The author of the proposal to charge a $6 fee for GP visits says hospitals may have to charge a similar fee to stop patients clogging up emergency departments.
Terry Barnes, who wrote a controversial submission advocating an end to free doctor visits for bulk-billed patients, said emergency departments would also have to charge to stop patients abandoning GP services.
''To keep access fair and equitable, but also to ensure that resources are managed properly, the states could charge a matching co-payment for GP-type services in emergency departments,'' said Mr Barnes, a former health adviser to Prime Minister Tony Abbott.
In a submission to the federal government's Commission of Audit, Mr Barnes said the government would save $750 million in four years by forcing patients who are bulk-billed to pay $6 to visit their GP for the first 12 visits a year. Doctors and health groups criticised the idea, saying patients would try to avoid the fee by using hospital emergency departments.
Journalists have been referred to a statement federal Health Minister Peter Dutton released on Sunday, saying the government was committed to ensuring the health system was ''sustainable and remained accessible''.
But Steve Hambleton, the president of the Australian Medical Association, said if patients were forced to pay a small fee at emergency departments there would be serious implications.
''We've only had free hospitals in Australia for three or so decades,'' he said. ''Try going back to the people who experienced the health system before then. They'll understand what the implications of this means.''
St Vincent's Hospital emergency department director Gordian Fulde said he did not want emergency departments charging a fee.
''One of the things we should be absolutely proud of in Australia is that people can go to an emergency department when they're in trouble and not worry about paying anything,'' he said.
Healthcare experts say Australia is already one of the most expensive countries in the world for out-of-pocket health expenses.
Data released by the National Health Performance Authority in March showed, in some areas, 15 per cent of people reported delaying seeing a GP due to cost. The Australian Institute of Health and Welfare, out of pocket payments by individual consumers amounted to just over 18 per cent of total health funding.
In 2009-10, out-of-pocket payments comprised 47 per cent of spending on medications and 61 per cent on dental services.
In 2010-11, each Australian paid an average of $1075 to access healthcare. Philip Clarke, a professor of health economics at the University of Melbourne, said what was needed was a broader examination of the share of costs borne by patients across the entire health system, including on medications and diagnostic tests, to ensure a balance between sustainability, equity and efficiency.
In its submission to the Commission of Audit, the Consumer Health Forum said it would oppose any increase in fees in the health system.