9 reasons why GPs are being screwed by government

GPs screwed by government

The government’s revised co-payment plan is a dog’s breakfast. Here are 9 reasons why the proposal has angered Australian GPs.

#1

Prime-minister Abbott’s reference to sausage machine medicine is insulting. If the government is unhappy about the way some clinics churn through patients, they should do something about it, but not punish all Australian GPs – and patients.

Besides, it looks like the government didn’t do their homework properly: A recent report debunked the myth that GP care is ‘6-minute medicine’. The authors of the report: “If people feel they must ignore the wide range, and refer to the length of GP consultations in one phrase, it would be far more accurate to call it ‘14 minute medicine’.”

#2

The revised co-payment plan will not make healthcare more efficient or reduce waste in the system. It unfairly targets a part of healthcare that is operating in an efficient and effective way. RACGP president Dr Frank Jones: “If the Government is serious about this move, it is reasonable to ask the question: why not across all healthcare services?”

#3

Medicare is not unsustainable. This is a false argument by the government. The increase in health expenditure in general practice has been slow, and in line with overall economic growth and GDP. Professor Jeff Richardson, Centre for Health Economics at Monash University said this:

“Public spending on health as a percentage of GDP is among the lowest in the OECD. Only Chile, Estonia, Hungary, Israel, Mexico, Poland and the Slovak Republic channel less of their GDP into health via the government.

#4

Yes, research shows that increased out-of-pocket costs stop people from going to the doctor. This is not rocket science. Research also indicates that areas with the fewest GP services have higher hospital costs.

It’s not rocket science either to figure out that more patients will attend the free, but more expensive emergency departments of public hospitals, thus increasing overall health expenditure.

#5

Unfortunately, out-of-pocket-costs will not weed out unnecessary visits. The extra expense will also deter people with a serious illness from going to the doctor – especially people on a low-income.

#6

If the revised co-payment plan will cut the amount of visits to the doctor, a highly skilled, expensive medical workforce will be doing less work. The revised co-payment plan does not change the opportunity cost of medical care.

#7

The government wants GPs to work longer for less. Up to ten minutes of work now pays $37.05, but if the revised co-payment plan goes ahead, the government will only pay $11.95 – a drop of $25!

Note that $11.95 is not doctor’s income: After practice costs (staff wages, rent etc) and tax are deducted about $4 will be left for the GP to spend.

#8

Look at the chart and it is clear that the expected drop in revenue, in combination with ever-increasing costs, will make GP practices unsustainable – unless fees go up. The fees will need to cover the before mentioned $25, and will continue to rise each year as the rebate will not go up until at least 2018.

Medicare

The expectation: If the government’s alternative co-payment plan goes ahead, Medicare income will drop and not change until 2018, while the costs of running a medical service will continue to climb. Note: this is a forward estimation only, not based on empirical data.

#9

The revised co-payment plan may stop certain clinics from bulk billing, but it will not prevent these clinics from undercutting more comprehensive GP services. The gap fees of those clinics will likely still be much lower.

In summary: This plan will alienate GPs, shift costs instead of making real savings, and not improve care in any way – it will only make things worse.

In her open letter to Tony Abbott and Peter Dutton, Dr Sally Cockburn wrote:

“Your government is taking advantage of GP benevolence with your cut to Medicare rebates. We’re sick of being kicked around. While most of my colleagues are too busy looking after patients to play political games, this time I think you may have woken a sleeping giant.

Sally, you are right!

Follow me on Twitter: @EdwinKruys

Sources:

10 thoughts on “9 reasons why GPs are being screwed by government

  1. this needs to be out there in the media instead of misleading statements about Abbot “backing down” or making compromises

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  3. GPs have been put in a terrible position and I do hope that a sleeping giant has been awoken.

    Why is Main Stream Media not reporting on how unfair this is to patients and GPs?

    We live in a democratic society so how can the Abbott government circumvent a democratic process in the Senate and just go ahead and do what ever they feel like against the will of the people.

    Lots of people I know are just in shock at the destruction of the Abbott government right across the board – 157 government agencies now being cut – what the? That’s right we have rising unemployment so lets tell 1,000s of people who work in these agencies just before Christmas (when government is not sitting) that you do not have a job in 2015. Lovely Christmas present to those poor people.

    People are very scared out there about the damage being done to healthcare and also to all the valuable services that monitor health and community issues as well as regulatory bodies that are in place to make sure that checks and balances are adhered to.

    It all very depressing to think we have another 18 months of this utter disrespect for Australians and what is the right and fair way to govern us.

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  4. I have already stopped taking my meds as next year when I lose the single parent payment I won’t be able to afford the increased cost of medication. Will still keep my sons meds going just like I will always feed him but skip meals myself

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  5. How about a class action over discrimination ….only GPs are affected by these changes. Surgeons, physicians, radiologists and pathologists are not targeted!

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  7. I’m very offended about being labelled “sausage machine” doctor – today between my practice nurse & I, we saw 40 patients – 20 of which involved less than 10 minutes of my time. Most of these also took considerably more time from a highly skilled practice nurse time. The remaining 20 took considerably longer than 10 minutes of my time.
    Most of our patients are bulkbilled because they are either very young or old or have severe chronic illness.
    The changes to level B consult results in a reduction of income to me of $400 a day – $2000 a week with no reduction in outgoings. My wage is already lower than a FIFO truck driver before this hit – maybe it’s time for a change of career – only issue is, I have a conscience and I love medicine……….

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  8. I don’t agree with the policies on ideological grounds and I also agree with Edwin they have zero evidence to back them up and in fact there is plenty of evidence that Abbot is wrong: no evidence of rampant “6 minute medicine” consultations, no evidence we have an inefficient health system – most people with health economics training know that we do quite well actually, not that you would believe it from all the government rhetoric. There IS evidence that increasing patient co-payments worsens outcomes and worsens efficiency. It seems more ideological than anything else, but disguised in the notion that they’re trying to fix problems in the system (that don’t exist).

    In my town, the “6 minute medicine” practices are the corporates that bulk bill but rely on high volume throughput to keep their revenue up. You can criticise them all you want, but they serve a vital need, offering extended hours and weekend services, short-notice and walk-in appointments, and my patients typically use it on weekends rather than go to the ED. I have my concerns about corporate clinics, but they have their place. By slashing the rebate and increasing the item 23 description to >10 mins, this business model is no longer viable. They can charge gaps (but I don’t think they will in my town as they tried that and business dwindled) or they can do a care plan on every single patient – which just might happen.

    I feel completely under attack as a GP. Rebate freezing and various MBS changes in the last few years have seem my income go down each year, not even keeping up with inflation. I’m pissed off. I recently discovered residents in the hospital get paid more than GPs, so I’ve arranged to do shift work in the hospital and emergency departments instead in 2015. I’ve had enough. It’s not worth it any longer and it’s disappointing to be treated like crap all the time. The government should stop attacking primary care when we are actually the most efficient part of the sector and “bang for buck” you get better outcomes and overall efficiency the more you invest in primary care.

    I’d hate to be Abbot’s GP right now. I’ve no idea if I could put my feelings aside and treat him. No longer an issue really, since I’m leaving the profession.

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