His comments are in response to a call for children to be exempt from the unpopular co-payment.

And his seemingly cold comment is cold comfort to parents of children who require constant medical attention and treatment.

We’re not talking about children with life-threatening conditions like cancer. What about the parents of chronic asthmatics, those with diabetes, chronic fatigue, even those prone to regularly contracting common conditions like bronchitis and gastro?

These are children who need to regularly visit the family doctor for check-ups and to renew prescriptions for medicines which help them get through the day.

The comments from the PM, who had already questioned why pensioners should be exempt, follow the unveiling by the Australian Medical Association on Thursday of its alternative model for the Medicare charge, which demanded vulnerable patients like pensioners and children be excluded.

The AMA also wants the government to scrap plans to cut the Medicare rebate by $5 for bulk billed patients, which would leave doctors out of pocket if they don’t charge the co-payment.

In response, AMA president Brian Owler said he would not horsetrade with the government on the co-payment plan.

“I think there’s a misconception that this was going to be a to-and-fro debate and that the AMA is in there wheeling and dealing and trading things,” Mr Owler said.

Welfare and health groups urged senators to reject any deal struck between the AMA and government, complaining that they had been frozen out of negotiations. “It would hit poor and chronically ill people hardest and exemptions would not go far enough,” Australian Council of Social Service boss Cassandra Goldie said.

The poor and chronically ill can least afford this co-payment, so for Prime Minister Abbott to essentially flatly refuse to budge on any sort of an exemption can only be described as a slap in the face to some of the nation’s most vulnerable.