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DOCTORS in major cities would be unlikely to charge the proposed $6 GP fee because of the stiff competition for patients, according to new analysis by an independent economist.
And while patients would initially cut back their visits to the doctor, after the initial shock, doctor’s visits would begin to grow again, undermining the projected $750 million savings.
A study of the proposal by independent health economist Roger Kilham for the Australian Medical Association has also found major errors in the maths of the plan.
The Federal Government’s Commission of Audit is considering the proposal as part of a raft of cutbacks to bring the budget back to balance, and the Government has not ruled it out.
Australian Medical Association president Dr Steve Hambleton has written an urgent supplementary submission to the Commission of Audit to bring its attention to the errors.
“My purpose in writing to you now is to alert you to what the AMA sees as very significant flaws in the ACHR analysis,” says Dr Hambleton in his submission to the Commission of Audit.
Terry Barnes, a former adviser to Tony Abbott, who authored the controversial proposal for the $6 GP fee erred by failing to count all GP attendances in the tables used in his paper, the analysis says.
He erred again by assuming GP services would grow by 3 per cent per annum.
In the last decade and indeed over the entire period of Medicare since 1984 the average annual growth rate of GP services has only been 2.25 per cent, the AMA paper says.
“Competitive pressure in urban areas with stronger GP supply will mean it is highly unlikely that GP practices will universally charge the $6,” the paper says.
“If the copayment is not charged in those areas, the volume reductions will not occur either,” it says.
At the same time as it over-estimates savings from a $6 GP fee the analysis shows it has not fully costed other savings.
The Terry Barnes plan also envisages freezing Medicare rebates for GP visits.
The AMA analysis says this would generate savings over four years of more than $1.1 billion and these savings would be even larger if Mr Barnes had correctly counted all GP services in his paper.
Mr Barnes came under fire in a Senate hearing this week for failing to take into account the cost to the health system of patients using emergency department to avoid a $6 GP charge.
Patients who failed to go to their doctor because of the $6 charge and as a result ended up in hospital requiring much more expensive care would also undermine savings from the plan.
Mr Barnes said he was “flattered” the AMA was taking his $6 GP fee proposal so seriously it had a respected health economist study it.
He had never claimed it was a sophisticated piece of modelling and was prepared to concede the work may be open to further fine tuning.
However, he said “if the Commission of audit looks at Kilham’s work and says “wow there are some real savings here”, (then) I won’t be unhappy”.
Health fund NIB has welcomed Health Minister Peter Dutton’s call for health funds to be given the right to move into primary health care.
“It’s crazy we insurers can’t legally reward a GP for working more closely with us to manage chronically ill patients, NIB chief Mark Fitzgibbon said.
“There’s no doubt we can bring a level of technological and other support to clinical decision-making and we know the GP isn’t ever going to buy into anything that might compromise health outcomes for their patients,” he said.
Source: Herald Sun