It began when Labor froze Medicare payments in 2012. It continues with the Coalition's decision to keep those Medicare payments frozen until 2018.

No-one else has a pay freeze for six years. No-

Why should the Medicare freeze matter to you? You remember when you kicked up a fuss about Joe Hockey's planned co-payment of $5 every time you visited the GP? That's going to look like one of Joe's very small beers, in comparison to what will happen because of the Medicare freeze. What we know now from new research conducted by the Bettering the Evaluation and Care of Health (BEACH) team at the University of Sydney, is that in three years or less, your co-payment will be at least $10.

Why don't you know about it? Because the government has carefully targeted doctors by effectively freezing their payments over time. We don't automatically love our doctors but doctors still have surgeries to run. They employ nurses and receptionists and cleaners, none of whose incomes are frozen. They pay rent for their premises. Those rents are definitely not frozen.

Now, there isn't much sympathy for doctors in the community. I call this the Ophthalmologist Effect. We pay those people huge amounts of money – and even though they can complete their operations much more speedily than they used to and get through more patients in the time – they still charge what they used to charge. Looks greedy from here.

But GPs, who are constantly working under pressure, are our frontline defence against disease. There are 108 full-time GPs for every 100,000 people in Australia, so about one and a bit GPs per 1000. The rate per 100,000 has remained steady over the past 10 years even though there are significant shortages in regional and rural areas. And all this uncertainty is causing medical students, and others who should be interested in local medicine, to seek the safety of other forms of medical work. It looks a lot more comfortable to observe the life and income of an ophthalmologist than to deal with squealing babies and weeping teenagers, exhausted parents and the chronically ill. It's no surprise that a recent survey of medical students, interns, registrars and new RACGP Fellows conducted by the RACGP shows nearly two-thirds of respondents are reconsidering their career path or interest in general practice as a vocation because of the government's proposed changes.

Now 85 per cent of us see our GPs in any one year. If you look at a period of two years, that figure reaches 94 per cent. That's a helluva lot of people to keep safe and healthy.

GPs are at the core of our disease defence. They immunise, they test, they measure, they tell you to get off your bottom and do some exercise. And then they nag you if you don't. They are the ones who first recognise we have diabetes, arthritis, heart disease. And their brilliant work means that Australians are on the high side of the average OECD life expectancy; and on the low side of OECD health costs. So win, win.

Governments don't seem to understand that the attack on GP income is also an attack on those figures. As Helena Britt, an associate professor at the University of Sydney and the director of the Family Medicine Research Centre which oversees BEACH, says: "If you make it too costly for people then they won't go and you won't get early attention . . . if you see GPs less often, you end up with higher costs."

What she means is, that if you put off going to the doctor, you are more likely to end up having to go to specialist or even hospital. Both those costs are much more than a visit to the GP. People who attend the GP regularly end up with more diagnosed diseases but if you aren't getting that initial primary care, you end up with secondary (specialist) and then tertiary (hospital) visits. Instead of someone who is very familiar with your blood sugar readings, you end up in emergency, diagnosed with diabetes because you've collapsed at work.

Liz Marles, the immediate past president of the Royal Australian College of General Practitioners, saw the Medibank Private trial with the Independent Practitioner network and now fears governments may look to this model of providing an environment where private health insurers encourage patients to go to particular doctors in return for a no-gaps policy. It's the American system, she says; and it hasn't done much to provide excellent healthcare there. Instead, the money ends up paying for the administration and compliance costs imposed by the insurers instead of being spent on looking after patients.

She's been a GP for 20 years and is now a unit manager of a big GP practice that sees everyone from the young homeless to the elderly and chronically unwell.

"It's a struggle to make our budget match our service. Unlike any other medical discipline, GPs have a long term relationship with their patients - and that's where the value lies."

Twitter @jennaprice or email jenna_p@bigpond.net.au