Rural doctors say the Federal Government’s decision to dump its controversial Medicare co-payment proposal is “a really good outcome for all concerned”.
But they are now turning attention to the freeze on indexation of the Medicare rebate, which the Rural Doctors’ Association of Australia says is hurting country practices.
Prime Minister Tony Abbott declared on Tuesday that the co-payment was “dead, buried and cremated”, following near-universal opposition from doctor and patient groups since the proposal was unveiled in last year’s Budget.
Rural Doctors’ Association president Dr Dennis Pashen said the co-payment would have disproportionately hurt rural Australians, particularly those in drought-affected regions who may be asset rich but cash poor.
“Particularly in areas and times of hardship, that’s a difficult environment in which to maintain your health,” he said.
“Rural people put off going to the doctor when they should be seeing the doctor. They often have low attendance rates and less access to care. There’s a higher mortality and morbidity rate in rural communities compared to metropolitan practices.
“We’re very keen to look at how you can rewards quality general practice in rural areas, and there are a lot of indicators that show what is good quality practice.”
Dr Pashen said while there had been “a perception” within government that the co-payment would reduce so-called “six-minute medicine”, and make Medicare more sustainable, he believed that would not have been the outcome if the policy were implemented.
“There’s not a lot of evidence that the co-payments would have performed as the government wanted it to, as a gatekeeper,” he said.
“In fact, it’s a very complex area, where a simple solution impacts on good practices as much if not more than it does on fast flow-through practices.”
Dr Pashen said his association was now turning its attention to the freeze on indexation of the Medicare rebate to GPs, saying it was locked in at a rate below inflation, putting the squeeze on rural doctors.
GPs claim a rebate from Medicare to cover some of the services they offer patients.
“The rebate has, for a decade, already been behind the CPI (consumer price index), so costs have been screwed down,” he said.
Dr Pashen said an appropriate Medicare rebate would help rural doctors meet their business costs, which he said was not only about offering proper health care, but about attracting new doctors to rural practice.
“If the rebate is indexed for the next however many years, that puts an increased burden on the business model of general practice,” he said.
“We’re trying to attract young doctors into general practice. No one gets rich in general practice.
“To make it attractive, it has to be seen to be rewarding.”