Co-payment policy in need of surgery
One of the most important roles in health advocacy is to influence governments to change or scrap bad health policy.
Rather than simply saying ‘no’, the more successful health advocates suggest changes to improve bad policy or produce a whole new policy to take its place. This is the AMA way.
The Federal Government’s co-payment proposal, in its current form, is bad health policy.
In fact, it is not a health policy at all. It is an economic policy poorly disguised as a health policy. Its objective is to save dollars, not lives.
So, ever since Budget night, the AMA has been on a mission to have the policy changed or scrapped.
The AMA cannot support the Government’s co-payment proposal as it stands because of issues for vulnerable patients, the people who really can’t afford to pay the co-payment – the poor, the elderly, the chronically ill, and Indigenous Australians.
There are also issues to do with the viability of some medical practices, not just in general practice, but also in radiology or diagnostic imaging.
The overarching problem is that the Government’s proposal goes against the grain of health policy, which should be to encourage people to see their GP for preventive health care and chronic disease management.
We know the problems, but what are the solutions?
The political reality is that the Government is committed to this policy in one form or another. But the Government knows that it will have to make changes to win over the votes of the Senate crossbenchers.
This is where the AMA comes into the equation. We have produced a fairer and more equitable co-payment proposal. After all, the AMA and the profession are not opposed to co-payments, in principle.
We have been upfront with Government and informed them that our proposal will not deliver the revenue they were hoping for with their original policy. Our proposal would, however, deliver better health care for the community.
I have received good hearings in personal meetings with the Prime Minister, the Treasurer, and the Health Minister.
They asked the AMA to put forward an alternative proposal.
We are still involved in negotiations with the Health Minister and his Department, so we are not in a position to make the details of our plan public at this stage. Rest assured, our plan protects the best interests of doctors and patients.
We have talked to members and worked with our AMA Council of General Practice to make sure that they are happy with our alternative model.
Our model still achieves part of the Government’s objectives, in that it sends what the Government likes to call a ‘price signal’, but it is not a price signal that would deter the neediest and sickest from accessing care.
We are placing a greater value on general practice. But we are also providing protections for those that are most vulnerable in our community, while still encouraging people to see their doctor for preventive health care.
Australia’s biggest challenge in terms of health care is going to be an ageing population and the burden of chronic disease.
As people get older, they often have more chronic diseases. They need their GP to help manage and coordinate their care.
About 50 per cent of people between the ages of 65 and 74 have five or more chronic diseases that need to be managed.
They are not going to the doctor to fill in time. There is no evidence of a widespread problem with unnecessary visits to the GP. Some are claiming that large numbers of older Australians are going to the doctor simply to have a chat. They aren’t. They are getting the best possible care and advice to manage their conditions.
That is why we need to value general practice and primary care, to make sure that we manage people in our communities, keep them well, and keep them out of expensive hospital care.
That is why we need to influence the Government to produce better health policy.