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

        • Twocupteabag on 15/01/2015 - 09:47

          What did you end up doing for a career?

        • PCHammond on 15/01/2015 - 14:23
          +1

          @Twocupteabag:
          I won't say, since it would easily identify me, but I work within the healthcare industry, so I know many many doctors and medical staff, and I know the rules/regulations and goverment policies well.

          I really don't understand why some people here are pissed off at Drs, let alone accusing them of being money hungry and unsympathetic. Of course there are some money hungry and unsympathetic drs, but Drs are like any other group of people and you have nice ones and mean ones. However due to the nature of the occupation, you find more sympathetic and kind people

          Personally, I think change is bound to happen, be it this year or the next or maybe even 10yrs down the track. Doesn't matter what party is in charge.

          For those of you who are all "OMG LIBERAL SUXXX LABOR IS BETTER", bear in mind that Labor is just as bad, but you probably won't hear about how they save in healthcare because they do it in sneakier ways. They liked to not approve drugs for the PBS because it would cost them X amount of money in the short term, even though it would save many millions more long term and many lives. There was a period of time during the last Labor government where damn near nothing went through to the PBS even though there was a positive PBAC recommendation. I wouldn't describe myself as a Lib or Lab supporter, since I think they both have their flaws.

      • eve on 15/01/2015 - 00:32
        +1

        Thank you thetownfool and FiftyCal.

  • [Deactivated] on 14/01/2015 - 12:57
    -1

    Why the negs for those (other than me) expressing alternate views about short consultations?

    • meumax on 14/01/2015 - 13:16
      +5

      I'm not sure short consultations are a problem. The average is 14 minutes and the median is 12 minutes. Only 10% were 0 - 6 minutes.

      Source: SMH

      I don't think the governments policy is aimed at the six minute medicine problem, it's a price signal to reduce demand for doctor consultations in order to improve the budget.

  • ironsword on 14/01/2015 - 14:06

    Does the revenue raised from this measure go towards the $20 billion medical research fund?

    • sagrules on 14/01/2015 - 15:34
      +4

      That medical research fund was a farce to get on the good side of voters. Only the interest earned would go towards the medical research fund once it reached a certain cap and even then the LNP were vague on the details. Why cut existing medical research to create a new fund?

  • shaybisc on 14/01/2015 - 15:44

    boo hoo- GPs will have to spend all of 11 minutes with a patient to earn their regular fee.

  • ethereal88 on 14/01/2015 - 17:47

    No lie here, don't #$!@ about with health. Just don't. I've had surgery last year more than once for fairly moderate conditions that really knock you down. I'm not talking about sniffles but chunks out digging with a scalpel. I was in no condition for anything for quite a while and if this GP did charge (never mind the specialists), there goes another few hundred. Health and education are sacrosanct, what good are you to society if you are stupid and chronically sick? I'm not talking getting pissed and a day or two off work, I'm talking real issues.

  • PCHammond on 14/01/2015 - 18:50

    You all do realise that if Drs do an excessive amount of consults like some of you are suggesting, Medicare investigates them for excessive billing. Doctors get warnings and can even be deregistered for this. I know of a few who have recieved official reprimands and are now being monitored.

  • amsaini15 on 14/01/2015 - 19:40
    +3

    I cant understand why government is not targeting family benefits (for people who can afford), people buying/selling properties to make profit, renovate/build granny flat sell, foreign buyers, tradies working cash in hand, taxi drivers showing less income, etc etc. There are plenty of loopholes to close before attacking medicare.
    Tony Abbott wanted to pay for mothers to sit at home and get paid but chronic sick have to pay for every visit?? Doesn't make sense.
    Not that Labor has offered any good alternative but I would be certainly kicking our Tony from the office come next election.

    • kabigon on 14/01/2015 - 21:14
      +3

      Next the govt will start charging people to attend their own Centrelink appointments.

    • Thaal Sinestro on 18/01/2015 - 03:50

      Don't forget negative gearing. it costs the government billions each year in lost incoming. Another form of welfare for the rich.

      • [Deactivated] on 18/01/2015 - 12:20
        +1

        The trades blackmarket, super concessions, trusts, novated car leases all relatively easy to fix with proper will. Or how about a mining super profits tax, or a tax on carbon emissions? Not for Abbott and his mob, they prefer to subsidise multinational mining (80% of the profit from OUR respources head overseas) and big polluters using taxpayer dollars.

