Seeing the doctor is about to become greatly more expensive for all Australians in a government move which will alienate both doctors and patients across the nation whilst it adds to the suffering of those most at need. Next week GP’s fees will rise suddenly by around $20 or more per visit because the Federal government has cut Medicare rebates and made other changes to GP’s consultation schedule by regulation.
Applying its “10 minute” rule will increase GP waiting times while from January 19, Medicare will pay $20.10 less for consultations lasting six to 10 minutes, consultations it has long paid $37.05 towards. Such “Level B” visits are required by millions each year for prescription renewals, blood pressure and other vital but routine check-ups. It will now pay $16.95, a reduction the medical profession fears will “destroy” free universal healthcare.
There has been no community consultation and no negotiation with the AMA, the professional body representing our doctors, a body which is now understandably angry at its exclusion by a government which has failed to negotiate with key stakeholders before making its decision. The decision constrains a vital part of the doctor-patient relationship, the time a doctor has with a patient, limits appointment-making by extending consultation times and will restrict access to medicine amongst the elderly, poor and needy. It is ill-advised, unnecessary and high-handed. It has not been well-received by the medical profession.
AMA President Associate Professor Brian Owler says the Government’s unilateral move to slash the rebate for GP consultations lasting less than 10 minutes, cut Medicare rebates by $5, and extend the indexation freeze on the Medicare Benefits Schedule through to mid-2018, has provoked the angriest response seen from the profession in many years.
Thwarted by being unable to get its GP co-payment legislation through the Senate, the LNP has chosen regulation to achieve its aim of ‘sending a price’ signal’. Whatever this piece of jargon may mean in plain English, the government is certainly ‘signalling’ not only a contempt for democratic processes but an alarming willingness to govern by any means possible, including if necessary, by decree. Democracy, for all its constraints, is infinitely preferable to the desperate ‘ad-hoc-racy’ of the current Federal government as it panics to implement its radical rightist agenda at any cost.
Sending a price signal is jargon for making a visit to your doctor cost you more in order to cause you to see your doctor less often. Around Budget time, we were treated to Joe Hockey’s assumption that some, if not many, visits we make to the doctor are not necessary. Hockey’s scenario is ludicrous, yet it has powerful adherents in the government: the price signal will bring us to our senses and eradicate malingering at a stroke of the regulator’s pen. Where he gets his information is never divulged because it proceeds from ideology rather than empirical fact. At worst, it is a palpable lie for the purpose of withdrawing funding from those who need it most: the elderly, the needy, those on low incomes. Discriminatory against key groups in society, given the structure of our economy and society it will punish women most, in what seems like a calculated act of callous indifference if not cruelty – all to meet a commitment to its grab bag of neo-con, radical hard right ideology.
Peter Dutton, until recently our self-effacing, under-achieving, Federal Health Minister, threatened late in November that the LNP government would introduce changes by regulation if necessary to send its coveted price signal. He sounded desperate if not petulant in his newly resolute tone, an understandable shift given his own failure to consult or negotiate his ill-fated GP co-payment before it appeared in Joe Hockey’s dud Budget.
If there were a crisis, it would be a crisis born of incompetence, a crisis of his and his government’s making, by its distaste for adequate public discussion prior to any policy formulation. A responsible political party might even have taken such a controversial idea to the people in the election campaign, but complete silence or misleading lies formed the course chosen by our current Federal politicians in the last election as they promised anything to get elected, whatever their subsequent commitment might prove but who carefully left out any detail of their real intentions. Soon after his bullying comment, Dutton was shoved sideways into Immigration’s contingent vacancy, a vortex of incalculable dimensions created by Scott Morrison’s move into Social Services and has not been heard of much again apart from his announcement that he would arm Customs Officials, a move which no doubt will suit arms suppliers but which is unlikely to increase safety, efficiency or public confidence.
‘It shows we are serious about border protection,’ is his line and he’s welcome to it.
Dutton’s successor, Sussan Ley, a Health Minister whose ministry is combined with Sport describes herself as a “recovering punk rocker from a time when it really mattered,” doubtless brings other strengths to her new portfolio such as an interest in regional and rural health and a commercial pilot’s licence, both of which commend her to our flying doctor service.
Too little is known of Ley’s post-punk and piloting credentials although much has been made of the fact that she is a woman. A former accountant with the tax office in Albury, it remains to be seen how she will position herself politically in her new job. Her performance, to date, however, as Assistant Minister for Education suggest strongly Ley is an economic dry who will happily follow a hard right agenda as articulated by fellow new blood, Assistant Treasurer, Josh Frydenberg.
People need to realise health care isn’t free and must be prepared to make ‘modest’ contributions to it, he said whilst new assistant treasurer, Kooyong colt, barrister, writer and tennis player Josh Frydenberg, was on message trotting out the ‘tough but necessary medicine’ line: ‘Hard reforms are sometimes unpopular,’ he continued, furthering his party’s abuse of the word reform when it means change or simply, cutbacks. Making a virtue of necessity, perhaps, as his government faces continuing decline in all opinion polls, he opted for a self-reassuring but utterly unconvincing lie: ‘We don’t seek to win a popularity contest.’
Frydenberg, appointed in December whilst his predecessor Arthur Sindodinis stands aside to better assist ICAC, has been a senior adviser to Downer, Howard and was Abbott’s parliamentary secretary in charge of the government’s deregulation agenda. His perspective fits the Abbott government’s hard right policy of dismantling our current system in favour of one in which the patient or ‘consumer’ will face prohibitive costs. The price signal is a key part of the myth. As Professor Jeff Richardson, director of Monash University Centre for Health Economics argues: ‘The unsustainability of government health expenditure in Australia is a myth that has been carefully nurtured to justify policies to transfer costs from government to the public.’ Sustainability panic argues Steven Duckett, Director of Health at the Grattan Institute, is often used to justify shifting the burden of controlling health spending from the wider society to a vulnerable few – people with poor health who frequently go to doctors and hospitals, for example, or those with high needs and potentially shortened life expectancy.
People need to realise health care isn’t free and must be prepared to make ‘modest’ contributions to … Frydenberg asserts disingenuously. He fails to acknowledge that we know all too well that our health care is not free, we have been paying taxes for it all our lives. Public understanding or support is ill-served by patronising and derisory comments implying the opposite. A little listening to the people is recommended before you tell us what’s best for us, Mr Frydenberg.
Australians are not mugs. Although it will be challenging, given the inertia and indifference dictating your government’s consultation by-pass, an operation made necessary by its sclerotic heart, you need to heed the message: the public is not fooled into being falsely reproached for its delusions: taking Healthcare something for nothing. It never did. Give the people some credit. They pay taxes, read newspapers and they also vote.
Setting up a straw man, a misconception which can only be destroyed by a price signal is irresponsible. Just give us the facts, Minister Ley. You are about to make Healthcare more expensive and elitist still as you dismantle a system which we pay taxes for so that it may look after all of us, not just the wealthy. Why? It is simply because it fits your mumbo-jumbo Hayek meets tea party ideology of letting the market rule, your slogan of ‘user-pays’. It is the price of your infatuation with ‘small government’, self-reliance and similar meaningless slogans and unworkable assumptions. The new fee rises are a travesty of any respectable health policy, and a betrayal if not outright abnegation of community, compassion and conscience.