FEDERAL government must remove the “freeze” on the Medicare patient rebate index to curb the dire health outcomes in rural and regional Australia, according to the Rural Doctors Association of Australia (RDAA).
In July, the government ruled indexation of Medicare rebates remain static until July 2018.
Indexation determines the return general practitioners (GPs) get from patient payments and visits.
Association president Professor Dennis Pashen said allowing fees to increase with inflation was essential to make regional general practices economically viable in the long term.
And that could only come with the removal of the “freeze”.
“You’ve already got a sector where the rebates have been behind indexation by a good two to three per cent for the past decade, so you’ve got all the costs of running a rural practice which are substantially higher than a metropolitan one,” Professor Pashen said.
He said regional GPs faced the added costs of living in a regional area, working 24/7 and trying to balance work and life.
If doctors tried to make their practices more profitable and charged an extra $10 a consultation to meet their growing costs, patients who were socially disadvantaged wouldn’t go to the doctor anymore.
“They’ll go to the hospital and then you’ve got increased hospital costs, or they’ll hold off until they are really sick and have to be admitted to hospital.
“Every day in hospital costs the equivalent of between 10 and 30 consultations in a general practice, so it’s a false economy to keep people out of primary care and general practice.”
He said GPs also needed to ensure they could gain holiday time away from the job to stay in the rural practice long-term.
But holidays meant hiring a locum, at cost, and generally while the doctor was away patients would wait until he returned, as they prefer- red to see a doctor they knew.
“So while you’re away your practice isn’t earning as much money,” Professor Pashen said.
“All these little factors are all part of rural practice and if you affect the business model of rural practice, you affect its attraction to young professionals who are looking at a rural lifestyle and a viable and sustainable business where they can grow and have their family and become part of the community.”
Professor Pashen said while there had been successive governments in the past decade who’d run some really good programs to encourage young medical students to go into rural medicine there was nothing to make the end point more attractive.
“If you make the end point less attractive than say, cardiology – where you are looking at a million dollars a year in salary – then people tend not to go in that direction.”
Professor Pashen said doctors in rural areas also had higher levels of patients per doctor per capita.
“For example in North Sydney it’s one doctor per 600 head of population, whereas in a lot of rural communities it is one doctor to 1200 or 3000 or 5000 patients.”