        Or they could take a leaf out of the conservatives in the UK (who are actually much closer to liberal in most cases than our US cloned neo-cons) and introduce deeming taxes on the tax-avoiding offshore mega companies. They can continue with their massively overpriced internal charges which simply shift profits to their low/non-taxing havens but they'll still be paying tax at the rate they should have. The western world will be watching that one closely assuming they actually press ahead with it.

  • [Deactivated] on 14/01/2015 - 21:29
    -3

    Please don't sign!
    From the beginning I was happy to pay $7, it was fair enough, $7 is not the price of a pizza or your lunch meal or your beer or wine or your smokes nor even going to movies let alone visiting a GP!
    Then people started whinging and whinging for $7, now we have to pay $27 which is still good, it is better than $57 if they later come up with a new idea, so please stop nagging!

    • what on 14/01/2015 - 21:53
      +9

      Please be aware that not everyone is in the same situation. It might be OK for those who can afford it. We, all of us, need to have more empathy for those who are not as fortunate as us. There are genuine people in society, who, because of no fault of their own, do not have much money. If these people become chronically it, how will they afford to go to the doctor. Some ill people need to see the doctor on a weekly basis. Even those who can afford it would begrudge the cost of a weekly appointment.

      • kingmw on 14/01/2015 - 23:26
        +4

        Also people who are generally ill or have a serious condition (such as cancer, 1 in 2 Australian men and 1 in 3 Australian women will be diagnosed with cancer by the age of 85 (Ref: http://www.cancer.org.au/about-cancer/what-is-cancer/facts-a…)) are unable to work and thus do not have the income to attend their medical appointments.

    • scrimshaw on 15/01/2015 - 00:11
      +8

      Like the previous commenter said: It's simply setting a precedent - this tax, once approved, will then be increased by successive govts.

  • sal78 on 15/01/2015 - 04:56
    +6

    im a practice manager at a clinic. they slyly brought this in and there's no way to stop it. senate isn't back yet to stop it. i'm so mad. this is worse than the $7 co payment. you may even see bulk billing clinics closing. as a principal doctor who ownsa practice, they may earnmore working for someone else. medicare fails to take into account small clinics with one or 2 doctors. even being a top earner, the principal gps jncome is the only income and they need to pay rent, staff, medical supplies, equipment and everything associated with running a business. but medicare doesnt look at any of that. a gp working for someone on $700k billing is the same as a principal gp on $700k billing eventhough the principal gp's net take home earnings could be < $100k. medicare only looks at medicare billing.

    we will definitely struggle since we bulk bill in low socio economic area. i feel bad for our patients especially those with chronic conditions. my gp is so good that even after reaching medicare's quota per day, if someone is really ill and walks in.. he will see them no charge. patient has no idea. it's business really.. still need to keep customers happy. they will come back.

    ive always voted liberal but never again. not now that even my job may be affected by their policies.

    • scrimshaw on 15/01/2015 - 10:46
      +1

      My local practise just posted a notice on their window stating they are switching to an appointments-only system by next week — people who turn up without making prior arrangement may have to either wait a long time or be asked to go home.

      • sal78 on 15/01/2015 - 11:27
        +1

        We recently changed to appt only now that we are under medicares watch list. Medicare does not take into account that often ppl in this area don't have credit to even make a phone call.

        • sagrules on 15/01/2015 - 15:36

          What is a 'Medicare watch list?'

        • PCHammond on 16/01/2015 - 14:19
          +1

          @sagrules:
          Based on what they said about reaching medicare's quota per day, it appears as if they were done for excessive billing by medicare, so medicare is keeping an eye on them.

    • shaybisc on 15/01/2015 - 13:22
      +1

      If everyone always voted Liberal like you there would be no Medicare.

    • arcticmonkey on 16/01/2015 - 19:43

      If anyone votes Liberal again they better be rich or they'll deserve the pain that's coming to them.

      Good luck getting a bulk billed GP appointment or a degree for a fair price.

      This is a heartless Liberal government and many average Australians are lucky that just enough people had the common sense to vote Labor, Palmer, Green or independent.

  • sal78 on 15/01/2015 - 04:57

    dbl post

  • sal78 on 15/01/2015 - 05:10

    now im afraid there will be longer waitlist at clinics because some gps may spend longer time with patient than they really need to.. butsome clinics have to do this for the business to survive. smaller clinics with 1 gp etc ppl always ask me how long the wait but i can inly give them an estimate. i would need to know why the patient is seeing the doctor. it could be after care wound dressing, back for parhology results etc those would be 5 min consults.

