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More bad news on the GP co-payment: BEACH study

In case you needed more evidence that the GP co-payment needs some further consideration, researchers at the University of Sydney have released has released a new study  on the estimated impact of co- payments, and the results provide interesting reading.

Estimated impact of proposed GP, pathology and imaging co-payments for Medicare services, and the increased PBS threshold.Additional cost burden to patients from budget co-payment proposals: BEACH data looks at the combined impact of the co-payments proposed by the government in the federal budget.

This study is of particular interest as it draws on the latest year of BEACH data i.e. GP consultations from April 2013- March 2014. The following table of examples from the paper suggests the impact for many is not insignificant.

Examples of the impact of co-payments

• A young family of four with two children (aged <16 years) and two parents aged 25-44 years would expect to pay an average of: $170 in co-payments for GP visits and tests + $14 for medications = $184 more per year.

• A self-funded retired couple aged 65 years or more (without Commonwealth concession cards) would expect to pay an average of: $189 in co-payments for GP visits and tests + $55 for medications = $244 more per year.

• An older couple who are pensioners (aged 65 years or more, with concession cards) would expect to pay an average of: $140 in co-payments for GP visits and tests + $59 for medications = $199 more per year.

Following the release of the study the RACGP who are currently under taking the “Copay No way” campaign produced the following press release:

$7 co-payment will hit patients’ hip pocket harder than expected

Leading primary healthcare research shows the effect of the Government’s $7 co-payment for general practice services will hit patients’ hip pocket harder than the Government has suggested.

The report, released today by the Bettering the Evaluation and Care of Health (BEACH) program, reaffirms the Royal Australian College of General Practitioners (RACGP) long standing position against the introduction of a co-payment and the removal of universal access to healthcare.

RACGP President, Dr Liz Marles said the report, which estimates the economic impact of the implementation of a co-payment model, confirms the RACGP’s concern the model will force Australian’s to think twice about accessing healthcare due to out-of-pocket costs.

“The reality of the co-payment is the out-of-pocket costs for general practice services go well beyond the nominal $7 figure here and there that the Government would like the public to believe.

“In fact, over a quarter of adult general practice consultations involve at least one test equating to at least $14 in co-payments, and approximately 3% involve imaging and pathology testing equalling at least $21 in out-of-pocket costs for a single visit to the GP.

“Even before the announcement of the co-payment, Australians were choosing to delay or avoid seeing their GP due to associated expenses. The introduction of a co-payment will only further exacerbate this alarming trend,’ said Dr Marles.

The report also found that under the proposed changes to the Pharmaceutical Benefit Schedule (PBS) medication co-payment, the overall cost increase for medications will be higher for concessional patients compared with general patients, despite a lower individual co-payment rate.

The co-payment on medications only applies to medications that cost more than the co‐payment amount. Medications that cost less than the co-payment threshold will not be affected.

“Concessional patients have far more medications prescribed that will incur the full co‐payment increase, ranging from an average0.87 medication per consultation for children to 3.54 medications per consultation for older patients.

“This poses a serious concern that even if patients choose to visit their GP; the increase in costs incurred by the patient for medications will lead to more patients not filling their necessary prescriptions.

“Combined, the co-payment on both of these crucial primary healthcare services will result in an average additional cost to patients from $36 for children to $122 for patients aged 65+ per year.

“Families, the elderly, and Australia’s most vulnerable populations will be particularly hard hit if the co-payment is implemented and will no doubt think twice about accessing clinically appropriate and timely healthcare and potentially rely heavily on more expensive hospital services.

“By proposing such a model, the Government has seriously compromised every aspect of the healthcare system at the detriment of the patient and the general practice profession who are both forced to absorb the costs of primary healthcare delivery,” said Dr Marles.

The RACGP is committed to achieving the best possible health outcomes for all Australians and will continue to advocate for a ‘Healthy Profession. Healthy Australia.’

Related Posts

Comments 4

  1. Ben Mullings says:

    ‘Croakey’ the health blog: now brought to you by private health insurance companies advertising at the bottom of articles about the impact of cuts to public health 🙂

  2. Melissa Sweet says:

    Correcting an error of fact in the comment above. Croakey receives no revenue from Crikey and it is Crikey that receives advertising revenue from this site.

    Croakey’s funding arrangements are detailed on the site here: https://croakey.org/about-croakeys-funding-sources/

  3. Ben Mullings says:

    @Melissa The banner underneath Croakey’s article shows an advert for a company called ‘iSelect’. Here is a screen capture taken just now which displays the banner advertising private health insurance: http://drben.com.au/d/Croakey_screen_28-07-14.jpg

    If you visit the iSelect link and click on the ‘How We Make Money’ link you will find a statement which says:

    For the private health insurance industry, we are an outsourced marketing channel offering a more cost effective way of gaining new members.

    I take your point that Croakey receives no direct revenue from such advertising, however, this health blog is hosted by Crikey – and Crikey does receive something to run these adverts.

    My point was about the positioning of advertising for private health insurance below an article about the demise of the public health system. I think that’s a bit off.

  4. Melissa Sweet says:

    Thanks Ben, I will pass your comments to Crikey. Cheers

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