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.