Wednesday, 27 August 2014
Matters of Public Importance
We heard from the Treasurer today that the impact of the $5-billion increase in the co-payment and the prescription charges will have the impact of reducing doctor visits by one million a year. It does not really give you a localised personal perspective on the nature of the issue. We heard the member for Boothby today describe it as 'modest'. We had the Treasurer compare it to beer and smokes. The member for Gilmore said it was just like a cup of coffee. We can probably answer that with comments by credible sources such as the AMA that said for practitioners, particularly those GPS providing care to patients in disadvantaged areas, the impact of the co-payment may make their practices unviable. Many patients in those areas will not be able to afford the co-payment and the GPs will not be able to charge it. Similarly, the Consumers Health Forum noted that the organisation is disappointed that the budget has not addressed underlying structural problems within the system, out-of-pocket costs and preventative and public health. On the one hand we have credible national organisations and on the other we have some parliamentarians who say that it is all peanuts.
In my electorate of Werriwa 96.2 per cent of visits are bulk billed, which is the seventh highest rate in the nation. I have looked at today's figure of one million and my estimate is that, if you look at that level of bulk billing, if you look at the socioeconomic characteristics, if you look at the reality that health problems are greater in poorer areas, then you have to say that the impact in Werriwa is going to be at least 10,000. That is a conservative estimate of the people who are not going to visit the doctor because of these changes.
I want to cite a local constituent, Dillon Tudor, who puts it in a personal perspective. His email said:
Hi there, I am a 21 year old uni student. I live at home with mum and my stepfather. The GP contribution will be the worst thing about this budget. My mum works hard to make ends meet at home for me and my 2 brothers. And this 7 dollars is just not affordable. When my 6 year old brother needs to see a GP mum is throwing away money that could contribute to groceries or bills. The financial situations of families are tough for most in Sydney. And just to make things better for mine I have been saving up to set up a (starting amount) $600 fund for my mother so when she is feeling the pinch she has something to reach into. Good to know she will have to eventually throw most of that lot away on something that should be free.
That is the real impact locally.
Statistics from the Family Medicine Research Centre at the Sydney School of Public Health noted that, before this change in 2012-13, 5.8 per cent either delayed or did not see a doctor because of the existing cost structure, which was before we even started going down this road. It is a road that the Treasurer says will lead to $1 million worth less visits. When that reliable research centre made that statement, they also said that a larger price signal than that as suggested in the media will arise. They noted that their figures were probably an underestimate for a number of reasons including the fact that one-quarter of consultations for people over 16 years of age actually led to $14, which is two visits. They also noted the additional cost of other than GP hospital pathology.
There is more research from other institutions. The Healthy Communities studies showed that in Medicare local areas, in 2011-12, a rate of between one per cent and a high of 13 per cent of visits were called off or delayed because of the then existing cost structure. Fifteen per cent of prescriptions were not utilised because of the cost structure.
The scare campaign from the coalition suggesting that we have to be alarmed at the level of costs in this country also has to be answered. As a percentage of GDP, Australian government spending on health is the 10th lowest of the 33 countries in the OECD database and the lowest among wealthy countries. What we have is a scare campaign which is designed, not to make Medicare efficient, not to save it, but to actually destroy it. That was shown by earlier speakers who noted that doctors will be, basically, $14 out of pocket if they maintain bulk billing. This change is designed to persuade doctors to abandon the system. It is designed to make sure it does not exist.
In the United States—a system the coalition government aspires towards—8.3 per cent of GDP is spent by the US government, which is higher than the 6.4 per cent spent by Commonwealth and state governments in this country. This is very clearly going to lead to the further impoverishment of people. It is going to lead to a lot of— (Time expired)