There may be some medical practitioners who charge fees that are considered unreasonable. On the other hand, the Medicare Schedule Fees for a vast number of medical services are unreasonably low. It is thus misleading to compare charges against the Medicare Benefit Schedule (MBS). To do so implies that the MBS reflects actual costs of providing specific medical treatments/services. This is not the case.

Medicare is like any other insurance. The insurer, in this case the federal government, decides what it will pay. Like any other insurer the government aims to reduce costs and has consistently decided not to meet the "real" cost. To this end, conservative governments, in particular, have pursued a policy of "user pays" in relation to Medicare, reflected in the complete freezing of schedule fees in some areas and minimal change in others.

Meanwhile the costs of providing medical services increases. The outcome is a continual decline in bulk billing throughout the health system (except in public hospital services), poorer access to the public system for specific treatments/services and an increase in patient co-payments well above the 80 per cent of the schedule fee that Medicare pays. Patients with private insurance fare little better with private insurers only paying the remaining 20 per cent gap for MBS services.

A critical impact that can also be linked, in part, to the failure of the MBS is that some ACT medical specialists, no longer provide specific surgical services in the public system. Consequently, for some specific surgical services ACT patients have no choice but to go private.

I concede that some fee levels appear to be on the extremely high end. However, concerns about perceived high charges are largely developed within a vacuum, in terms of what represents a reasonable fee for a specific service. Any proposed development of a mechanism to control what may be considered unreasonably high charges for some medical services is not realistic in the absence of a benchmark that indicates what is considered a reasonable fee for a specific service.

The MBS in its present state does not do this.

Overall, this is a multifaceted issue, but the result is the less privileged in the ACT are often unable to access services in a timely manner in the public system, and in some cases not at all, and cannot afford to meet the costs of private health services.

However, even the more privileged and those with private insurance are increasingly finding the costs challenging.

Steve Evans' article: "ACT doctors 'greedy' says health expert" (September 7, p11) raised several issues.

Let me preface my comments by saying I am a 74-year-old male and my only connection to the medical profession is when visiting a GP, or when in a hospital due to serious illness.

I hold top private medical insurance cover and have done so ever since childhood. I too keep forking out for the "gap" when settling medical/hospital bills. And that's on top of the ever-increasing, government-approved private insurance premiums that bear no semblance, percentage wise, to the CPI, by which our pensions and salaries are annually "increased".

Are doctors and dentists really "greedy", or does the fault lay in the way reimbursement regimes are set? When did the government last review that regime or update it, to reflect our cost of living constantly heading north? Have the overhead costs of running medical practices and surgeries ever been taken into account, like litigation insurance, rent or new equipment, to name a few?

Judging by the many office and retail sites that remain empty, sometimes for years on end, the cost of commercial rent in Canberra must be horrendous.

Perhaps before the medical profession in Canberra is accused of being greedy, a Royal Commission should be established into all private health funds, as well as government methods for setting medical reimbursements limits and take account of all expenses that doctors have to bear.

In response to Mr Denham's letter (Letters, September 9) and to put his mind to rest the reason for the Canberra Services Club's application to remove the concessional status of both their blocks (Manuka and Barton) is "Security of Tenure".

I ask Mr Denham would he be happy with a concessional type lease on his own property, knowing that the government could resume it at any time.

If he needed a loan to purchase that property would his lender be happy to take a mortgage over a concessional lease. I don't think so.

To my knowledge most social clubs started with a concessional lease and, in the past, their applications to remove the concessional status has been approved.

We are the first club to be rejected, so we ask, why not in our case? And I ask again: is there an ulterior motive?

Populist poppycock, Elizabeth Dangerfield? (Letters, September 10). Tell that to my friend who's stacked shelves at one of the local supermarkets for the past 12 years.

She'll tell you where to take your no-blame society, along with the drug-dependent bludgers that live on our taxes.

The hours and pay might suck, but she's never taken a zac from the public purse. She has two qualities that are in short supply these days; a work ethic and personal pride.

"Thank you for your email. The ACT Government does not remove or trap cats on private land. It is the responsibility of landowners to manage feral cats on their land". That was the response from an ACT public servant to a recent query.

