Patients Face New $20 Fee for Seeing Their GP [Sign Petition]

sagrules on 13/01/2015 - 09:46
Last edited 22/01/2015 - 10:39 by 1 other user

Came across this article this morning regarding changes to Medicare charges that will be implemented in the coming weeks on 19th Jan.

http://www.smh.com.au/federal-politics/political-news/patien…

Thought it was over when they couldnt pass the $7 GP fee through the Senate - so here they are by passing it in another way.

The new changes basically mean:

  • If your doctor bulk bills they will absorb the pay cut (sincerely doubt this). The article says "It will prompt many doctors to stop bulk-billing shorter consultations because the payment does not meet their costs"
  • If your doctor charges a fee you will receive $16.95 rebate. Depending on what your GP charges this will change your "out of pocket" or gap" fee

I believe this new fee structure will increase waiting times at the GP or place additional pressure on local hospitals (for those wanting to avoid the fee). Can anything be done to stop these changes?

EDIT: If everyone could please sign this petition, that would be great. We need to get the word out!
https://www.change.org/p/the-hon-sussan-ley-quit-targeting-g…

EDIT: So the private industry's response to this is to increase the cost of PHI for everyone by 6% a year (triple inflation) so that more people rely on the public system and don't take it up.
http://www.smh.com.au/business/why-private-health-insurance-…

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Comments

        • Incrediho on 20/01/2015 - 11:35

          @eve:

          That is a lot of questions/ data you are asking for. I'd love to list out my manifesto for a better society, but that would take many, many, many pages and OzBargain probably isn't the platform.

          Well, I doubt monks would be able to support a whole family in what I referred to as comfort. As I listed in the links above. An average take-home salary of an Australian GP is (AFTER practice/clinic expenses are deducted) $175,000 - $400,000. Registrars (GPs in training) are earning ~$100,000 to $280,000. It's not like they are greatly suffering financially during their long journey to full qualification. Maybe your definition of luxury is different to mine, but I would call a multimillion dollar home, and nice cars, plus money for nice holidays each year luxury - maybe I'm just a filthy peasant.

          As for who deserves more/less - I can tell you one thing - doctors (even GPs) sit above the median salary for every profession. I.e. on average, every profession earns less than doctors. GPs are only "beaten" by other specialist doctors. I don't think they should earn less than many other professions, but EQUAL? Yes. A medical doctor could earn somewhere similar to the median doctoral (or highest level) qualified engineer, lawyer, professor, mathematician, scientist etc etc. Which again, varies greatly, but probably falls somewhere in the position of $~150k. Yes the the 90th percentiles of many of these careers + executives + partnered accountants and lawyers MIGHT earn more - but most command only a small fraction of the job satisfaction, respect, stability, flexibility, etc etc.

          Yes, I recognize that doctors regularly have longer and continual study obligations, plus unique challenges to their work (I would argue unique rewards - both intrinsic and extrinsic). But that would go back to my apparently rampant idealism, that doctors should be entering for field primarily for genuine passion, and (wait for it), love - rather than the huge money potential.

        • eve on 21/01/2015 - 00:48

          @Incrediho:

          Where did you get the take home salary amounts from? And does it take into account urban/rural, procedural/non-procedural, after-hours/on-call, private/bulkbilling? Rather than the range - what's the median + standard deviation?

          I spoke with a GP today who as a final year GP registrar in 2014, her take home for full-time in a busy bulk billing country practice was $66 000. I will keep asking around for real numbers rather than stats. I'm finding it's not matching up - supposed salaries vs actual salaries..

          I don't think it makes sense that just because a job has more job satisfaction/respect/stability/flexibility that it means it should earn less.
          Don't doctors, dentists and vets have the highest suicide rates compared to the general population anyway?

          I think that it is perfectly correct to want doctors to enter the profession because of a passion for health. But I just really don't think a lower salary will result in more passionate doctors, but perhaps more burnt out ones.

        • Incrediho on 21/01/2015 - 02:05

          @eve:

          The numbers are from the two industry bodies I linked in in an earlier comment (I won't paste them here again, refer to page 1). I understand your passion for the numbers but so far I have presented far more reputable statistical data than you (i.e. aggregate reports rather than hearsay). Even if you were to take lowest figures in the range, they still outstrip most other developed, high GDP nations.

          Put it this way, if $66,000 was the median I would be saying GPs were underpaid. I'm not the cruel hard taskmaster that expects doctors to work their assess off for a pittance. I've consistently been saying $100-150k is fair money. I just don't think that GPs should be earning in excess of $200,000 a year. In many cases 300 or even $400k is achievable. Unfortunately (maybe, depending on your viewpoint), a high salary is not indicative of a "good" doctor (often it is indicative of a financially motivated one who will rapidly churn through patients and never bulk bill in areas where choice is limited or nonexistent).

          My point has always been doctors should never be earning salaries to where they are "burnt out" or even vaguely financially worried. I think you are distorting my position. I really can't fathom a situation where GP is going to be "burnt out" by earning $150,000 a year, unless they are intentionally living beyond reasonable means.
          Doctors (and GPs in particular) report high levels of job satisfaction —> https://www.mja.com.au/journal/2011/194/1/australian-doctors…

          Norwegian GPs also report high levels of job satisfaction, despite substantially lower average salaries —> http://informahealthcare.com/doi/abs/10.1080/028134305003117…
          They somehow managed to derive many non-monetary benefits from their work and environment and still remain highly content with their profession (they also go through extended and rigorous medical schooling). The vast majority do not feel burnt out.

    • GaryQ on 14/01/2015 - 17:42
      +2

      Nope - the 21st Century version of Work Choices and this is definitely a part of it says go to work until you die. If you infect everyone in your work place, there are plenty more desperate to replace you

    • fredz0r on 14/01/2015 - 18:45
      +2

      But you don't need to see a doctor to get a medical certificate. Pharmacists are able to issue certificates for personal leave (sick leave) and only costs like $10.

      • Miss Dior on 15/01/2015 - 19:53

        They are? I didn't know this. Will ask next time I am in a pharmacy. Thanks for the info.

