AMA co-payment compromise a sick joke

A co-payment compromise plan by the Australian Medical Association has rightly been slammed by leading welfare and healthcare organisations. Under the plan, released in August, a minimum $6.15 co-payment would apply to all patients with an exemption for concession card holders and people under 16.

“The AMA, like the government, talks about sending a ‘price signal’, but out of pocket costs are already far too high and the introduction of co-payments will only shift further cost burden on to individual patients … This will only turn people away from seeing a doctor and they will head to already crowded hospital EDs, or worse still put off being treated altogether,” said Lee Thomas of the Australian Nursing and Midwifery Federation. The CEO of the Australian Council of Social Services also denounced the proposal.

Rather than put the interests of patients and health first, the AMA has chosen to prioritise doctors’ financial interests. The plan supports a user-pays vision for health care with no protection against the co-payment rising in the future.

It wants to reduce the rate of bulk-billing because bulk-billing sets a government enforced limit on the price of GP consultations. Currently doctors that choose to bulk-bill do so without any money or billing transactions taking place. They are paid directly by the government (capped at $36.30 per consultation). There is an incentive to bulk-bill because it means avoiding costs associated with administering payments. But under the AMA plan all medical practices that bulk-bill will be forced to administer billing of the co-payment. Any co-payment removes the incentive for doctors to bulk-bill and ends the efficiency of a scheme that does not require any money transaction. This would open the door to higher fees and the privatisation of GP consultations.

The AMA’s compromise plan has helped Abbott try to revive a proposal that should be dead by now. While the government doesn’t appear to have the numbers to push their current plan through the Senate, a negotiated deal may give it new life. Abbott has rejected the AMA’s plan, but both he and Health Minister Peter Dutton have indicated that there is still plenty of time to continue negotiating.

By Matt Meagher

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