Lenore Taylor, political editor
theguardian.com, Tuesday 20 May 2014
Doctors say the patient who confronted treasurer on Q&A was right to say he will be out of pocket after Medicare changes
Korey Gunnis on Q&A on Monday night.
When Korey Gunnis - sufferer of rheumatoid arthritis, cerebral palsy, osteoporosis, osteoarthritis, chronic asthma, hearing loss, anxiety disorder and clinical depression - asked Joe Hockey on the ABC’s Q and A program how he was supposed to cope with the new “heartless” $7 Medicare co-payment, the treasurer’s answer was unequivocal. Gunnis would not have to pay it.
“Well from what you said you wouldn’t be hit by the so-called medicare co-payment, you wouldn’t be affected,” Hockey said.
“Initially I would”, Gunnis interjected from the audience, presumably referring to the fact that even concession card holders are required to pay the co-payment for their first 10 visits to the doctor each year.
“No you wouldn’t because you would be on a care plan with your doctor, obviously you have a number of chronic diseases, in that situation you would not be affected by the co-payment,” Hockey insisted.
But according to the Australian Medical Association, Gunnis is very probably right.
The budget does exempt doctors’ visits listed as “chronic disease management items” from the co-payment, but these are likely to be only a very small proportion of the visits to the doctor by someone with chronic health problems like Gunnis.
“Chronic disease management items” include an initial consultation to develop a chronic disease management plan and another consultation with other health professionals - for example with a diabetic educator and a podiatrist for a sufferer of diabetes.
But if a chronic disease sufferer gets sick, or needs a new prescription, or has any other health problems their visit to the doctor counts as a standard consultation and attracts the $7 co-payment - for the first 10 visits if they are hold a concession card, or indefinitely, if they do not.
AMA president Dr Steve Hambleton said “people with chronic disease are likely to pay the co-payment for most of their normal visits to the doctor, which would be considered standard consultations.”
He said his organisation was not “against” the co-payment overall, and for most people it would pose no problem for their health care.
But he said doctors were worried about its impact on the most disadvantaged patients they saw - very low income earners especially those with chronic conditions, some aged care or dementia payments and some patients in indigenous communities.
“There are definitely people who are going to struggle and we need to talk to the minister about how we are supposed to handle those people, because the system as it stands discourages doctors from bulk-billing or waiving the co-payment for those in greatest need,” he said.
“If the co-payment means very low income earners, or the very sick, defer getting medical care and then present when their condition is much worse it will be a bad outcome for them and potentially a net cost for the health system,” he said.
“There is definitely more work to be done on this new system.”
Hambleton has said doctors could lose 12-25% of their current income if they do not adopt the co-payment when it is due to come into effect next July.
