Illustration: Ron Tandberg
A minimum $6 fee to see a GP would lead more patients to seek treatment in overcrowded emergency departments including those with conditions that had deteriorated because of deferred care, doctors say.
Australasian College of Emergency Medicine president Anthony Cross said any disincentive to see a GP would send patients elsewhere.
''EDs [emergency departments] do have a reputation of being able to see and treat anything - there is a sense of a one-stop shop - so if they have to pay $6 that might sway people to come to an ED,'' he said.
''People for whom the $6 is most likely to be a disincentive are people from poor backgrounds with chronic and psychiatric disease, the people who need care the most.''
Australian Healthcare and Hospitals Association chief executive Alison Verhoeven said the chronically ill were likely to defer seeing a GP, leading them to become sicker and need more treatment.
''That will obviously cost more and that's not a good trade-off, it's not going to put more dollars into the system,'' she said.
Health Minister Peter Dutton has called for debate on the GP co-payment, which has been proposed to reduce rising health spending.
Policy consultant Terry Barnes, a former adviser to Prime Minister Tony Abbott, suggested a $6 fee to see a GP or for GP-type treatment at a hospital emergency department, in a submission to the government's Commission of Audit.
He said funding agreements between the Commonwealth and states prevented hospitals charging patients for public hospital treatment, and would need to be changed if the government adopted his plan for a $6 co-payment.
Mr Dutton said on Wednesday one of his government's most important tasks was ''to grow the opportunity for those Australians who can afford [it] to contribute to their own healthcare costs''. He questioned whether people on ''reasonable incomes'' should expect to pay nothing to see a doctor leaving other taxpayers to pick up the bill.
Treasurer Joe Hockey on Friday flagged changes to health funding.
''The starting point is if our health and welfare and education systems stay exactly the same, Australia is going to run out of money to pay for them,'' Mr Hockey told the Seven Network on Friday.
''If nothing happens, we will never get back into surplus, we'll never pay off debt.''
The Treasurer flagged that other programs, including the aged pension for people over 65, were also overdue for review and would have to be examined.
In the second half of last year, 81.7 per cent of GP visits were bulk-billed, meaning patients incurred no out-of-pocket costs.
But, Consumers Health Forum spokesman Mark Metherell said, many bulk-billed patients received concessions, for example pensioners with chronic conditions, and other patients already paid a fee to see a doctor.
Patients who are not bulk-billed pay an average of $28.60 to visit their GP, according to Medicare data.
Victorian Council of Social Service chief executive Emma King said the poor already faced significant costs for quality healthcare including for medications and tests.