      • burningrage on 16/01/2015 - 23:35

        I second Miss Dior. Since when?? lol…

      • kirynflare on 17/01/2015 - 00:29

        Pharmacists "can" issue medical certificates, but be aware, most pharmacists I'm aware of don't, because they are not accepted universally like a doctor's certificate. Be sure to check with the requirements before paying a pharmacist to write one up.

    • 2ndeffort on 16/01/2015 - 13:25

      Everybody blaming Abbott but whenever I go to the Doctor, after I get the speech about how hard it is to do business and why i have to pay over the rebate, I head back out to the carpark and walk past the lineup of Porsches and Maseratis in the carpark. The specialist my son has to see for his acne literally has a BMW M3 in his parking spot at the lavish inner city offices. He is a great doctor but explain to me why this is all the Government's fault. Why should we as a society go further in debt to publicly fund the massive salaries of doctors.

      • PCHammond on 16/01/2015 - 13:59
        +2

        This is about GPs, not specialists. As part of my job, I know over 1000 GPs. Of them, there are only 3 with super fancy cars (1 Porsche, 1 Aston, 1 Ferrari), all have very wealthy families. Otherwise it's a 5yr old E class merc or lower. Hell, I drive a better car than many doctors.

        And as I have said, if you are that brilliant and put in so much time and study and continual study and stress and just want money, then medicine is probably the wrong field for you. If you want our best and brightest to go do other things instead of medicine then are you really willing to go see doctors who aren't so bright and aren't so studious?

      • eve on 20/01/2015 - 04:54

        The cost of healthcare goes through your taxes so that the less fortunate can receive healthcare too (public hospitals and bulk billing GPs, not really private doctors other than to try to reduce public waiting lists and public use of resources)).

        Medicine is ideally a higher calling but it's a specialised set of skills, requiring a certain dedication and a service too.

        If you don't think it's worth your son getting treatment for elective/cosmetic reasons, then perhaps don't pay for it. Dermatologists tend earn a lot because one of their businesses is beauty and in a 1st world country, that's what people care about and spend their money on. It makes sense that if your business is beauty, then these people are going to judge you on how you present and for the people who can really afford it, probably judge you favourably on appearances eg lavish office and over-the-top car, so that's going to be passed on to clients/patients. Dermatologists also have another role of treating diseases (for example skin cancers) but it seems here that's beside the point…

        I suspect this specialist centre with lots of expensive cars you go to is more surgical in nature? Though I dont agree with excessive spending, spend a day in the life of a surgical trainee before you complain and say they don't deserve the right to decide how they spend their savings… (@Thetownfool?)

  • Ebayee on 13/01/2015 - 12:30
    +3

    further cut $5 to go ahead from 1 July also :(

  • scrimshaw on 13/01/2015 - 14:54
    +13

    Well damn, better visit my doctor before next week then..

    The future is going to be very bleak for low income earners. With the costs of many basic human needs rising (healthcare, education) and welfare benefits (e.g pension, Newstart) being rehauled, the poor are just going to get poorer and the rich even richer.

    • tyler.durden on 13/01/2015 - 19:20
      +1

      yeap

      and most ozbargainers are poor…

    • what on 13/01/2015 - 23:45
      +1

      Poorer and, unfortunately, sicker.

    • MondaySleeper on 17/01/2015 - 13:14

      unfortunate but a truth we all have to accept ……. Praying not to fall sick….. :(

  • TPbMe on 13/01/2015 - 14:56
    +31

    A co-payment of $5 or $7 for bulk-billed clients will not save the Govt any money as it will cost both the GP's & public service 10 times more than that in administration. It's simply setting a precedent - this tax, once approved, will then be increased by successive govts.
    Unfortunately Mr Abbot was born privileged -male, white, wealthy & obviously healthy (he missed out on 'handsome'!) he has absolutely no understanding of or empathy for the average Australian or those less fortunate(they're just a scourge)who will become further marginalised (& cost the Govt more in the long run). Like Hockey(what a great economist-"a petrol price increase won't affect pensioners because they don't drive far!!)he's simply an embarrassing idiot & Australia deserves better leadership.You would think with all that free University education in the 70's they'd both be better wordsmiths!

    • Bullion78 on 14/01/2015 - 14:10
      +3

      Yet this country can find 20 odd billion buying sub standard fighter jets.. We have our priorities utterly messed up in this crazy corporate controlled society.. I feel sorry for future generations, the time will come to pay back the debt and it will be picked up by those not responsible for accruing it, and of course the segment of society that is most vulnerable will pay the biggest cost.

      • PCHammond on 14/01/2015 - 19:06
        -1

        The $5 reduction in reimbursement does not affect the most vulnerable (those on healthcare cards). If they are bulk billed now, they will probably be bulk billed again (depending on centre policy)

        • jackary on 16/01/2015 - 13:06

          Note how you said probably. Shot yourself in the foot there, champ.

        • PCHammond on 16/01/2015 - 14:02

          @jackary:
          As I said, it depends on centre policy. Some already do not bulk bill healthcare card holders. Either way, even if they are not bulk billed, healthcare card holders will not be affected by that reimbursement change, so even if they currently pay a gap, that gap will not change unless the practice changes their billing.

          The "probably" means it is non definitive, as it depends on the practice itself. I'm not going to say something definitively when it's open for practices to decide for themselves. However, I stand by that most practices who currently bulk bill HCC holders will continue to bulk bill HCC holders, based on proposed changes.

        • jackary on 16/01/2015 - 15:26

          @FiftyCal: I think you summed up what I was getting at in your last sentence. The issue is that nobody knows how these changes will affect us, let alone those on Centrelink fortnight to fortnight. I think what many are concerned about is the fact that if the doctor is also working on a thin margin, he may no longer be able to continue absorbing.

      • 2ndeffort on 16/01/2015 - 13:32

        At least we will HAVE a future society, without a means to defend our sovereignty and way of life the future might be very different.

        What choice do we have but to have a strong Defence Force capable of countering the expected threat from any future opponents. The last government had Defence spending at historic low levels. The people that will pay for policy like that is our children when they are asked to go to future wars with obsolete outdated weapons, just like they were in 1939.