  • richmond12 on 15/01/2015 - 09:43
    +1

    I think this introduced to target the doctors abusing the bulk billing. Unfortunately the minority has ruined it for everyone else.

    Seen it time and time again, the minority of 'GP doctors' hammering through customers just swiping for their medicare cards. I remember trying a few who just didn't care about solving the issue, just interested in getting you out of there as quick as possible. All they didnt was a type a few things in their computer and 'doctor google' version. I remember walking out a few times just confused. It was a waste of time and the waiting times were huge because they would like up like chickens ready to go.

    Most of the good doctors out there don't go this and spend time with you. Just stay away from those mass produced bulk billing places.

  • ilikeradiohead on 15/01/2015 - 13:24

    Everyone can cool it with the fearmongering, Abbott has backflipped

  • tommy-darko on 15/01/2015 - 13:29

    Adolf Abbott - Eliminate zee weak! Build zee master-race!

  • CI on 15/01/2015 - 13:31
    +2

    It has been abandoned!! http://m.theaustralian.com.au/national-affairs/health/govern…

  • [Deactivated] on 15/01/2015 - 13:48
    +3

    Another embarrassing back-down. This mob is clueless.

  • shaybisc on 15/01/2015 - 14:08
    +3

    Doesn't this government ever consult with the Senate before they try this sort of stuff on? They looked like they had never talked to any of the new senators on July 1 last year, 9 months after being elected, and everything they've done since has followed on from that.

    • tommy-darko on 15/01/2015 - 14:18
      +1

      Libs are a joke! Keep trying and failing, one term Tony! Bahahahaha

    • arcticmonkey on 16/01/2015 - 19:45

      Pyne should stop text messaging Senator Lazarus!

  • [Deactivated] on 15/01/2015 - 14:34
    +2

    It's been scrapped….for the moment…

    http://www.theguardian.com/australia-news/2015/jan/15/medica…

    • CheapCoffee on 15/01/2015 - 14:41
      +2

      I was just about to post this. They just have no idea what they are doing…

  • WaterMark on 15/01/2015 - 14:38
    +4

    Great work OP, your petition made them scrap it. LOL

    • sagrules on 15/01/2015 - 15:39

      I hope that is the case lol :-)
      Social media can be used in magnificent ways! Thanks to all those that signed the petition as well.

  • meumax on 15/01/2015 - 15:05
    +1

    Sanity has prevailed at last.

    • sagrules on 15/01/2015 - 15:39

      Lets hope that its not reborn post AMA consultations….
      From this article :
      http://www.smh.com.au/federal-politics/political-news/health…

      "Ms Ley said she was still committed to introducing price signals into Medicare including the revised $5 GP co-payment due to start July 1, but pledged to "pause, listen and consult".

  • sagrules on 15/01/2015 - 15:54
    +3

    On an unrelated note - I found this to be quite interesting diagram of broken promises by Abbott Govt
    http://www.abc.net.au/news/factcheck/promisetracker/

  • [Deactivated] on 15/01/2015 - 16:05
    +1

    (unscrupulous) doctor of au rejoice!

    Ch 7 news just reported:

    You can still get your $40 for 2-5 minutes work.

  • kche3572 on 15/01/2015 - 17:38
    +4

    $37.05 for 5 minutes of doctor consultation
    seriously, no one here think that's a bit too much?

    • x d on 15/01/2015 - 18:49

      Actually I have been thinking about what Tony Abbott is trying to do. Obviously there is money funding issues that the government is trying to fix.

      The changes would have discouraged short consultations, and hopefully better medical care quality. As a result there would be some savings in the budget as the daily billings for doctors who pushes patients through will be reduced on average.

      One might hope that the savings can be put back into say increasing the medicare rebates to other medicare item numbers, or to return the Medicare rebates to indexation, instead of freezing them to 2018 (imagine if no-one, polititians included get any payrise for the next few years).

      I myself have become a supporter of this proposal and bravo to the LNP for trying despite it not making through to the finish line.

      By blocking this I wonder what other funding models do the Labor and the Greens propose.

      Cheers.

      • what on 15/01/2015 - 19:28
        +2

        or maybe he just wants to raise funds for his paid parental leave scheme.

