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Government keen to hear AMA ideas on co-payment

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Government keen to hear AMA ideas on co-payment

The Federal Government has signalled it is keen to work with the AMA on doctor concerns about the $7 co-payment model and other health funding measures in the Budget as it faces a roadblock on changes in the Senate.

In a constructive hour-long meeting with AMA President Associate Professor Brian Owler just before Parliament rose for its five-week winter recess, Treasurer Joe Hockey made it clear that the Government was open to AMA ideas on how to improve key Budget measures.

At the meeting, A/Professor Owler reiterated the AMA’s position that, although it was not opposed in principle to patient co-payments, the model proposed by the Government was unacceptable because of its effect on patients, particularly the elderly, those with chronic illnesses, the less well-off and Indigenous patients.

“We talked about a range of issues regarding health funding in the future and AMA ideas about the sustainability of health funding,” A/Professor Owler said. “They [the Government] want to stay engaged with the AMA.”

The AMA is developing a co-payment model to present to the Government that will protect vulnerable patients and support access to primary care for all.

The meeting with Mr Hockey came two weeks after the AMA President held a similarly promising meeting with Prime Minister Tony Abbott and Health Minister Peter Dutton, following which the Government indicated it would reconsider its plan to apply the $7 co-payment to patients in residential aged care.

The conciliatory noises being made by the Government have come as it has hit a brick wall in the Senate, which has blocked a raft of savings measures in the Budget.

While a Bill to introduce the $7 patient co-payment is yet to be put to a vote in the Upper House, the measure in its current form appears doomed, with the majority of cross-bench senators appearing set to side with Labor and the Australian Greens in opposing it.

The political difficulties it faces in dealing with the Senate were driven home to the Government when it suffered a shock setback in its attempt to ram legislation axing the previous government’s carbon pricing regime through the Senate earlier this month.

It finally secured passage of its Bill last week, but only after agreeing to a raft of amendments demanded by the Palmer United Party.

It has now adopted a more conciliatory tone on other measures, including the co-payment and other proposed changes to health funding.

In this spirit, Mr Dutton revealed to the Australian Financial Review that he has begun talks with minor party and independent senators on the co-payment.

“My judgement is that there is certainly, in my space, the ability for us to negotiate on the co-payment, and on the measures the Government has in place otherwise,” Mr Dutton told the AFR. “We’re negotiating in good faith, and I’ve certainly been encouraged by the level of engagement from those senators so far, and those conversations continue.”

The future of the co-payment appears to hinge on the votes of the minor party and independent senators, as both Labor and the Greens appear entrenched in their opposition to the measure.

Last week, Labor leader Bill Shorten and Shadow Health Minister Catherine King presented a petition signed by more than 2500 doctors objecting to the $7 co-payment to back their calls for the Government to change course.

The petition included accounts from doctors about the potential impact of the co-payment.

A Melbourne GP recounted how a 66-year-old pensioner presented at their St Kilda East practice complaining of “a little headache” and checking to see whether they would be charged $7 before agreeing to see a doctor.

Upon examination, the patient was found to have very high blood pressure and needed to be rushed to hospital, where he collapsed and had to undergo emergency surgery.

“I am 100 per cent sure that if the co-payment was already applicable he would have gone home and died,” the GP said.

Another doctor from Norwood in South Australia recounted how, in the course of vaccinating a six-month-old infant she checked the baby’s weight and found that it was falling away.

She was able to explain to the mother the child’s need for more solids and more frequent meals, a diagnosis and intervention the doctor said would be unlikely if the mother, to avoid paying the co-payment, instead took her child to a local council centre for vaccination.

“These are real stories from doctors about real patients – 2500 of them,” Ms King said. “The Government needs to listen to these stories and needs to dump its unfair GP tax.”

Several health Budget measures were passed by the House of Representatives during the last sitting week before Parliament rose for the winter, including an increase in the co-payment for Pharmaceutical Benefit Schedule medicines and changes in the PBS safety net thresholds.

The changes are due to come into effect from 1 January next year, and the Government plans to introduce them to the Senate when Parliament resumes in late August.

But the Government is more relaxed about the timetable for its proposed co-payment. It is not planned to come into effect until 1 July next year, leaving almost a year to negotiate changes and amendments.

Adrian Rollins