  • [Deactivated] on 13/01/2015 - 18:49
    +1

    So I wonder how the immunisation and health checks (there are currently five in the first year) for kids will be charged then?

  • Rashed on 13/01/2015 - 18:52

    Tonny Abbott's leadership skill is similar to Stephen Elop, if you know what I mean.

    • [Deactivated] on 13/01/2015 - 20:43
      +5

      The founder of Eneloop?

      • scrimshaw on 13/01/2015 - 20:58
        +8

        No, he was CEO of Nokia for a very short period. He criticized his own company's products, which was infamously known as the 'burning platform' memo which later leaked out into the press and subsequently killed all consumer confidence in the product. He then later sealed the deal with M$ which basically meant what was left of Nokia's customer base with no Symbian / Maemo phones to look forward to.

        • arcticmonkey on 14/01/2015 - 07:37
          +2

          Yep, sounds like Abbott except Abbott can kill so many peoples quality of life (health cuts) and chance to better themselves (education).

          Elop on the other hand may just hurt his company.

        • Sammy2000 on 14/01/2015 - 19:27

          But then… Microsoft/Nokia started to make decent phones again. Then Microsoft bought them out.

    • twig on 15/01/2015 - 10:02
      +1

      A fox in the hen-house.

  • what on 13/01/2015 - 19:48
    +8

    OK. Have I got this right. I go to the Dr, where I normally get bulk billed. Get a referral for a blood test, pay $20 out of pocket. Then I go back to get the results, another $20 out of pocket.

    • PVA on 13/01/2015 - 20:10
      +7

      yep

      • what on 13/01/2015 - 20:12
        +1

        Bugger. He is punishing us because he couldn't get the $7 co-payment through. At least there was a $70 cap with the co-payment.

        What about people with a health care card. Will they also be $20 out of pocket per visit.

        • PVA on 13/01/2015 - 20:20

          the doctors may not pass on the cost if they are happy pushing through patients every 2 minutes.

      • [Deactivated] on 13/01/2015 - 20:41

        +1

  • [Deactivated] on 13/01/2015 - 20:39
    -8

    Assuming a patient every 5 mins: $17 x 12 = $204 per hour, or $1428 per 7 hour shift.

    Don't know about you but that seems like a pretty good income. That Merc 450SL purchase is not in danger!

    • PVA on 13/01/2015 - 20:52
      +3

      my local doc charges $93 for a standard visit.
      he has a nice Porsche, wife has a M BMW and Mini. Office has lots of photos of the OS holidays and is closed every Tuesday cos he plays golf. His kids when they were younger were at boarding school (even though the boarding school is 10 minute walk from where he lives). Poor bugger.
      stopped going to him when he tried to get my medical records off his computer and they had all disappeared, wasnt even interested in trying to get them back. Nice guy but not worth the money.
      I go elsewhere now .

      you may find bulk bill doctors dont pass the full $20 on but only part to keep the customers coming in.

      • jackary on 16/01/2015 - 13:10

        Do you hold as much resentment for every checkout chick that's better off than you too?

    • jzdhgkd on 13/01/2015 - 23:21
      +10

      What kind of GP pushes that many patients? All the ones I've ever visited only see 4-5/hr at the most.

    • eve on 14/01/2015 - 03:36
      +10

      That's a really big assumption and a poor one at that.

      If your GP spends 5 minutes with every patient then you need to leave them right now.

      A good GP has the skills and passion to make a real difference to your health and your life.

      Skills in palliative care, psychiatry, geriatrics, minor surgery, dermatology, endocrine, cardiology, respiratory, paediatrics, gynaecology, obstetrics, sexual health.. I might as well list all the specialties along with these and throw in counselling and social work too.

      None of the above take 5 minutes. You are just clearly not someone who understands what illness is.

      If you take it back to something that is less unrealistic - $17 for 10 minutes or $102/hr pre-tax, then take into account business expenses and registration expenses - paying for a clinic overhead, paying for the secretary, nurses, the medical record/information security, various registration costs, ongoing costs of education.

      I don't know which of your bulk-billing GPs is driving a merc…

      • kingmw on 14/01/2015 - 23:00
        +1

        A consultation would normally include calling in the patient, waiting for the patient to come and seat down, taking the history, performing the examination, prescribing medications, printing a medical certificate, ordering tests and telling them about follow up. All this is not possible in 5 mins (i.e. 3mins of patient contact time) unless you are cutting some serious corners.

        • Miss Dior on 15/01/2015 - 20:15

          "Cutting serious corners"….. Like this doctor, note the "background":

          http://www.caselaw.nsw.gov.au/decision/54a63ffa3004de94513dc…

          It took over a decade to catch up with him. I saw patients spend 3 minutes or less in his surgery years ago and wondered how he got away with it. Yes he was in a bulk billing practice for many years. Medicare managing to get repayments back from him doesn't resolve the poor care provided to the patients. All of which was predictable when reading the background. It was obvious there was a problem in 2002 but it took until nearly 2015 for deregistration to be the result.

          If a doctor is cheating the system in one way then they are probably not the best in other ways and that reflects badly on the many good ones in the system.

          Interestingly another doctor who has practiced at the same practice has recently been charged with murdering his wife.

          http://www.dailytelegraph.com.au/news/nsw/woodbine-gp-brian-…

          Sadly these people are practicing in an area that has many people from low socio-economic groups who rely on this type of bulk billing large scale medical practice. I'm not sure that changing the way doctors' visits are paid for will change the bad behaviours of those responsible though.

  • sleet on 13/01/2015 - 21:32
    +9

    Working in the health industry, I have a few comments to say. Cunning move by the Abbott government. Doctors are raking it in too, don't feel too sympathetic.

    Most important of all - look after yourself guys. Eat healthy, exercise regularly and enjoy life spiritually and mentally. The cost of health, as a young adult may be low but later on it in life, you don't want to be reliant on 5-6 different medications to keep you going.

    • what on 13/01/2015 - 21:53
      +1

      You are so right. Unfortunately, once someone is in the system, it is very difficult to get out.