        • arcticmonkey on 16/01/2015 - 19:49

          Or give more incentives to wealthy minors.

      • [Deactivated] on 16/01/2015 - 11:10
        +3

        I don't think it would have discouraged short consultation, it would have just encouraged people to pad out their consultation into a longer one to avoid the fee. Or Doctors who know some of their patients might be having financial difficulties will extend the consultation to make sure their patient doesn't have to pay.

        This is the problem with this government: they come up with ideas but never consider their practicality(or sometimes their humanity). Remember asking job seekers to look for 30 or 40 jobs a month? Everyone thought this was a dumb idea from welfare advocates to business groups. It put unreasonable pressure on job seekers and would have flooded every business in town with incessant enquiries about jobs that probably didn't exist.

      • 2ndeffort on 16/01/2015 - 13:38
        +1

        I agree X d, I personally know of an elderly couple that used to book a double appointment every year on their family doctor's birthday. They would bake a cake and take it in to him, then have a chat and share the photos of the grandkids. he had been their doctor for a long time and it is nice in a certain way that they had that level of trust and realtionship BUT…they had pensioner health cards and used to do this appointment essentially on the government purse. That's right, he billed the government for the catchup out of our taxes then drove home that night laughing all the way to his Brighton house in his leased Mercedes.

        I am sure this is an isolated small example but what other things are doctors able to bill the government for with essentially little justification. If people have to pay $7 a pop they will only go if it is needed. Doctors wont be able to dream up bogus appointments and charge taxpayers for them (unless they throw in the corresponding lots of $7 each).

        Of course the government could never come out and say this because the medical associations would be all over them for it. Have a look at the doctor's carpark next time you have an appointment and then tell me why doctors couldn't absorb a bit more.

        • PCHammond on 16/01/2015 - 14:11
          +3

          So basically, it's the Dr's fault that the elderly couple wasted his time and everyone else's time? They booked the appointment, not the dr.

          I do agree about going when it's needed if people have to pay. Right now there are so many people who go to bulk billed centres while chucking sickies, or to dr shop for drugs, or to waste time. You would be suprised at how many old folks book appointments to have a chat. On one hand the old folks waste everyone else's time, however there are many who need this chat for their mental health, and often ailments can be picked up while having this chat. I hope you do realise that many doctors would support a copayment because they are sick of patients not taking them seriously because their services are free.

        • 2ndeffort on 16/01/2015 - 14:31
          +1

          @FiftyCal: Fair call 50 Cal, Not the Doc's fault for other people's reasons to book an appointment but we as taxpayers are still paying for it. Not sure I'm happy to pay more tax to support somebody else's social catchup or somebody else's 'get out of work' or 'shop for drugs' jaunt.

        • PCHammond on 16/01/2015 - 15:13
          +2

          @2ndeffort:
          Yeah I'm not happy about supporting the time wasters either. They just clog up the system and piss everyone off, especially the drug seekers. You would be suprised how many drug seekers there are and the extent that they go to. There have been many who are tracked going up and down the entire eastern seaboard going from doctor to doctor and pharmacy to pharmacy.

    • nikey2k27 on 16/01/2015 - 22:56
      +1

      No it not as 7year at school just be a GP i think they should get 180,000 min per years need to pay back 100,000 plus in debt to do it.

  • jwrathall on 15/01/2015 - 17:47

    Don't fear everyone…

    "Government scraps proposed Medicare rebate changes: Health Minister Sussan Ley reiterates commitment to GP co-payment"

    http://www.abc.net.au/news/2015-01-15/medicare-government-sh…

  • soupratt on 15/01/2015 - 22:58
    +4

    Its astonishing how much hysteria and misinformation is being peddled here by people that have't got the faintest idea about what is actually proposed. Hearing it from your friend's uncle's best friend who's auntie is your cousin doesn't make it right …. Read up on it properly and then pass judgement (I am not saying it is a good or bad idea but the stupidity of some of the posts is beyond belief).

