Log in with your email address username.


Important notice

doctorportal Learning is on the move as we will be launching a new website very shortly. If you would like to sign up to dp Learning now to register for CPD learning or to use our CPD tracker, please email support@doctorportal.com.au so we can assist you. If you are already signed up to doctorportal Learning, your login will work in the new site so you can continue to enrol for learning, complete an online module, or access your CPD tracker report.

To access and/or sign up for other resources such as Jobs Board, Bookshop or InSight+, please go to www.mja.com.au, or click the relevant menu item and you will be redirected.

All other doctorportal services, such as Find A Doctor, are no longer available.

Copayments and the evidence-base paradox

- Featured Image

To the Editor: The recent perspective by Keane on the effects of copayments on low-income populations1 overlooked the results of the 1968 decision in the Canadian province of Saskatchewan to impose a fee of $1.50 (all amounts are in Canadian dollars) for office visits and $2.00 for home, emergency department or hospital outpatient visits.

At the time the fees were introduced, the definition of low income was $1550 for single-person families to $4800 for families of five or more. The result of the fee was a statistically significant 14% decrease in the use of general practitioner services and a non-statistically significant decrease of 5% in specialist services by the poor.2 The health outcomes effect of this decrease in the use of services was not examined.

The Saskatchewan natural experiment should serve as a reminder that even small amounts of money can affect the volume of services that the poor receive.