18 May 2016
by Jenna Price

How the federal government is destroying the evidence

The federal government continues to push a sickness tax. If you are sick, you will pay more for being sick. No-one will be immune.

The decision by the Coalition to continue the freeze on Medicare rebates for general practitioners will have a huge impact on those who work at the front line. The vaccinators. The blood pressure takers. The mole and freckle checkers. The collectors of Pap smears. The very people you visit when you feel like hurting yourself or feel you can't go on.

The Opposition leader says Medicare needs to be protected and stay in public hands.
But it will have an even bigger impact on you.

Every time you visit a GP, you will be forced to pay more so GPs can continue their excellent work. I'm sure you know, don't you, that you already pay for Medicare. In fact, the median income in Australia is $52,000 and anyone earning that, pays $780 towards Medicare. So, it's not as if you don't put in already.

Medicare is taxpayer funded basic health insurance and now there are changes being made to how you can claim on that health insurance.

These changes are serious. The Royal Australian College of General Practitioners fears that more than one-third of its members will be forced to stop bulk-billing. Frank Jones, the president of the RACGP, reveals his members say they won't be able to bulk bill kids under 16. They can't bulk bill the frail, who visit often. They won't bulk bill those on pensions. On pensions! Jones, whose practice is in Mandurah, Western Australia, is already in conversation with his practice partners about exactly what changes they will have to make to be able to survive.

These changes will have an enormous impact on all Australians. Even you.

And how will we know what effect this is having on our general practitioners? It turns out that the federal government will make sure we will never ever know.

The Department of Health has now cut funding to the one organisation in all of Australia which really examines how GPs work and what they do. The Bettering the Evaluation and Care of Health program (BEACH), run out of the University of Sydney, mysteriously had all its funding disappear from June 30 this year. Staff members were warned in November last year that there may be changes but no inkling that all the money would go. My view is that this is punishment for the work BEACH did to expose the lies in the National Commission of Audit. In 2014...

Tony Shepherd released the report commissioned by the Coalition government and claimed Australians visited the doctor 11 times a year, in a bid to push through a copayment scheme.. BEACH made it quite clear that those figures were wrong –it was able to deliver transparent analysis of the figures by dividing the number of claims to Medicare by the population and arriving at 5.59 visits per person.

The proposed co-payment scheme fell apart amid BEACH's revelations and strong campaigning – but now we have what's called copayment by stealth.

Graeme Miller, the acting director of BEACH, fears for the future of general practice research. Every single decision made these days is meant to be based on evidence – but the federal government is setting about destroying the evidence.

General practioners save our lives. If you don't believe me, ask Matt Grudnoff, senior economist at the Australia Institute. He's not considering the emotional or social aspect of the funding for health – he's just looking at the numbers.

"Australia has excellent health outcomes when compared to other countries and we have one of the most efficient health systems in the world.

"It tends to be that the more efficient your health care is, the more involved the government is." But what's more surprising is this – in the US, where health spending per capita is three times what it is in Australia and the system is highly privatised, the health outcomes are measurably worse. I've spoken to so many rural GPs about the freeze – and from Western Australia to Tasmania, from Queensland to South Australia, the GPs speak with one voice. They will be forced to stop bulkbilling entirely.

Anna Chilcott, part of a practice in the adorably named townlet of Snug, says she and her partners are in emergency meetings about how they will cope. She grew up in Tasmania and trained as a doctor in Tasmania – and she predicts there will be an even bigger impact than the immediate one on patients. She says young medical students won't want to train as GPs or work in rural areas if they can't earn a reasonable living. And then who will be looking after the people of Snug.

"This freeze targets poorer regions. It's a direct hit on people who are already struggling. The working poor don't have concession cards and now they will have to choose between seeking medical help or paying to buy their food for the week.

"I have to think very hard about the voting decisions I make and everyone else has to do that now too.

The government tried to screw with pathologists in changes to Medicare but that group of specialists fought back with a 600,000 signature petition. The deal now is that pathologists have somehow scored themselves a delay on the changes until after the election – and have also managed to secure a deal to make sure that collection centres will have controlled rents. And guess who will lose out on that deal? Yes, your local GP. She will now be subsidising specialists whose income is six times that of your average GP.

Perhaps Mr Turnbull caved because he runs into pathologists at the Athenaeum Club where he dropped in during the first week of the election campaign. GPs are much less likely to frequent the exclusive Melbourne club.

But the rest of us? We run into our GPs all the time. And they no longer vote in quite the same way you'd imagine.

I ask Frank Jones whether the membership of the Royal Australian College of General Practitioners is scandalised by the lobbying.

He laughs. They are pleased, he says, because 95 per cent of them want an organisation that stands up.

"No, they want us to be in the advocacy space." Yes, Australians, your health care has been targeted. Now it's time to make politicians the target instead.