    1) Medicare cost $8 billion a decade ago and will top over $34 billion by the end of the decade. The population has not quadrupled in that time…
    2) See point 1 for discussion about sustainability but for those that keep on peddling ideas that all is fine, remember that eventually, the proposed changes then will make anything that gets considering now look like a mild paper cut.
    3) The medicare levy covers less than half of that Medicare cost, the rest being paid for by general tax revenue. The NDIS levy will only cover a quarter of the cost of the NDIS when its fully operational. So guess where the rest of the money comes form ?
    4) 83% of GP consultations are bulk billed. Anyone want to argue that all 83% are the "vulnerable" or "battlers" we keep on hearing about. Seems that anyone living on the street or earning > $100K is in the same boat… Fair ?
    5) only 6% of the consultations are in the category where the changes are proposed. That is, consultations that are around 6 minutes. It is up to the GP if they wish to charge a $20 fee for a 3 minute script consultation. But how many patients would tolerate that ?
    6) Is it fair that a six minute conveyor belt or a proper 15 minute consultation are rebated the same ? Even more importantly, should the GP be charging you the $20 gap for a 6 minute consultation when they earn the same for a 10 minute consultation.
    7) The monolithic bulk billing clinics have made it their mission to cram in as many patient sardines into a one hour block as possible. They probably account for the 6%.
    8) Does anyone think there can be anything more than a cursory consultation in 6 minutes. All the people bleating about chronic illness, I can assure you, no preventative medicine happens in 6 minutes.
    9) The AMA is just a union like all others only interested in the hip pockets of their members. Nothing more or less. Not a criticism of it but it is what it is. But the AMA ARE however astounding hypocrites because not that long ago they had discussions trying to stamp out 6 minute conveyor belt medicine.
    10) The $20 fee if the GP decides to demand it does NOT apply to 94% of all other consultations. And I bet most GPs don't practice 6 minute medicine considering that it only comprises 6% of all consultations. The the hysteria about the end of the world as we know is completely unfounded.
    11) The idea of FREE healthcare is an illusion. It hasn't been free from 1960. There are copayments for PBS (medication) and try getting any radiological investigation without a copayment. The PBS copayment increased $6 under the ALP between 2008-2013 and the outrageometer wasn't going off the scale.
    12) The are very few countries (including most socialist nirvanas) that don't have a copayment. Even Sweden, with its existing massive tax base charges > $30 for a GP consultation. And their emergency departments have not imploded. Actually, there is a charge there for a ED review also …
    13) One of the mounting problems we have in Australia is that everyone is encouraged to be a victim and self interest as well as multitude of interest groups make any rational discussion impossible. Sadly, its going to be to the peril of the same groups when the trap door eventually opens and its a long way down to reality. By then, minor cuts and behaviour modification will be but a wild fantasy. I guess we can keep on pointing fingers and pick whoever it deluding us into believing that we can have everything forever and it will work… For a while at least.

    And in answer to the OP's statements

    "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?"

    There is ABSOLUTELY no evidence other than scare campaigns by interest groups. It hasn't happened anywhere else where there is a copayment. And the quick fire way to stop it is to change a copayment for ED reviews for patients who are not being admitted. Even the ABC agrees despite their spin.. http://www.abc.net.au/news/2014-05-07/catherine-king-gp-co-p…

    "It will prompt many doctors to stop bulk-billing shorter consultations because the payment does not meet their costs"

    Or maybe, just maybe, they will actually treat patients like real people and actually spend a realistic amount of time trying to diagnose problems rather than just being a triage service. Ironically, statistics that show only 6% of consultations are in the category of proposed rebate changes, means that short consults are NOT the bulk of GP visits. The only ones who will financially drown are the Edelsten type vultures who just rort the system.

    As I said, make up your mind about the plan, but FFS use actual information not shrills from the perpetually enraged.

    • 2ndeffort on 16/01/2015 - 13:46
      -1

      WOW, some sense in a public forum, I think I need a 6 min consultation to check my pulse and sanity!

    • Peck on 16/01/2015 - 19:47

      It is all academic now, but it was absolute BS that the government was peddling that the changes (now shelved) would result in better health care, AND savings of the expenditure on Medicare!! Thank Christ that the public saw through the lies!!

  • [Deactivated] on 16/01/2015 - 00:02
    +2

    Quote from an actual Doctor:

    After 20 years of medicine, I have become disillusioned with our broken health-care system, which
    requires me to churn through 40 patients a day, often scheduled in hurried seven-and-a-half-minute slots,
    leaving little time for us to actually talk, much less bond. I almost quit when a longtime patient told me she
    had planned to confess to a sensitive health issue she was hiding from me. She rehearsed what she would
    say for days, with the support of her husband. But when it came time for her to spill the beans, apparently,
    I never removed my hand from the exam-room door.
    She says my eyes were blank. I was a robot too busy to let go of the door handle.
    When I read that letter, I got choked up, felt a hiccup in my chest, and knew in my heart that practicing
    this kind of medicine was not what drew me to my profession. I had been called to medicine the way
    some are called to the priesthood, not to churn out rote prescriptions and blow through physical exams
    like a machine, but to be a healer.

