low incomes.
The government argues that the extra $2 that the GP “makes” when they charge the $7 fee can be saved to offer free visits for the very poor.
In reality this arrangement pits the interests of doctors against their patients. GPs providing care for the poorest in the community are to be faced with a choice—take food out of the mouths of the poor, or lose money.
The attack on Medicare is far more about entrenching the acceptance that health should be user pays than it is about the budget bottom-line. The $3.5 billion over five years the co-payment is forecast to save will have no impact on the deficit whatsoever, with the money redirected into a new medical research fund.
But it will have a big impact on the poor. The government knows that it will deter people from going to the GP—that is precisely how it is meant to reduce to cost to government of GP visits.
What this means is cutting the level of services going to those on low incomes. The only people deterred will be those who already struggle to pay the bills.
Over time the Liberals hope to force more and more of the costs of the healthcare system onto workers and the poor, so they can cut corporate tax rates even more. This began with the effort to force more people into private health insurance under the Howard government, boosted by taxpayer subsidies.
If we don’t defeat the $7 co-payment, it is only the start of the fees that will come. The government’s Commission of Audit recommended a fee of $15 for GP visits.
Forcing virtually all patients to pay a fee will erode Medicare as a provider of bulk-billed universal healthcare. Doctors will increase up-front fees further over time, with less and less simply charging $7 and bulk-billing the government for the rest of the cost.
Health expert Stephen Duckett has pointed out that since now, “previously bulk-billing GPs have to introduce billing systems, why would they stop at the government-mandated minimum?”
This is what has happened with university fees. Students resisted the introduction of HECS in 1989 even though initially the fees were only $1800. They were right to argue that a low fee was only the “thin edge of the wedge”. Now students leave university with tens of thousands in HECS debt, and the Liberals now plan to increase fees further.
The Commission of Audit shows where the government is heading. It recommended all middle and high income earners be forced to take out private health insurance to cover all their health needs, including GP services. The idea is to remove them from the Medicare system entirely, which would remain simply as a second-class safety net only for the very poor.
The is precisely the horror story seen in the United States. There the population pays twice as much per person for healthcare as we do in Australia. Most of the extra money doesn’t go to improved care, but into the pockets of the private health insurance industry.
In the richest economy in the world the working poor die of preventable diseases and consistently face the choice of accessing the doctor or paying for food.
For Abbott the attack on Medicare is symbolic. It represents the way the government wants to shift costs onto the working class from big business. Because of this, defeating the $7 co-payment is vital for all workers and unions across the country.
Unions have fought to defend a universal free and fully funded health system before. In 1976 unions staged a general strike when the Fraser Liberal Government attacked Medibank.
Since January when the co-payment was first raised unions including the NSW Nurses and Midwives’ Association, the HSU and the USU have been actively involved, working alongside students and community activists. This network now need to be translated into combined union action and mass demonstrations to stop Abbott.
By Jean Parker