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Wednesday, 14 September 1983
Page: 808


Ms MAYER(9.29) —The 85 per cent of the schedule fee is now accepted by most doctors when they direct bill in respect of pensioners. That amount of the schedule fee is reasonable if one accepts, as we do, the recommendation of the Jamison Commission of Inquiry into the Efficiency and Administration of Hospitals that patients should have some responsibility for the health care they receive; and 15 per cent of the schedule fee represents an amount of money which it is not too difficult for most people in this area to pay. I do not believe there will be an incentive to overservice. In fact I am surprised that the Opposition has such a shady view of doctors in the community. Certainly the medifraud inquiry has revealed that not all doctors are as honest or as straightforward as we would hope they would be. However, the people turned up by the fraud and overservicing detection service do not represent the majority of doctors or even a very large minority of doctors, but very few indeed. I do not believe that a medical service such as this will simply be abused by doctors in the way in which the Opposition is so certain it will.


Mr Newman —You are naive.


Ms MAYER —Perhaps that belief is naive but I think that basically it is very strange for people on the one hand to cry about fees for service and the rights of doctors in private practice and on the other hand to slander every doctor in private practice in this country. Given the 85 per cent contribution from Medicare, the 15 per cent patient contribution will be made by people whose income is over $128 a week for single people and $214 a week for married couples . Thus the one per cent levy will mean that the very large group of people on very low incomes who at present pay very high health insurance will now pay a very small amount through their Medicare levy and an equally small amount on top of the 85 per cent of the bill if the doctor does not care to direct bill.

I think that with the efficiency of the Health Insurance Commission and the reduction of the gap between claim and payment, doctors will be direct billing a great deal more than they are now. The convenience for the patient is one thing to which I am sure doctors will give some consideration. I think they will also give consideration to the cost for chronically ill patients. The limit of $150 which a chronically ill patient must pay to the doctor before Medicare benefits come in at 100 per cent is a fairly high cost for some people. One hopes that doctors will be conscious of the cost in a financial year of $150 to people who may find it difficult to pay-the chronically ill patients for whom they care on a consistent basis. One hopes they will direct bill those patients. One hundred and fifty dollars is the total amount which a chronically ill patient who can afford to pay will have to pay for medical services in any financial year. That total is much smaller than that which many chronically ill patients are paying now for their health care. I believe that this amendment is one of the very important parts of the Bill. It should be passed.