    • PCHammond on 16/01/2015 - 08:01
      -1

      So basically, that doctor churned out a ton and blames the system instead of themselves?

      Avoiding the blame much?

    • eve on 18/01/2015 - 14:40

      So if the government actually cared about reducing short consultarions, the medicare rebate for short consults should go down and for the other levels of consultations should go up?

  • [Deactivated] on 16/01/2015 - 07:34
    +7

    For those saying "the health care system costs money, this should have been removed" consider that it's a fair enough assumption by a tax paying population that we have a right to affordable health care.

    I personally don't care what anyone says about the "costs" of health until the many tax rorts for the wealthy such as super concessions and negative gearing (which wastes billions on failed policy given that over 90% of NG claims are against existing dwellings) FIRST.

    I also suspect the people are the same ones who don't for a moment consider that preventative health costs potentially save far more burden on the system later.

    • arcticmonkey on 16/01/2015 - 19:55

      Post of the thread right here.

      Close these loopholes Joe Hockey before crippling and hurting average Australians.

  • sajidmib on 16/01/2015 - 07:59

    Relax Guys its taken down with all your efforts on signing the petition

  • Davo1111 on 16/01/2015 - 17:06
    +1

    After recieving spam from change.org (even after deactivating my account), i will never every sign a petition ever again

  • tyler.durden on 16/01/2015 - 22:37

    What about 5 dollar copayment?

    • andyken on 17/01/2015 - 01:09

      $5 start on july 1, so $20+$5
      http://www.theage.com.au/federal-politics/political-news/wha…

      but this $20 only for consultation less than 10 min, more than 10min no change.so this only effect for dodgy doctor who want to make quick cash

      • tyler.durden on 17/01/2015 - 07:41

        how can they still make u pay $5?

        I thought you need to pass legislation..

        • andyken on 17/01/2015 - 11:12
          +1

          CMIIW, Co payment need legislation but medicare rebate can be change by government without needed a permission from parliament/senate.

          It actually not a Co-payment, it is a cut off rebate from medicare ($5). its like the current $20 cut off (for short consultation) rebate.

  • p1 ama on 17/01/2015 - 10:18
    +3

    This is what I really don't get - why are we paying doctors the same amount regardless of whether they spend a couple of minutes with a patient or a full 20 minutes? That just doesn't make sense to me and it's not how most industries work.

    Why don't we work out an hourly rate for a doctor, then add up all the consultations the doctor has during the day and then pay them for the number of hours where they were with a patient. That way, if a doctor consults for 7 hours during the day, he gets paid for 7 hours. The number of patients he saw would be irrelevant.

    None of this discrepancy crap where a doctor can see 24 patients in 8 hours and get paid less than half of one who sees like 70 patients in that same time frame. They both worked for 8 hours didn't they? That doesn't seem very fair to me and the current system is simply begging doctors to churn through patients more quickly.

    • [Deactivated] on 17/01/2015 - 11:23

      We aren't. There are different rates for short and long consults.

      • p1 ama on 17/01/2015 - 12:14

        Yes, but do you really think it's fair that a doctor who sees 4 x 5 min patients earns 4 times more than one who sees 1 x 20 min patient?

        If we assume that doctors, like the rest of us, want to earn more, they're naturally going to prefer having shorter and more consultations.

        • thetownfool on 17/01/2015 - 13:56

          Incentives work on doctors as much as anyone. Pay someone for 7 hours work, regardless of home much they actually do, and you'll have a rather inefficient system. Pay someone for how much they do, rather than hours worked, and you've given them incentive to be efficient and work harder, which is what you identify in your second paragraph. The downside is that some will take advantage and abuse this, which is where the government was hoping to crack down.

          It's worth noting that the average consultation length is 12 minutes, only 12% are 6 minutes or less. Most (almost all?) doctors would see a mix of short and long consults in a day. But if one doctor sees 10 more patients over their 8 hours, those patients are satisfied and their health outcomes are equal, why should they not be rewarded for being more efficient and keeping their waiting room queue shorter.

