The dismantling of the principle of universal healthcare in Australia is a trend that should be resisted. The ability for every Australian, regardless of their means, to be able to afford to visit a doctor is a pillar of our progressive, caring society. Yet at the same time as the United States is expanding its health coverage to make up for historical inequality, Australia is dismantling a system that is the envy of much of the world.
The federal government’s decision to dump its proposed $7 GP fee and instead reduce by $5 the amount the government pays to a GP when they see a patient – and allow the doctor pass on the $5 fee – is tricky politics. Worse, it is political cowardice because it forces the local GP to become the villain who collects the fee.
The Age welcomes the government’s decision to provide exemptions to the $5 fee, which include veterans, concession card holders and children under 16. This makes the government’s plans less unfair. Nonetheless, we believe the modified proposal is still inequitable and poor policy. Introducing an upfront user-pays element to basic healthcare will hit hardest those with the least ability to pay. And it is notable that the government considers a “price signal” appropriate policy on the basic right to health care but not appropriate for large carbon emitters in a warming world.
The dangers are clear. We share the concerns of the Australian Council of Social Service, which fears that poorer people may miss out on timely and appropriate medical advice because of the new fee. And we agree with the Australian Medical Association that local medical centres are likely to move away from bulk-billing customers to private billing, where the doctor charges the patient the full cost of the visit in advance and the patient claims a rebate from Medicare. This would mean that instead of having to find $5 to visit the local doctor, a sick person would need to find as much as $70 up front.
At the federal election last year, Australians did not vote for this dismantling of Medicare. The Age believes that, rather than wind back the universality of our healthcare system in a bid to ease pressure on the budget, the government should devote more effort to cracking down on corporate and individual tax avoiders. We acknowledge that the nation’s healthcare bill will continue to escalate as the population grows and ages. But a fairer way to help meet the increased costs would be to increase the Medicare levy, which is structured in such a way that the higher a person’s income, the more they contribute.
Mr Abbott, speaking on ABC radio in Melbourne yesterday, dismissed this idea as a “tax increase” and said he supported “solutions that are more innovative”. Yet the $5 fee will have only a modest impact on the budget bottom line; it is expected to save about $800 million over the next four years. By comparison, other measures announced as part of the package – including a reduced Medicare payment for visits of less than 10 minutes and freezing fees paid by Medicare for all other services until July 2018 – are expected to save the Commonwealth about $2.6 billion over four years. If, as anticipated, the government runs a national advertising campaign spruiking the asserted benefits of the new system, how much will have really been saved in the end?
The $5 GP fee smacks of an ideological agenda. We call on the Abbott government to rethink it.