My understanding is that no one in the ACT actually owns land as it is all leasehold, not freehold. So doesn't that mean the government should be responsible for at least supporting those willing to do trapping?

Please explain why, if the government is really serious about protecting wildlife from feral cats, they do not support conscientious ratepayers by providing traps for the purpose.

Passing laws but not catching and fining anybody does not solve the problem when ignorant, selfish people do not desex their cats and dump unwanted cats and kittens.

On Tuesday, September 10, my wife and I made a decision to travel on the tram to Gungahlin for lunch.

From door to door it took us one hour and 18 minutes.

The bus to Civic was uneventful but the next few minutes was a shocker. The 50-metre walk to the tram via two sets of walk lights took approximately six minutes.

The tram was waiting. We had just turned to board the tram when it set off without any discernible warning.

About 10 people were left standing. One person was actually pressing the "door open" button, when off it departed.

On boarding the next tram, I asked the conductor/cabin person why passengers would be left stranded. His response was "we ring the bell (not heard at rear of tram) and we have a schedule to keep!"

The tram ride itself was comfortable, smooth and quiet. Not quite the same on the return journey when school kids took over!

Where was the conductor/cabin person?

Overall an interesting outing. The lunch was pleasant. Gungahlin was like a ghost town, and the tram experience was not unpleasant after a bad start.

I'm glad our trip was free (Seniors) as the journey by car would have taken about 25 minutes, and probably cost less than paying the normal fare.

I was disappointed to witness the treatment of a losing side at Manuka Oval on Saturday. These young men, after playing the game they had loved since childhood, had played in a grand final before embarking on their lives as adults.

While a few may be able to continue on in the sport this game was, for most of the players, the pinnacle of their sporting careers.

The accolades and podium were given over to the victors. The only acknowledgement given to the other achievers, the losing team, was from the captain of the winning side. He understood the commitment that was required from all who had played on the day.

The Canberra organisation responsible for the junior AFL competition should ensure they address the achievements of both sides on days such as these.

I feel an apology is due to the young men from the Tuggeranong Hawks. Please note that I am a supporter of the winning team.

I was full of hope a couple of weeks ago when I started walking around with an Aldi bag but, alas, no cash has appeared in it.

A propos of Jack Waterford's article ("Hypocrisy cannot hide behind a Secret stamp", Forum p2, September 7). It is just about 50 years since those A4 posters on light-poles all around the ANU grounds were calling on the police to free Jack Waterford, a future The Canberra Times editor, and stop verballing him. It seems that with the advent of Morrison, Dutton and Pezzullo nothing has changed.

Any penalty for Witness K will add to Australia's disgrace.

I spat my pudding upon reading Neil Richards's list of great railway cities of the world (Letters, September 6). How one could possibly overlook Brockway I find most troubling. It may be all tucked away down there, but like Canberra, it's rail network should be lauded. I hope it's citizens proud. Our light rail is fast, efficient and glides as softly as a cloud.

Albert White (Letters, September 5) s spot on about Wing's delivery drones promoting instant gratification and wasteful consumerism. Noisy delivery drones are the very opposite of "keeping a high quality of life", promoted in the ACT government's Our CBR September newsletter discussing Wellbeing indicators.

Sandy Paine (Letters, September 5) has made an excellent suggestion with regards to a new Australian flag when Brexit renders our current flag obsolete. A further thought could be to keep the Southern Cross and place the Aboriginal flag where the Union Jack now is.

After seeing all the mess that is happening in England now, I can say (with confidence) that we will have similar problems if we decide to become a republic and change our system of government. But it will still be worth it.

Your article "Housing stocks to grow", September 10, p1) raises the question of what is in the head of our Chief Minister. Sydney is taking old industrial sites and, especially on the harbour, turning them into parks. Our chief minister is turning parks, like the iconic city hill and west basin, into ghettos. He has no conception of the city beautiful.

Pope's characterisation of PC (Pee Cup) Lambie (September 10) graphically illustrates the devil in the details.

Graham Clews and Murray Upton (Letters, September 9) on population reminded me of Sir Mark Oliphant starting a speech in Canberra over 30 years ago with the words: "There are too many people".

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