      • eve on 14/01/2015 - 03:55
        +4

        Take control of your health and have a consultation with your doctor about medication rationalisation.

        The fundamental of a doctor's job is to help guide you through the choices you can make for your health. The GP is MEANT to be in the ideal role to coordinate your health care, supported by specialists if required.

        Doctors are systemically pressed for time (due to whatever lack of resources - funding, staff numbers)… and this reduction in rebate makes it worse for the doctors who really care. (I'm thinking from the GPs office to our overcrowded EDs and blocked out public hospital wards).

    • eve on 14/01/2015 - 03:51

      What part of the health industry do you work in?

      What do you mean by "raking it in"?

    • ordinaryboy on 14/01/2015 - 09:30
      +8

      Working in the health industry you should be aware that sometimes people get sick despite living a completely healthy lifestyle.

      • sleet on 14/01/2015 - 20:35

        I understand people get sick despite being fit and healthy. I was purely advising people to look after themselves to minimise illnesses and future morbidity.

      • tyler.durden on 14/01/2015 - 21:02

        yes, people do get sick

        but u can reduce your chance of getting sick…

        As they say prevention is better than cure

  • chonghe on 13/01/2015 - 22:23

    Does this scheme affect a OSHC (Overseas Student Health Care) student?
    I am with OSHC Medibank and previously I visit a GP paid $50 and got $36 rebate after that (paid $14)
    Does it mean that in future I have to pay $34?

    • lplau on 13/01/2015 - 22:39

      The government doesn't have any say about private health insurance. hence the name PRIVATE.

      This only affects Medibank which is the government health system, overseas students don't have access to medibank.

      • what on 13/01/2015 - 22:44
        +4

        Correct me if I am wrong, but don't you mean Medicare? I'm pretty sure that Medibank is one of the private health insurance companies.

        • chonghe on 14/01/2015 - 07:26
          +1

          I got what you mean. Is Medicare that's affected, not Medibank?
          I feel sorry for fellow Australians.
          Thinking the other way round, is a good motivation for us to keep healthy!

        • lplau on 14/01/2015 - 09:16

          @chonghe: Haha typo, too late at night for me. I meant Medicare.

  • bargain-bunny on 13/01/2015 - 23:22
    +5

    And what about the people with chronic conditions/diseases that require them to make routine/regular visits to the GP? I can feel Australia's health status plummet already…

    • what on 13/01/2015 - 23:42
      +4

      I'm with you. This is going to be terrible for anyone with a chronic illness. Unfortunately, those that cannot afford it will visit their doctor less and potentially jeopardize their health.

    • [Deactivated] on 13/01/2015 - 23:56
      +3

      That's right. My mum needs to have blood tests to keep an eye on liver function and blood pressure trsted every week, that's 2 consults = 1 to get referral, then 2 days later get the result.

      There is no way she could afford this. She will either not go every week, or go to hospital emergency and clog up even more our already stressed public hospitals

      • what on 14/01/2015 - 00:13

        Poor lady. She must be concerned. She will have to wait for ages to be seen via the public hospital emergency system.

      • arcticmonkey on 14/01/2015 - 07:44
        +5

        Just a question, Labor told you all before the election the Abbott government would cut, cut, cut yet many people seem surprised.

        Did anyone follow what was happening in different news sources and make an educated vote?

        • lplau on 14/01/2015 - 09:19
          +6

          Everybody just had their pitchforks out for Labor because of Gillard. However they didn't realize that Labor is actually the better evil between the 2 parties.

          Cut Cut Cut is where we are heading for the next few years, people are going to lose more money because of the Abutt Government.

        • JayM on 14/01/2015 - 15:50
          +1

          One word: Murdoch.

        • 2ndeffort on 16/01/2015 - 16:22

          I follow the news closely and I was straining at the bit for 8 years to get rid of Rudd and Gillard. The choice was either 'cut cut cut' or 'borrow, spend, borrow'. You cant have your cake and eat it too.

          If your credit card is maxed out you dont fix your problem by listening to a bank that tells you about all the nice things you can continue to have by increasing the credit limit, you listen to the people that tell you to make some hard decisions and tighten your belt, adjust your lifestyle and get your debt down. There is no point whingeing when the reality of having to miss out on some of the things you were buying on credit kicks in.

      • GaryQ on 14/01/2015 - 17:48
        +1

        Tony Abbott thinks your mother is a burden on the system, since she is not working or paying tax

  • x d on 13/01/2015 - 23:45
    +2

    Official release from the RACGP - the college of general practitioners of Australia:

    http://www.racgp.org.au/download/Documents/News/Patient-info…

    At the very end there are links to make your feelings know about this issue to the government.

    Cheers.

  • [Deactivated] on 13/01/2015 - 23:51

    Slightly Off-Topic:

    I cant understand why in AU we are being ripped off for the cost of medicines

    I was in Paris last year, got a sore throat, and the pharmacist gave me anti-biotics (amoxycillin) - no doctor visit = no additional cost. The brand I think was GSK (same manufacturer as the ones here)

    And the price: 2.45 EUROS. This was over the counter. And the prices are similar throughout WESTERN Europe, Germany, Italy, etc. not communist russia.

    Here in AU the same meds are $6 on concession, and $24 full price. 400% difference!!!

    Can someone PLEASE enlighten me?

    • eve on 14/01/2015 - 04:15
      +13

      In Australia, to that we would say two words: antibiotic resistance.

      Australia is concerned about antibiotic resistance and multi-resistant pathogens therefore a doctor review is a must. And it would be better if the rest of the world thought the same way. Medical governance of antibiotics. In India and other countries, there are aggressive bacterial organisms affecting people for which the range of antibiotics is diminishing due to historically inappropriate administration of antibiotics.

      For the actual cost of medications - ask the pharmaceutical companies and pharmacists. Doctors don't have anything to do with that.

      • PCHammond on 14/01/2015 - 18:40
        +1

        For the actual cost of PBS medications, ask the government and PBAC. They dictate what is paid. Often, drugs will be knocked back because the govt thinks it's too expensive.

