In a letter members, Brian Owler wrote, "...The AMA does not support measures that take billions of dollars out of general practice, undermine the viability of individual practices, and ultimately disadvantage our patients... Yesterday, the Government made regulations that require Level B consultations to last for at least 10 minutes. Unfortunately, this will come into effect on 19 January 2015, and practices will need to urgently prepare for this change. It will proceed, at least in the short term, as the Senate is not in a position to reverse this change until after Parliament resumes in February next year. The AMA will do everything we can to assist this reversal process. Your feedback on this measure has been very clear. While there is no support for business models based on the high turnover of patients, the reality is that GPs still deliver high quality consultations of less than 10 minutes’ duration, and these need to be properly recognised..." Click on the link below to read the full text of the letter.
"Under the newly revised model, the Government has proposed a $5 cut in the GP patient rebate from 1 July 2015, a freeze to rebates until 2018 and an introduction of time-based changes to Level A consultations from 16 January 2015... The RACGP labels these proposals as unacceptable...At its very core, the $5 reduction in patient rebates is an actual cut in the subsidy the Government provides to patients and will result in higher out-of-pocket costs...The introduction of a time based change to Level A consultations will have an immediate negative effect on how the majority of GPs practice, with an adverse flow on to practice infrastructure and the ability to provide quality patient services."
See the full text of the media release here.
“A cow’s udder is inches away from its backside; that’s why the milk we drink is pasteurized, to get rid of the germs...If you don’t pasteurize milk, the raw milk can carry harmful bacteria and other germs that can make you or your family very sick - or even cause death."
Dr Tony Isaac notes that young families without health-care cards will be hit hardest.
Photo by Max Mason-Hubers
What a disaster...
Excellent commentary http://theconversation.com/six-things-you-should-know-about-the-co-payment-scheme-35329, and http://blogs.crikey.com.au/croakey/2014/12/10/plan-b-the-political-appeal-of-a-gp-co-payment/.
RACGP response http://www.racgp.org.au/yourracgp/news/media-releases/revised-co-payment-model/
AMA response https://ama.com.au/media/government%E2%80%99s-new-co-payment-model-%E2%80%98mixed-bag%E2%80%99
AMA WA branch response http://www.abc.net.au/news/2014-12-11/ama-wa-at-odds-over-gp-payment/5961448
An excellent letter to The Newcastle Herald by Richard Terry follows:
"Hope you all noticed the executioner's blade fall on good general practice last night.
With the current proposals by what seems to be an increasingly incompetent liberal government, they have in one blow:
1) increased the gap that private patients pay by $5.00
2) abolished a fairly large number of level B consultations, converting them to brief consultations as Item 23 is no longer content based but time based.
This effectively means these sorts of consultations are now brief consultations
• BP checks and re-scripts
• Children's URTI's, middle ear infections
• simple skin rashes
• examining and ear, syringing out wax
• examining a skin lump, making a diagnosis and arranging treatment
I could go on-and-on. No doubt many of you will disagree with me, however many many things we do in general practice take < 10 mins but require years of training and complex thought processes.
Excluding GPMP/TCA, most longer consultations are loss-makers in GP Land - if you add up the cost to you of sitting with a patient for 30 mins doing a complete checkup taking all your expenses into account, you lose money on these. They are subsidized by the quicker consultations we currently charge as Level B's because of content. Excisions where the skin lesion turns out not to be a malignancy cost us quite a bit of money - another loss, cf to what we get for the consultation fee.
Sadly a fairly massive fee drop is presented as a 'co-payment'.
Sadly the AMA have not come out howling in protest, not a complaint from the RACGP who undoubtedly have advised the government about this and are smirking in the wings as they continue to smother general practice in the increasing mire of bureaucratic regulation and paperwork.
Big bulk billing practices will continue to push through patients at a rate of knots, finding new ways to exploit the medicare item numbers. Practices like mine - solo - where we spend a couple of hours a day doing unpaid paperwork, often getting to work early and working in lunch time, and see patients from 9>5:30 seeing maybe 25-30 patient's per day with not a minute to spare (a number of these consuming alot of time being loss-making level C consults to sort out patient's complex issues,) will continue to go backwards and eventually be forced to close.
Good work Tony and I bet GP's don't even whimper.