The worst possible outcome for the Abbott government would be if its proposal for a $7 Medicare fee actually became law, Australian Medical Association president Brian Owler says.
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Addressing the National Press Club in Canberra on Wednesday, Associate Professor Owler said public opinion was clearly against the proposal, announced in the May budget, for a $7 fee for GP visits, pathology services such as blood tests and diagnostic imaging services such as X-rays.
"I think the worst thing for the government would actually be if by some miracle they got the co-payment proposal through the Senate, because every time someone went to the doctor, they would be reminded about the co-payment," Professor Owler said.
While the Coalition has not yet introduced legislation for the change, the proposal appears unlikely to pass the Senate, with Labor, the Greens and the Palmer United Party strongly opposed.
But the government has signalled a willingness to negotiate and at the invitation of Prime Minister Tony Abbott, the AMA is developing an alternative proposal that would provide greater protections for vulnerable patients.
Professor Owler said while the AMA was not opposed to co-payments in principle, it was opposed to the government's proposal because it threatened "the universality and affordability for health care for the neediest and sickest in the community".
In a wide-ranging speech, Professor Owler, a Sydney neurosurgeon known as the face of the “Don't Rush” road safety campaign, took aim at private health insurers, who he accused of a "concerted effort" to "undermine and control the medical profession".
"The AMA supports a strong role for private health insurers but we will not allow private health insurers, motivated by profits and market share, encroaching into the doctor-patient relationship," he said.
Professor Owler said the AMA had become concerned about insurers introducing arrangements requiring prior approval of certain medical procedures.
"The stage is being set for a US-style managed care system in both the primary care and hospital settings. I am concerned that the government is also looking towards such a system," he said.
Professor Owler said the nation's largest insurer, Medibank Private was circumventing the law that bans health funds from paying for GP services by paying an administrative fee to medical practice manager IPN in return for their members receiving preferential treatment in trials under way in Queensland. Professor Owler said the spread of such arrangements would mean people without insurance would have less access to a GP.
He also expressed concern about the possibility of private health insurers tendering to operate Primary Health Networks, organisations the Coalition plans to co-ordinate primary health services.
"The AMA has concerns about the appropriateness of such an arrangement and the inherent conflicts of interest," he said.
Responding to Professor Owler's comments, Michael Armitage, the chief executive of the lobby group for health insurers, Private Healthcare Australia, said: "The only thing we're interested in is quality outcomes for our members.
"We look forward to discussing with the AMA the quality of care they deliver, rather than the quantum of money we pay for it," he said.