  • OzPunter on 14/01/2015 - 00:17
    +3

    Now my medicare card is as useless as my debit card!!!Damn this Government

  • BartholemewH on 14/01/2015 - 01:18
    +1

    I currently pay $78 per visit and have paid over $55 for the last decade. Bulk billing doctors in regional areas are as rare as rocking horse s***.

    • PCHammond on 14/01/2015 - 19:04

      I know of a bulk billing centre in the middle of nowhere of NSW.

      To say that I was shocked when I found out that it was bulk billing would be an understatement. It's a damn small town.

  • thetownfool on 14/01/2015 - 01:18
    +46

    As a doctor (not a GP) this is beyond (profanity) up. I try not to take a side on the political fence, but the stupidity of this should be evident to both right and left.

    General practice is what keeps patients out of emergency and should be as accessible as possible. Pay $50 to see your GP or go to ED for free? Do people honestly think that won't play a factor in the decision making of those without expendable incomes. It punishes those who see doctors the most - the chronically ill and elderly, as well as those with young children. These are the groups that as a society we should be looking after - and if you don't ever visit the doctor then feel very fortunate. While smoking and obesity play a role in chronic illnesses, many others have nothing to blame but bad luck.

    In response to some comments above

    • Medicare doesn't cover dental, so that's not a fair comparison (you can have your appendix or gall bladder out in Australia for free). Whether it should is another argument entirely. It was trialled and abused by a small number, as government funded services generally are.

    • $1428 per 7 hour shift - Genius right? Except you forgot the receptionist, the nurse, the rent for the building they're consulting in and the utility bills, the computers and infrastructure, medico-legal insurance. Also I know of no GP that sees someone for 5 minutes non stop for 7 hours. Pull your head out of your arse.

    • Yes a lot of GPs don't bulk bill anymore. That's because the rebates have barely increased over the last decade or more and have actually decreased when compared to CPI/inflation. Those who do try to make up for it in bulk - these are the GPs who get you in and out. So who does this cut target - the GPs who see patients quickly, which, you guessed it, will be more often than not those who still bulk bill.

    • Doctors are raking it in? Well yes I've never met a poor one. But when you've been top of the class in school, studied for many years, often more than a decade, and have to work on call and weekends, yeah they can probably argue to be financially rewarded. GPs aren't even in the high income earning groups of doctors, especially those who bulk bill - it's bizarre to attack them.

    Have no doubt this will target those who see bulk billing GPs the most and force many people into ED. It's bad from a patient care point of view, it makes no sense from a preventative medicine and health economics point of view, it's unfairly targeted at the poor and chronically ill. I'll stop my rant now, I think you get my point. Might be better off going to a government funded position at a private college and studying homeopathy….

    • kirynflare on 14/01/2015 - 22:50

      While I absolutely agree that health care should be affordable and accessible by all people who need them (which is how health care should be according to WHO), I would like to point out some of my observations.

      • I have seen a doctor who saw patients in 5 minute time slots for 7 hours straight - as an observing student, I was shown their appointment schedule. This is, disappointingly, a GP who owned the clinic, and gave the longer consultation requiring patients to his colleagues, while he raced through his consultations and raked in the money. NOTE: A huge majority of GPs are NOT like this, just pointing out there are people abusing the system (no surprise).

      • Many other health professionals work extremely hard in their studies to provide the best health care for their patients, and in some cases are equally qualified to provide the same level of health care. Too many patients visit the GP for minor things like the sniffles, and it's increasing waiting times for those who genuinely need to visit a doctor. I believe the government are "trying" to target these people with the increase in fees to reduce their expenditure in health care, but their approach is a complete miss.

      • eve on 15/01/2015 - 01:07
        +2

        Are you a medical student or studying something else? That must have been an extremely disappointing and uninspiring attachment. I hope you reported it to the education faculty so that they are not used as a preceptor again.

        A GP is important as a primary care point - a long term care coordinator. Allied health is important, but fragmented health care is not ideal.

        Ideally, a GP is a holistic generalist who will understand your health needs by getting to know you and your family through short and long consultations over years. Other health professionals may be qualified to provide care in specific areas of health, but (thinking at the top of my head) are unlikely to be able to comprehensively coordinate and cohesively interpret all aspects of health care as a GP should.

        A good GP as your primary health care contact is inexplicably important.

        • kirynflare on 15/01/2015 - 01:55

          I won't mention which field I'm studying, so blind neggers don't accuse me of bias. In addition, I would like to point out my following paragraphs are the collective opinion of several health student friends from multiple health disciplines, including medicine, pharmacy and nursing.

          Now, back on topic, a good GP is extremely important, as you have said, but what is even more important, is allied health, where health professionals communicate with each other. I believe the eHealth system the government is supposedly building is working towards that, where it places the responsibility of health upon all relevant health care professionals.

          Yes, a good GP should be a primary health care contact, but they shouldn't be the only point of contact. With a well developed eHealth system, I believe (with permission from the patient of course), any point of contact with a pharmacist for example, should be recorded, and be able to be viewed by the doctor upon their next visit. There is a lot of information, such as OTC medication, that the patient may not think as relevant, which the doctor may need to know about.

          EDIT: I couldn't complain to my education faculty, as it was considered an external visit I organised myself.

        • eve on 15/01/2015 - 03:19

          @kirynflare:

          I was interested in clarification as you commented you were an observing student, but it didn't sound like you were a medical student.

          Every person comes here with their own perspective and experience and your background does allow others to consider what biases/insight/lack of insight may result in your comments. Negs don't matter other than to give you an opportunity to consider why someone may have a different perspective. But you absolutely reserve the right to not comment on your background for any reason you see fit.

          To explain, I don't think anyone "only" sees GPs, I didn't mean that when I describe GPs as holistic generalists. Because of the training that a GP receives, they are in the best position to collate & understand information from medical specialists, the allied health (pharmacists, OTs, physios, nurses etc), and also possibly alternative practitioners (chiropractors, naturopaths) - and in result, (hopefully) convey the "bigger picture" information adjusted to a patient's level of technical understanding.

          It should be ingrained in the allied health professions to communicate to GPs.

          eHealth sounds nice.

