Coalition considers end to free GP visits
The Abbott government is refusing to rule out a fee for every GP visit in a bid to rein in health spending. Nine news.PT1M32S http://www.canberratimes.com.au/action/externalEmbeddedPlayer?id=d-3022t 620 349 December 30, 2013
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- Coalition considers end to free GP visits
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The announcement of a $3.50 co-payment for people who were bulk-billed under Medicare in the August 1991 budget arguably cost prime minister Bob Hawke the Labor leadership.
But the political times were very different and the issue of tinkering with Medicare is far more emotional within the Labor Party than it is likely to prove within the Coalition.
Renewed pursuit of a co-payment: Prime Minister Tony Abbott. Photo: Jay Cronan
In 1991, Hawke was in the countdown to an election, not the first year of a new government. He was also facing leadership tensions: he had seen off one challenge from his rival, Paul Keating, who was smouldering on the backbench.
Hawke and his deputy Brian Howe had become convinced that without further price signals, the costs of healthcare would continue to grow.
Perhaps because they knew it would be unpopular, they unveiled the $3.50 co-payment charge without consultation as part of the budget. It was coupled with a cut in the rebate so that people who paid their doctor directly were also hit with an increase of about $3.50 in healthcare costs.
Costly decision: Former prime minister Bob Hawke lost substantial popularity after introducing Medicare co-payments. Photo: Jay Cronan
Hawke immediately faced a backlash from the public, the Australian Medical Association and the Left and Centre Left of his party.
The AMA accused Hawke of deceiving it because pre-budget discussions had been entirely about the cut in the rebate. The architect of Medicare, Dr John Deeble, slammed the plan as ''unjustified, ill-advised and destructive''.
The ACTU stepped in as well, saying it was ''not convinced that the [$3.50] co-payment proposal necessarily solves the problem of overservicing''.
But the real trouble was within the ALP itself. The Left and Centre Left factions briefed the media that the co-payment would hit the poorest.
The ALP executive made its displeasure known, too. Then ALP national secretary Bob Hogg said the changes would ''not be a plus'' at the next election.
Howe was forced to suspend the introduction and set up a backbench committee to consider other options.
The committee came back with a slapdown for Hawke. ''The introduction of co-payment for direct billing actually implements the first stage of Liberal Party policies and puts at risk the community's widespread acceptance of Medicare,'' its report said.
The states were also up in arms and some threatened to introduce outpatient fees to stop people flocking to hospitals to avoid the new upfront charge.
In the end, a compromise was reached with the Left, for a reduced $2.50 charge, as a face-saver for Hawke.
But the battle had left such bitterness that it was only a matter of time before Keating moved. As treasurer, Keating had opposed a co-payment charge and made sure his views were well known to his caucus colleagues. Just a week before Christmas he ousted Hawke.
The payment was gone by March 1992.
The Abbott government's renewed pursuit of a co-payment has been given impetus by a research paper by Terry Barnes, a former senior health adviser to Tony Abbott. It argues that co-payments would provide a ''simple yet powerful reminder that we have a responsibility to look after our own health and not simply pass on all the costs of and responsibility for caring for ourselves to fellow taxpayers''.
The issue might not be as divisive within the Coalition, but it will again draw opposition from doctors, welfare groups, pensioners and, importantly, from state governments, most of which are now Liberal.