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    Sian Morton

    The inability of many, in particular health workers, to understand the difference between ‘universal’ and ‘free’ has always niggled me. I believe that people need to understand that there are tax-payer borne costs associated with their health care even if they are bulk-billed. It is my understanding that we are legally required to obtain consent from patients when we are billing Medicare directly on their behalf so, in my view, we should also be required to give people a receipt or some sort of evidence to clearly show them how much has been deposited into the account of their GP/health professional. This would go a long way to ensuring a degree of accountability for tax-payer dollars.

    In the current debate about the proposed $7 copayment and the planned funding of research from $5 of this copayment the government has failed to make it clear that the Medicare rebate for many item numbers would be reduced by $5 and that the $7 copayment is in part intended to compensate for this. Also, at the present time health professionals receive an incentive payment for bulk-billing (ie accepting a fee that is significantly less than the scheduled fee) for pensioners and children but in the proposed copayment model they will lose this incentive payment if they bulk-bill but choose to forgo the $7 copayment. Taking away an incentive designed to encourage bulk-billing when someone bulk-bills seems very bizarre to me.

    There are many preventative health strategies and programmes designed to reduce the barriers to access primary health care and improve health outcomes. The proposed copayment model has the potential to undermine all of these.

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    Oliver Frank

    Anne Lambert said: “(…) Medicare is not free. It is a universal health system that is predominantly supported through a levy on taxpayers.”

    The last that I knew, which was some years ago, the Medicare levy paid for only 1/9th of the cost of Medicare, with the rest coming from the Commonwealth’s consolidated revenue. Is this or something similar is still the case, it is far from accurate to say that Medicare is “predominantly supported through a levy on taxpayers”.

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