    • eve on 14/01/2015 - 05:00
      +3

      Should we separate out GPs who care & GPs who don't care?

      RE "every GP only sees 5 minute consults for the whole day". The only that would be possible is if every patient that every GP in the GP practice saw was for a repeat script for pandal osteo. Even then, once in a while the GP would want to review the liver function, mobility, pain, consider physio, OT, referral to geriatrics/ACAT team, referral to orthopaedics, review mental health, check for other age-related comorbidities e.g. cardiac risk factors etc…

      I don't know much about the GP financial situation but I don't feel that your comments on how much you think they make are framed realistically.

      Re the "hmm hmm okay" doctors.. well the doctor-patient relationship is paramount. So if you don't feel you trust your doctor, then you need to find a new one who you feel cares. Isn't it a bit like finding a plumber, a gardener etc? You've got your good eggs and bad eggs. Anyway, Medicare does audit doctors already from my understanding.

      RE Progress in Western Medicine: time to catch up with the advances. Read on targeted therapy. e.g. afatinib for EGFR mutation NSCLC. It's the way things are moving now. Surgeons are fantastic and very important, it's about cutting out what you see, they've advanced in techniques too which is fantastic. Medicine is about biology and physiology, the micro and the nano… It's taken time and technology and research. It will need more time, technology, passionate researchers and funding. But there has been change in leaps and bounds exponentially especially in the last 10-15 years. I can't wait to see what will happen in the next 10.

      I would expect all good doctors would actually advise conservative measures including environmental changes and other non-pharmacological measures if you hadn't given them a good try already for mild issues first.

      I know this is being nit-picky but I am pretty confident that you would not be able to treat a kid in full blown respiratory distress from an asthma attack with natural medicines or environmental changes. Likewise with severe weeping, painful or infected eczema… I would be pretty confident to say that natural medicines or environmental changes aren't going to cut it at that stage.

      The "natural medicines" and "homeopathic medicines" are run by practically "big pharma" too.. so what makes anyone think its advertising is any different to Western conventional medicine?? (Other than the lack of quality evidence based research in many cases lol)

    • mooboy on 14/01/2015 - 12:25
      +3

      havent got very far in 100 yrs

      A few years ago, one of my friends got leukemia. The particular type he had, about 20-30 years ago, had a 100% mortality rate. Thanks to advances in areas like chemotherapy, he's now alive and pretty much 100% cured.

      I doubt he'd agree with you that there's been little advances in the last 100 years, especially as those advances are the only reason he's around now to be able to disagree with you.

    • thetownfool on 14/01/2015 - 14:37

      Deleted as not worth replying to.

    • Bullion78 on 14/01/2015 - 16:05
      +1

      I agree with you mate in some part. I have a love/hate relationship with big pharma. I am dependent on them for my survival being on immune suppressant medication for life after being transplanted, yet am convinced that many of the drugs that have been pushed on me ever since surgery have been unnecessary and have resulted in me collecting heart disease, type 2 diabetes, kidney disease, macro edema etc along the way.. And you know who benefits for me being afflicted with all these unwanted extras? One guess!!.. Yep big pharma as I remain a customer for life and are extremely profitable for them.. The losers are of course the tax payer and posterity who will pick up the tab later. The can of debt just gets kicked along the track for future generations to pay for.. What I have learned in my almost 40 years of having a hospital and doctors clinic my second home is that that medical doctors medicate, that's what they are trained to do, effectively drug pushers for the corporation. They are not in the business of preventative health and are invariably not interested in educating on why, how, prevent illness from occurring or managing.. Proof is in the fact that the average consultation is less than 10 minutes to see a gp, just enough time to give you a basic examination and scribble on a script for another drug… But our society has been conditioned not to question any of this stuff and to cast people that do as fringe or outside the accepted paradigm of accepted thinking. So 6 months ago, I revolutionized my diet in an effort to halve the medication I was on, without getting into specifics and boring you.. I have gone from injecting 60 units of insulin per day to none at all simply by removing carbohydrate and sugar from my diet almost entirely, perfect blood sugar range..chronic gout disappeared and no medication for it, kidney function substantially improved from.. Ready for it? Daily sodium bicarbonate.. And have dropped about 15kgs and feeling in the best shape of my life and none of this advice came from a medical professional, in fact when I presented at my last clinic appointment they were flawed by the transformation in all my blood markers.. When I mentioned the changes I had made all I got was raised eyebrows. Now people can scoff all they life but the reality is these changes were enforced by thinking outside of the box, changes that made good common sense and the results have been astounding. So I am firmly of the belief that our diets in the west groom us to become future customers of the pharmaceutical corporation and to make that contention is not conspiratorial at all, go and research Novartis profits over the last decade vs Apple, that should be enough. A few months ago, a poster shared a free streaming of the documentary called Cereal Killers which I encourage anybody in doubt to check out, it makes a heck of a lot of sense.

      • eve on 14/01/2015 - 23:41
        +1

        I really think you need to feedback to your transplant team. The Western Australian transplant teams.. they are phenomenal.

        It's really shocking to hear that you didn't receive adequate pre and post transplant counselling regarding the reasons for your medications and the long term side effects they cause in trying to prevent your body from rejecting your new organ. I would have thought it would be part of the informed consent process. I'm really sad to hear that you weren't involved with a multidisciplinary team that included transplant educators and dieticians or a diabetes educator. At least one of them would have talked to you about losing weight.

        I'm shocked to hear that none of your doctors advised you about losing weight and eating healthily.
        You've done an amazing job to lose weight - it's not easy and you have to be proud of your will power and achievement. Changing your diet would have helped you significantly in reducing your insulin resistance and your weight.. insulin also makes people put on weight so you've broken that vicious cycle! The weight and diet would have worsened hypertension and high cholesterol and increased your cardiac risk, worsened gout, renal failure etc etc..

        Organs are rare and a noble gift - the goal of the transplant team is to preserve and respect this. I'm really shocked that you felt scoffed by your transplant team - in fact you should be celebrated because you are the most important part of the team and did the right things for your health by losing weight!!

