Co-payments, and why they’re not always appropriate

If ‘one size’ truly fit everyone, we could all hang up our stethoscopes, go home, and let Dr Google see the patients! If a co-payment is inevitable (and I’m yet to be convinced it is), I think the onus is on us, as medical professionals, to make the system work for our patients. I envisage regular patients – concessional, aged, people with chronic diseases – spending time with their GP under the chronic disease item numbers (no co-payment), and with the practice nurse (no co-payment), getting better, co-ordinated care. I think the radiology and pathology companies will absorb the co-payment and just not charge it – for basic testing. This will hopefully decrease the ordering of unjustified tests – the ‘everything’ blood test and CT lumbar spine come to mind. I’ve spoken to a few doctors, and the ‘threat’ of a co-payment to our patients has really incentivised us to think ‘outside the box’ as to how we can continue to care for them – some really good ideas have come up. I’d really like to work on these ideas!

Doctor's bag

Co-payments, and why they're not always appropriate

A one-size-fits-all approach doesn’t work in my job. There are always plenty of valid reasons why a particular approach or treatment works for one person but not for another.

One-size-fits-all healthcare is bad medicine. Bulk billing everyone doesn’t make sense. It’s not necessary and doesn’t cover the costs. In the same way, charging a co-payment across the board doesn’t make sense either.

There are people out there doing it tough, such as Melbourne mother Kaye Stirland who wrote treasurer Joe Hockey a letter that went viral on social media. Kaye represents a group of people who cannot afford to pay $7 to see their GP.

The co-payment also puts healthcare providers in a difficult position. RACGP president Liz Marles said in Medical observer: “There will be times with patients we all see – mentally ill patients, young people, homeless people, people just doing it really tough – where GPs will have…

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