The former adviser to Tony Abbott who proposed a $6 fee to visit the doctor has welcomed reports that the Coalition government has adopted his idea, but has called for it to go further and impose a means test on Medicare bulk-billing.
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Terry Barnes, who worked for Mr Abbott when he was health minister in the Howard government, proposed the $6 fee in a submission to the National Commission of Audit on behalf of the Australian Centre for Health Research, calculating it would save $750 million over four years by reducing unnecessary GP visits.
News Corp reported on Tuesday that the Abbott government's expenditure review committee had decided to include the change in its first budget. Patients would not have to pay the fee after their 12th visit in each year, meaning the extra burden on an individual patient would be capped at $72 a year, News Corp reported.
The government has not confirmed the report. Asked about the report on ABC radio on Tuesday, the Assistant Minister for Social Services, Mitch Fifield said he would not comment on budget speculation. Health Minister Peter Dutton has been contacted for comment.
Previously Mr Dutton has flagged an overhaul of Medicare, arguing that the current rate of growth in health spending is unsustainable
''In the end, we want to strengthen Medicare and we want to strengthen our health system, but we can't do that if we leave change to the 11th hour,'' Mr Dutton told Fairfax Media in January.
''The threshold question is whether people want the health system of today strengthened for tomorrow because at the moment the health system is heading to a point where it will become unmanageable.''
Annual spending on Medicare climbed from $8.1 billion in 2002-03 to $17.8 billion in 2011-12, an increase of 120 per cent. Growth in Medicare spending was faster than growth in the total health budget of 104 per cent over the decade, and Pharmaceutical Benefits Schedule spending, which rose 79 per cent over the same period.
Figures released by the Productivity Commission in January showed the Commonwealth spent $7.4 billion on GP services in 2012-13, up from $6.2 billion in 2006-07 after adjusting for inflation. But GP spending per person has increased little, from $301.60 in 2006-07 to $304.40 in 2011-12.
The number of GP services per 1000 people has also seen only a modest increase, from 5553 in 2008-09 to 5768 in 2012-13.
In an article published in the journal Health Voices last week, Mr Dutton compared Medicare to the Holden Kingswood.
"I doubt many Australians would find the features of a 1970s or '80s Kingswood would meet their expectations of a vehicle today. Yet that is what we are doing with Medicare - we're still using the '80s model," Mr Dutton wrote.
Labor has branded the proposal of a fee for visits to the doctor a "GP tax" and campaigned on the issue in the February byelection in Kevin Rudd's former seat of Griffith, and in the recent Senate byelection in Western Australia.
Labor's health spokeswoman Catherine King said the fee would put more pressure on Australia’s hospital system, leave families out of pocket and lead to worse health outcomes.
“This is yet another example of the Prime Minister’s twisted budget priorities,” Ms King said.
“Labor believes that all Australians should get the healthcare they need – not just the healthcare Tony Abbott says they can afford.
“The Prime Minister’s new GP tax will mean more parents will be out of pocket when they take their sick kids to the doctor, or families just won’t get the care they need.”
Public health groups have also criticised the proposal, predicting it would hurt the poor and sick the most and would be unlikely to produce savings because people would avoid seeking early treatment and would require hospital care when their conditions deteriorated.
Mr Barnes said on Tuesday he felt "delighted and vindicated'' by the report that the government had adopted his proposal and congratulated Mr Dutton for his ''political bravery'' in allowing debate on the issue to proceed.
''Provided that the budget measure builds in protections for the less well off, elderly and chronically ill, as I recommended, it is a modest price signal that will remind patients that world-class GP services come at a cost," he said.
But Mr Barnes urged the government to go further and impose a means test on all Medicare bulk-billing ''so that those who do have the means to pay as they go do so".
''To not do so would fail to spread the cost burden fairly amongst all Australian health consumers."
Mr Barnes said the Commonwealth needed to also allow states and territories the discretion to charge fees for GP-type services in public hospital emergency departments, to deter people from presenting at hospital to avoid paying the fee.