        Sodium bicarbonate is treatment used in conventional renal medicine for chronic renal failure. Ask your renal physician.
        Have too much of it and you'll go into metabolic alkalosis so if you are still active with your transplant team, make sure they know of it.

        There is really nothing alternative or non-conventional about the concept of losing weight to a healthy BMI, eating healthily, exercising, not smoking… these are really fundamental in the practice of modern Western medicine… Yes, doctors are trained to diagnose and fix things, but Preventative health is definitely in the curriculum of medical school and it is definitely on the best-practise agenda of all primary care doctors. Doctors didn't waste the prime years of their life studying to make sure people get sick and stayed sick.

        At the end of the day, a doctor can only guide you. It's up to the patient to listen, learn, be motivated and take control of their life.

  • qazwsx on 14/01/2015 - 04:55
    -4

    I read this article and thought it was one of the biggest beat up headlines out there. Given some of the previous posts, this might not be flavor of the month though.

    The $20 hit is exclusively for those with <10min consultations. Full stop. The $5 hit is separate and that affects everyone, but different topic.

    My 2c:
    1. This move actually encourages doctors to spend more time with you - why so much negativity? I don't think a check up <10min is appropriate for a lot of instances, and in the occassion it is warranted, well the doctor gets paid less for performing less work. Not sure where this initiative is catastrophically wrong.

    1. This headline is a beat up because it assumes every Joe blow has a <10 min gp visit.

    2. Just a general observation - universal health care does not mean free. It means easily obtainable and readily affordable health care - ie universally accessible.

    3. Country comparisons are always simplistic - different standards apply in different countries, and different inputs give different results. Wouldn't it be nice to live in a place that has the train system of Japan, the health system of the Scandinavians, the fresh produce of Australia, the cost of living of Indonesia, the highways of germany, the opportunities of america and the personal tax rates of Luxembourg.

    • lplau on 14/01/2015 - 09:22
      +9

      You left out all the people who have chronic illnesses. Poor people who needs to go in to get a referral to do some sort of procedure e.g. blood tests, x rays, etc.

      You have 2 ways of thinking about it, it will either make less people go to the GP e.g. people who need to get help but they don't due to not being able to afford it.

      Or there will be longer waiting lines due to GP's deliberately taking longer. lol.

      Not sure why Libs are trying to fix something that isn't broken. There is so much more areas they can cut costs in, but they choose not to because those large corps who support the Libs will get pissed off.

    • onlyletters on 14/01/2015 - 10:52
      +2

      I walk into my GP every 6 months and request a full blood test which tells me how my health is, I can check my blood sugar and blood pressure at home, far better than getting my doctor to diagnose me.

      For me, I will talk about shit for the other 9 minutes just so I don't have to pay the full $20.

      The government is stupid.

    • meumax on 14/01/2015 - 13:31
      +2

      It might not just affect those who have < 10 minute consultations. Consider this scenario:

      GP currently bulk bills all patients. Changes come into effect to reduce benefit for <10 minute consults and then the $5 reduction to all benefits kicks in after July 1.

      So the GP is now losing money on their short consults. Plus, they now have to decide what to do about the $5 decrease across the board. Do they charge a $5 co-payment to make up the shortfall? If so, they might have to invest in new cash register terminals (if they didn't have any), and train or hire more staff to handle the extra administrative burden.

      Because the Medicare rebates are already behind CPI increases and will be frozen until 2018, the GP may get sick of the governments constant attacks on their business and take the option to stop bulk billing altogether and just recover what they think is the fair cost of each consultation from everyone which might be more than the Medicare benefit schedule fee.

      If GP stops bulk billing, then everyone (including those who have a long consult) will have to come up with the cash up front to see the GP. Sure, they could apply later for a rebate from Medicare, but given that the Medicare schedule fees haven't kept up with CPI over the years, it's likely the GP would be charging more than the schedule rate which would leave you out of pocket. A "gap" if you will. Unfortunately not a gap which could be covered even by private health insurance as PHI doesn't apply to services for which there is a Medicare rebate available.

      So by attacking GPs businesses and undermining their profitability it could force more to stop bulk billing just to remain afloat. When that happens, everyone will be affected, not just those who might have a <10 minute visit.

    • dazweeja on 14/01/2015 - 15:15
      +2

      It always was less. Now it's so ridiculously low that either a) the doctor will BS for 5 minutes to get the consult over 10 minutes, b) the bulk billing doctor will now not bulk bill and the patient will now get a consult charge + $20, c) the cost of a non bulk-billing doctor will go up $20. All of these consequences are undesirable. In the first, what a waste of valuable resources and what happens to the patients who would otherwise have received care? In the second, spare a thought for all the people with chronic illnesses that just need a script. If I've got the cold that's going around and I don't want to share it with my co-workers, I have to get a certificate. That will now cost $20 more so maybe I'll just go to work and make everyone else sick instead? Great outcome.

      I'm sorry but all these measures that the government are thinking up to stop people going to see a doctor are completely misguided.

  • meumax on 14/01/2015 - 11:02
    +3

    There are currently three types of medical practice.

    1. Bulk bill all patients regardless of status
    2. Bulk bill some patients only e.g. pensioners/children etc. Non bulk billed patients apply for rebate themselves later
    3. Charge all patients for service. Patient can then apply for Medicare rebate themselves later

    Over the years the medicare benefit for consultations has not increased in line with CPI with the result that GPs who bulk bill are already feeling the pressure because their overheads have gone up (rent, electricity, wages etc), but their rebates stayed the same.

    In response, some previously bulk billing GPs have already shifted to full fee recovery. Some have claimed that some GPs respond by reducing the consultation times and trying to cram in as many patients as possible. The so called "6 minute medicine" problem.

    Currently around 80% of all GP visits in Australia are bulk billed i.e. the patient didn't pay anything at the time of consultation.

    The fear is that by reducing and then freezing the medicare rebate until 2018, this will force even more GPs who currently bulk bill to move to full fee recovery. Then that would definitely be the death of the "Medicare culture". I define this as the expectation that visiting the GP should be free.

