Published
letters
"Why medical care should be free"
It has been suggested that a universal modest co-payment should be used as a disincentive for overuse by patients (Editorial, 29/4). Yes, co-payments are a disincentive for sick and less well-off people to access health care but research in many countries over many years shows they do not make any difference to so-called frivolous visits and deter the use of appropriate health services.
In
Co-payments ignore the unequal ability to pay and the unequal need for health care. They reduce access for the less well-off, improve access for the wealthy and place a higher financial burden on the sick and less well-off.
People can be poor judges of when they need medical care. That's what doctors are for. We do not need economic disincentives to access health care.
Dr Tracy Schrader
The
Australian
1 May 2003
"The dangers of US-style health"
Ray McHenry says it is the middle and upper classes who benefit most from Medicare, not the poor (2/5). This is rubbish. Universal health systems are paid by taxes and therefore high-income earners contribute the most. This underlies the squeals from the wealthy that universal systems cannot be sustained.
Like John Howard, McHenry recommends an American-style system of private insurance, copayments and safety nets. I recently read an article in The New York Times about a woman who was unsure of her health insurance status. She had a heart attack, but instead of calling an ambulance she phoned her insurers. While looking for insurance papers, she died.
I cannot believe most Australians want to live in a country like that.
Dr Andrew Gunn
The
Age
3 May 2003
Michael Morton-Evans questions why middle
Please allow me to spell it out: T-A-X.
Dr Andrew Gunn
The
Sydney Morning Herald
5 May 2003
Myths about Medicare are everywhere:
•If it's bulk-billed, it's free. Wrong: it's an insurance product, paid for by taxes and the Medicare levy. Everyone pays taxes.
•If there is no co-payment, it will not be valued. Wrong: what do I say to my patients who bring me gifts after being bulk-billed? People value service.
•Co-payments stop "frivolous visits". Wrong: only if it is big enough to affect your pocket; the rich are unaffected.
•Stopping "frivolous visits" is a
good thing. Wrong: a patient often doesn't know how serious his or her
apparently minor complaint is. The mild flare in asthma, which, treated early,
can avoid a visit to the emergency department at
•We can't afford Medicare (the real one, not Howard's proposed "Mini-care"). Wrong: what we can't afford is a US-style user pays/safety net health system where twice as much per person is spent on health care, and people die younger.
Dr Tim Woodruff
President, Doctors Reform Society
The
Age
5 May 2003
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