Board Chairman of the Mid North Coast Division of General Practice, Dr Ian Arthur.
Board Chairman of the Mid North Coast Division of General Practice, Dr Ian Arthur.

Rebate freeze a hard pill to swallow for Coffs GP

USE of blunt instruments by governments is hurting those who can least afford it, says a leading Coffs Coast GP, and the wounding will worsen as time goes by.

Dr Ian Arthur, chairman of the Mid North Coast Division of General Practice, said the three-year freeze on Medicare rebates to GPs, subsidising private health insurance and forcing people on higher incomes to take out private medical insurance or face an extra tax were all blunt instruments of policy.

He said the proposed but abandoned GP co-payment, while it would have superficially helped GPs, was another blunt measure that would not have been in the public interest.

He said research had shown it would be more economical, efficient and equitable to redirect the money now paid into the coffers of private health insurance companies and private hospital owners into the public health system.

Dr Arthur said estimates showed the freeze on GP rebates, which is in place until June 30, 2019, would cost the average GP a drop in income of about $50,400 and when the freeze ended, any new increase would be on a lower base, which would have a long-term effect on the viability of GP practices well beyond 2020 and would encourage the growth of corporate medicine.

He said government figures showed bulk billing rates had dropped by half a percentage point in the last quarter, the first decrease in a significant time and showed a tipping point had been reached.

But he said because most doctors used a mix of bulk billing for some procedures like spirometry and wound dressing, while charging for consultations for some patients, figures showed the bulk billing rate just for consultations was around 69% rather than the overall 85% quoted for overall bulk billing rates.

He sees no evidence that bulk billing has encouraged people to visit their doctor unnecessarily.

Dr Arthur said the effect of the freeze would be gradual and the first to feel its effects would be people who had lower incomes, but were not eligible for pensions or health care cards, as GPs gradually reduced the number of people they bulk billed.

The Mid North Coast Division of General Practice covers the area north to Ulmarra, south to Stuarts Point and west to Dorrigo, an area which includes about 135,000 people.

Two general practices in the region have closed in the last 18 months.

Political activist group GetUp is organising a petition to the Federal Government, saying patients at one Sydney practice that had abandoned bulk billing were facing gaps of up to $18 for pensioners and $38 for others.

Their report shows GP patient costs rising at 6.5% a year, putting pressure on local practices as the Medicare rebate stays at $37.05.


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