Federal Health Minister Peter Dutton has fanned speculation that the Abbott government will introduce a fee to visit the doctor by arguing that well-off Australians should make a greater contribution to the cost of their care.
Speaking to reporters in Canberra on Wednesday, Mr Dutton refused to confirm the change would be in next month’s federal budget, but said the nation needed "an honest conversation about how we build and strengthen our system".
"We will take care of those that can't take care of themselves," he said.
"But at the same time people on incomes like mine, or a reporter on $300,000 or $400,000 a year - should we expect to go to the doctor for free? That's a reasonable question to ask.
"I want to make sure that we can strengthen Medicare but we're not going to do that by giving free services in the hundreds of millions each year in a country like ours."
Tony Abbott's chief business adviser on Tuesday night backed the introduction of new fees for GP visits, saying he should not be able to see a doctor without paying something.
The Abbott government's expenditure review committee has reportedly decided to introduce a $6 fee to see the doctor in its first budget, but the government has not publicly confirmed the plan.
A former adviser to Tony Abbott, Terry Barnes, proposed the $6 fee in a submission to the National Commission of Audit on behalf of the Australian Centre for Health Research, calculating it would save $750 million over four years by reducing unnecessary GP visits.
Interviewed on ABC TV on Tuesday night, Maurice Newman, the chairman of the Prime Minister's business advisory council, said the nation needed to reconsider its priorities in order to rein in debt and reduce the deficit.
''It doesn't seem to me to be just that . . . if I go to the doctor, that my consultation should be free. I should of course make some sort of contribution to that," said Mr Newman, a former chairman of the ABC and the Australian Securities Exchange.
''Yes, there should be a basic safety net. And I don't think anybody disagrees with that. But my safety net and your safety net could be very different. And I think that's where the politics comes in as to where the trade-off should be."
Interviewed on ABC radio on Wednesday, Opposition Leader Bill Shorten said by introducing the fee the Coalition was ''undermining the universal nature of our Medicare system’’, while Consumers Health Forum chief executive Adam Stankevicius accused the government of seeking to shift costs on to the states.
''In the absence of any evidence which supports the government's assertion that a co-payment will reduce alleged over servicing or unnecessary GP visits, we are only left to guess about what the true motivation for its introduction may be: cost shifting to the states or revenue raising," Mr Stankevicius said.
Australian Medical Association vice-president Geoffrey Dobb also criticised the idea, expressing concern it might deter patients from seeing the doctor when they needed to, leading them to seek treatment in hospital, either in the first instance or when their condition worsened.
“It’s unlikely to save very much money from the health budget and may even result in an increase in costs if care is transferred to the hospital sector,” Professor Dobb said.
Labor's health spokeswoman Catherine King branded the fee a "GP tax'', which would leave families out of pocket.
“Make no mistake – with the GP Tax, the Abbott government is dismantling universal healthcare as we know it in this country," she said.
“Labor believes that all Australians should get the healthcare they need – not just the healthcare Tony Abbott says they can afford."
Mr Dutton has previously flagged an overhaul of Medicare, arguing that the current rate of growth in health spending is unsustainable, and well-off Australians should pay more for their care.
''The threshold question is whether people want the health system of today strengthened for tomorrow because at the moment the health system is heading to a point where it will become unmanageable,'' Mr Dutton told Fairfax Media in January.
Annual spending on Medicare climbed from $8.1 billion in 2002-03 to $17.8 billion in 2011-12, an increase of 120 per cent. Growth in Medicare spending was faster than growth in the total health budget of 104 per cent over the decade, and Pharmaceutical Benefits Schedule spending, which rose 79 per cent over the same period.
Figures released by the Productivity Commission in January showed the Commonwealth spent $7.4 billion on GP services in 2012-13, up from $6.2 billion in 2006-07 after adjusting for inflation. But GP spending per person has increased little, from $301.60 in 2006-07 to $304.40 in 2011-12.
The number of GP services per 1000 people has also seen only a modest increase, from 5553 in 2008-09 to 5768 in 2012-13.
Mr Barnes said he was delighted the government had reportedly adopted his idea, but urged it to go further and impose a means test on all Medicare bulk-billing, and allow states and territories the discretion to charge fees for GP-type services in emergency departments, to deter people from presenting at hospital to avoid paying the fee.