    The thing is, studies show that GPs are the most effective way to maintain a healthy society. Therefore I can't see how anything acting as a price signal to ration access to GPs could lead to better health outcomes. This morning I was reading how in the UK, hospital emergency rooms are swamped by people trying to get free consultations. I would not like to see something like that happen here.

    I read another study (forget where) in which one group was charged nothing to see a GP, another was charged a little and another was charged a lot. The study found that even the small charge deterred people from seeing the GP. Unfortunately it is the first GP visit which is the most vital in saving lives (and money) by the early diagnosis and intervention of treatable illnesses. Again, I cannot see how a price signal to deter GP consultations can lead to better health outcomes here.

    More evidence. In the US it's user pays for everything. Yet per capita for dollars spent on health, the US ranks far behind Australia on health outcomes. The lesson I think is that an evidence based policy would not attempt to limit GP consultations in any way, but actually encourage them and also increase the supply of GPs to the system.

  • [Deactivated] on 14/01/2015 - 11:09

    I don't give a shit what the doctor costs, if I'm sick, I'll pay to get healthy. You can't put a price on health.

    • [Deactivated] on 14/01/2015 - 12:46
      +2

      And that is what they count on. People will pay anything to get better, even 000's to witch doctors and charletans

      • [Deactivated] on 14/01/2015 - 16:51

        I agree, when the target wage for senior orthopaedic surgeons in Melbourne is $3 million a year, it is too much, but we are talking GPs here.

    • what on 14/01/2015 - 13:09
      +8

      You are right. You cannot put a price on health. Where will the poor get the money from when they get sick?

        • what on 14/01/2015 - 17:00
          +2

          Sometimes it is not their fault that they are poor and their illness may stop them from working.

  • Stevecro on 14/01/2015 - 12:05
    +1

    I don't know enough about this situation, but why don't they just increase the medicare levy from 2.0% for example to 4.0%?

    • Incrediho on 14/01/2015 - 12:33
      +2

      Well, for one that is a large tax for relatively limited "free" healthcare benefits.

      Personally, I'd be happy to pay for it if it increased coverage to dental and "allied health" + if the rebate percentages were higher where it didn't already cover all costs. But I think it would be a hard sell for many who already complain about how high their taxes are.

      • [Deactivated] on 14/01/2015 - 12:44

        +1 agreed

  • [Deactivated] on 14/01/2015 - 12:32

    As far as I could see the govt aim is: MAKE DOCTORS CARE MORE ABOUT PATIENTS rather than treating them as cash cows. Im not saying that is their motive though, im surr its money :)

    My prev GP centre bulk bills, and EVERY doctor drove a Merc at least, and not a "cheap" $50K one either. So the GP business seems to be profitable.

    My family were patients from when they opened (foundation members?). They were very caring at first, but as time passed they became more and more the 5-minute "hmmm, hmmm, take these, see me next week [doctor walking towards door]" doctors. While the Mercs started lining up in the car park. So we left.

    Before the drs among us start bagging me: I am retired now but have had over 30 years experience in conventional and alternative medicine (not doctor). So sometimes I know what I am talking about.

    I dont agree with the Liberals very often (btw I was a member and got out) but in this case I agree with them: get away from 6 minute medicine. So, who was it that said "youre afool if you think doctors see a patient for only 5 (6?) minutes"? Say sorry. Just heard Frydenberg say this exact thing. So the govt knows it but you cant admit it. Dr eve? Dr the town fool? Anyone?

    • thetownfool on 14/01/2015 - 14:14
      +7

      Yikes… not even sure where to begin here.

      The medicare rebate amount is hardly relevant to your anecdotal evidence that every doctor drives a mercedes. Yes GPs make a comfortable living. Why on earth shouldn't they, they've excelled in their studies, go through a decade or more of training, which is always ongoing, and work afterhours/on call/weekends. You think they should absorb the cut for the common good rather than increase their charges? As a previous member of the LNP that's a pretty bizarre almost beyond socialist attitude.

      Make doctors care about patients? Really? Your 30 years of experience tells you we don't care? I've had friends and bosses in tears over poor outcomes and bad diagnoses. I've worked 30 hour non-stop shifts to look after patients as their was no one else on. I'm hardly the only one. I'm sorry some doctors have you jaded because they drive mercedes but that statement is pretty offensive. You have no idea what you're talking about.

      I lost you at the end there? Not sure what you're on about. We know exactly how many consultations are 5 or 10 minutes from the BETTERING THE EVALUATION AND CARE OF HEALTH (BEACH) study. Holy shit evidence!? Yes, actual logic and reason rather than personal experience and anecdotes. No doctor would deny some patients are seen for 5 minutes as that is all they need, why see them longer and keep the waiting room full?

      You went to a bulk billing GP as it was free. Now you expect everyone to pay? Will you happily pay when your GP stops bulk billing? What do you think those who have to see their GP weekly or who can't afford it will do?

      Sometimes you might know what you're talking about. Sadly, not this time.

      • PCHammond on 14/01/2015 - 19:01
        +2

        Agreed. It looks like your friend loves his anecdotal evidence.

        FWIW, I know plenty of doctors who drive pretty crappy cars. Hell, my own father is a GP and drives a car that was made before 2000 (that I consider a pile of junk).

        I tell everyone the same story. When I was a kid and finishing high school, I asked my dad what to do. He said firmly not to become a doctor. You need to be the top of your class, do a TON of study for years and years that never ends, you need to go through a long process before you can even practice wherever you want, and you forever need to bow to the government. Plus the added stress from patients abusing you (always plenty of drug seekers) and the government wanting to pay you less. Then you need to have continued education and pass any exams or else you will be deregistered. Then you need to put up with practice management. Then you need to put up with the emotional and mental stress of patients dying.

        When a patient dies, you get very upset because they are someone that you know well and someone who trusts you. Sometimes you can second guess yourself and ask yourself if there was anything you could have done. Then theres the possibility of litigation from people who second guess you.

        In the end, it's not worth it to become a doctor if you are in it for the money. If you are that brilliant and hard working to be a doctor, you may as well do something else (eg law) and earn a ton more. You need to have a real passion to become a doctor.

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