Copayments for general practice visits
How do general practitioners view this possible change in financial arrangements?
There are reasons why it may be tempting to think that imposing a copayment for visiting a general practitioner is a good idea. It could instantly reduce the number of GP consultations, perhaps conserving funds for a possibly threatened Medicare. As GPs are “gatekeepers”, and therefore a bottleneck to accessing specialist services, fewer GP services might mean fewer downstream services. It might also be one of several means of reducing overdiagnosis.1 But is it really this straightforward?
Copayments are not new to health: we already encounter them between Medicare and specialist services, between the Pharmaceutical Benefits Scheme and medicines, and between health insurance and private hospital charges. On this basis, insisting that GP services should be “free” seems to devalue GPs. Why should GP services be shouldered with a bargain price while nearly all others charge more? Indeed, many GPs already charge their own “copayment” — arguing (in addition to the obvious pecuniary benefits) that patients will consequently value their care more. Moreover, most GPs are aware that some visits from patients are unnecessary, involving something that could easily have been managed at home, such as a self-limiting acute respiratory infection.