Pensioners should get a pay rise to compensate them for the proposed $7 Medicare fee to shepherd the controversial measure through a hostile Senate, according to the man who restarted the debate about free healthcare.
Terry Barnes, a policy consultant who worked for Tony Abbott when he was health minister, proposed a $6 fee to see the doctor in a submission to the Commission of Audit last year.
The Abbott government's proposal to charge patients $7 for GP visits, pathology and diagnostic imaging was influenced by Mr Barnes' proposal but differs in several respects.
Mr Barnes told Fairfax Media that just as previous governments had compensated vulnerable groups for tough changes such as the GST and the carbon tax, the government should consider boosting the payments of carers and age and disability support pensioners to soften the impact of the Medicare fee.
Under the Coalition proposal, concession card holders and children would be bulk-billed after paying the fee 10 times in a year.
''If the proposed safety net is 10 services or $70 a year, then a one-off adjustment of $70 would be not unreasonable,'' Mr Barnes said.
Mr Barnes said such an arrangement would still encourage people to value their healthcare, ''but it would blunt the criticism that it is inherently unfair''.
To make the fee easier to administer, Mr Barnes said it should not be collected from residents of aged care homes and could be dropped to as low as $5.
Mr Barnes praised the government's political courage for proposing the fee, but said the most important thing was that the fee became law and introduced a price signal into the system even if this meant making concessions that shrunk the savings to the budget.
''What's on the table almost certainly won't pass,'' he said.
To get the measure through the Senate, the Coalition will need the support of either Labor or the Greens or the Palmer United Party and other crossbenchers.
Labor health spokeswoman Catherine King said on Monday it could not support the fee in any circumstances, adding ''it's telling that even the lone voice for this policy thinks the government has gone too far''.
Greens health spokesman Richard Di Natale called on the government to ditch the idea.
''No amount of tinkering will change the fact that a Medicare co-payment targets the pooor and vulnerable,'' Senator Di Natale said.
Palmer United Party leader Clive Palmer said: ''It's over. There'll be no co-payment.''
But Health Minister Peter Dutton said the proposed 10-visit cap provided a ''comprehensive and appropriate safety net''.
Mr Dutton said that when former Labor prime minister Bob Hawke introduced a $3.50 fee for GP visits in 1991 (later scrapped by his successor, Paul Keating), he argued it was ''very difficult to suggest'' that sum, which is roughly equivalent to $6.40 in today's dollars, would ''create great hardship''.
''For these reasons, we're confident that people will see the reasoning behind what we're trying to do,'' he said.
''If you look at the commentary surrounding this measure, it's interesting to note that people are no longer opposing it, but rather considering for themselves how we can make it work. That's extremely pleasing.''