| Upfront fees not necessary I write in response to the editorial, Up-Front Fee May Be Necessary (C-M Apr 24). The idea of a co-payment of $5 seems innocuous to editorial writers and Department of Finance bureaucrats. However, such a measure is squarely directed at low-income earners who are perceived to overuse medical services because they attend bulk-billing doctors. These are the people who can't afford a co-payment now. A compulsory co-payment will be a very blunt fiscal instrument, stopping some trivial consultations but also reducing preventive health care in the areas where it is most needed. It will be a hurdle in the way of accessing cost-effective services like ante-natal care, immunization, blood pressure and cholesterol checks. In Queensland it may also put extra pressure on our public hospital system which is already struggling with excessive work loads and underfunding (15% less than the Australian average on the most recent Commonwealth Grants Commission analysis.) An influx of co-payment refugees with minor injuries and chronic illnesses into our public casualty and specialist clinics may be more than the system can bear. As your editorial suggests, it is a dangerous political exercise to mess with Medicare. Honest John Howard would become as crooked as a corkscrew overnight after such a major breach of trust with the Australian people. But more important, a co-payment will have adverse consequences for the health of many ordinary, working Australian families. Dr John Flynn Doctors Reform Society Qld The Courier-Mail April 1997 |
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