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Patterson: Government will have "no control" over doctors' fees under Medicare changes.

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Stephen Smith MP Member for Perth Shadow Minister for Health and Ageing

24/2003 Sunday 27 April 2003


Health Minister Patterson admitted today that when the Howard Government announces changes to Medicare tomorrow, there will be “no control” over the fees that doctors charge their patients.

It’s confirmation that, when the Howard Government announces changes to Medicare that allow doctors to charge patients a co-payment as well as billing Medicare directly, Australian families will pay more for a visit to the doctor.

The Health Minister’s admission today confirms what the Australian Medical Association told its members on Friday 28 March - that in return for agreeing to bulk bill pensioners and the poor, the Government would allow doctors to charge their other patients “uncapped co-payments”.

The Government’s proposals give doctors the green light to charge higher fees.

Millions of Australians who do not have Pensioner Concession Cards or Health Care Cards will be asked to pay more when they visit their GP.

The Australian Medical Association said this week that, for the thirteen million Australians who do not have a Pensioner Concession Card or a Health Care Card, the cost of seeing a doctor will increase.

The President of the AMA, Kerryn Phelps, said:

"What will need to happen is that for doctors to continue to bulk bill their concession card holders, they're going to have to charge their non-concession card holders more in order to meet the cost of running their practices."

Bit by bit, visit by visit, the cost of seeing a doctor will increase, and Australian families will pay more.

Since Medicare was introduced, doctors have never been allowed to bill Medicare as well as charging patients directly - it’s either been one or the other.

That arrangement has helped keep a lid on doctors’ fees.

Once that is changed, many doctors who currently bulk bill families will start charging co-payments for the first time.

And for doctors who are already charging private fees instead of bulk billing, it will be far easier to increase their fee from $20 to $25 than it is to increase it from $45 to $50.

The changes to be announced tomorrow will be the realization of John Howard’s long-standing vision for health care in Australia.

In 1987, John Howard committed himself to abolishing bulk billing except for pensioners and the disadvantaged and promised that:

“Doctors will be free to charge whatever fees they choose.” (Health: The Next Liberal Government’s Policy, 17 June 1987)

And the Coalition’s ill-fated Fightback policy stated in 1992:

“Bulk billing will be retained for pensioners, veterans, war widows, health care card holders and the disabled. Bulk billing will no longer be available for the rest of the population.”(Coalition Health Policy, 1992)

The Howard Government’s proposals will destroy bulk billing for the overwhelming majority of Australians.

In time, under John Howard’s plan, doctors will only bulk bill pensioners and the poor.

It will mean that bulk billing will become a second-class safety net only for the poor while everyone else will be expected to pay even more for a trip to the doctor.

Under the changes to be announced tomorrow, unless you have a Pensioner Concession Card or a Health Care Card, you will be paying for your visit to the doctor with a Credit Card.

Media Contact: Andrew Dempster 0407 435 157

The transcript of Stephen Smith’s interview on Sunday Sunrise this morning is available at