          On your original point, as possumbly pointed out, there is a schedule of medicare rebates for differing consultations and a 20 minute one is not the same as a 5 minute one. Arguably, the doctor who has seen 4 in 20 minutes has worked harder? But I get your point that some doctors will abuse they system (as with any government funded setup).

          Simple fact is if you cut rebates GPs won't take a paycut, they'll just stop bulk billing and this will lead to patients paying out of pocket. You can argue GPs earn enough, but the practices are private businesses, they are entitled to charge as they see fit to run their business.

        • p1 ama on 17/01/2015 - 14:19
          +1

          @thetownfool: I'm all for doctors being paid well, because I'm aware of the hours they've put in, both before and during their time in private practice. I actually did a few years of medical school, but after spending time on the wards and seeing the hours doctors actually put in, I opted out, just wasn't my cup of tea.

          Everyone I met whilst in my medical course were smart people. After dropping out, I went into another course, practically graduating at the top of my class and going into honours and research…etc. So I know, first hand, that any person who has the capacity to get into a medical course and go through being an intern, resident, registrar and pass their fellowship exams will be able to easily get an equally well paying job in any industry they want. Yes, doctors are paid well, but equally intelligent people in any industry are paid just as well. I get that 100%.

          However, the problem is, unlike in most industries, there doesn't seem to be any sort of judgement on the quality of a GP. If you want to be an engineer, for example, you are, somewhat, paid based on the quality of your work output. You are paid an hourly rate, but if you work harder and are more efficient, you (usually) bring home a fatter salary.

          The problem with general practice, in particular, is that there doesn't really seem to be a system which benefits everyone.

          1) The current system lends itself well to doctors seeing more patients. If they can see more patients and shorten consultations, they get paid more, regardless of the health outcomes of their patients.

          2) The system I proposed, you rightly criticise as encouraging doctors to be inefficient, they drag on the consultation, so each consultation is longer so they earn more, but of course, longer consultations don't usually mean better health outcomes, they could just be chatting about the footy to beef up the time.

          I still think there needs to be a way to charge patients and pay doctors based on finer details, not just time and number of consultations. E.g. Do you agree that if a patient rocks up for just a repeat script, then the doctor should (obviously) be paid less than if he had to do a physical examination, for example.

        • PCHammond on 17/01/2015 - 15:49

          @paulsterio:
          You are assuming, like 90% of people here, that doctors are churning out <6min consults, when in fact the stats show that they arent.

          What you will find in real life is that there are many doctors who spend plenty of time with their patients and don't give 2 damns about short consults and trying to cut the time short. However, you will find that the majority of these doctors are private billing.

          You will also find that doctors who churn out huge amounts of consults get done for excessive billing by Medicare.

          You will also find that, like any population, there are some doctors who are absolute bludgers who will exploit any hourly based system. This would also clog up the already clogged up system.

          An hourly based system would also be hard to bill, as many doctors have a mix of private and bulk billing, as well as workcover and medicals.

        • p1 ama on 17/01/2015 - 15:58

          @FiftyCal: Perhaps a billing system more like the dental style would be more appropriate, for example, you're billed for each individual service done rather than as an all-in-one consultation?

        • [Deactivated] on 17/01/2015 - 21:01

          @paulsterio: Medicare already has this.

  • congo on 17/01/2015 - 21:52

    This will eventually leads to fewer good GP…
    GP have to dedicated many years to obtain their license, I think their renumeriation is justified.

    The politicians should just charge a tariff for each time they fly…

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

      I really agree that the quality of GPs will go down if society treats them with disrespect and disdain… It's the way I feel about teachers — they bring up our children and create the foundation for the next generation..but they arent treated with the respect they deserve!!

      And respect is not about how much they earn but the judgemental comments people make..

      Eg What is up with all these comments about doctor cars? It sounds like people dont believe doctors work hard enough to "deserve" luxury. So who in society does? Engineers? Movie stars? FiFo truckies? Real estate agents? It sounds like tall poppy syndrome!

      • [Deactivated] on 18/01/2015 - 15:30
        +1

        The broad brush attacks on teachers by the Abbott opposition and government is a national disgrace. There are always people in every walk of life who aren't up to it - the vast majority of teachers are and for what they do it's arguable at least some are underpaid, like a lot of public/social service workers.

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