Upfront Medicare Payment FAQ

Some people – conservatives and libertarians – have problems with those who oppose the Commission of Audit’s – and, very soon, the Abbott Government’s – proposal to charge $6 (or $5, there seems to be confusion amongst the news networks about what it is) to see your general practitioner: or, GP. This FAQ aims to answer some of their political challenges masked as innocent questions.

Before we begin, the main reason given in order to support this scheme is to cut ‘unnecessary’ GP visits i.e. disincentivise people from going to the GP for non-serious issues, and therefore ‘better target’ people who really need medical attention, as reported in the Daily Telegraph. In other words, lines are too long and we need to deter people away from misuse.

Q: It’s only $6 – that isn’t much, right?

A: Well, there’s two ways to respond to this. Firstly, to most people, no. To most people, that’s about $6-$18 a year to see your GP every now and again. But this assumes good health. For many people, especially the elderly, this could mean up to $600 if they see the GP twice every week and every week for a year. It’s also just an unnecessary addition to one’s cost of living, in the sense that – as this post will explain – it achieves nothing. It’s a bit like making someone flush a dollar down the toilet every time they walk their dog through a public park: an unnecessary cost regardless of how little or large the fee is.

But I think this is besides the point. After all, the current proposal states that it will only be valid for the first 12 visits, which means a maximum of $72. The point is that for most people it isn’t very much to pay $6 for a GP, in which case, what’s the point? If the purpose is deterrence, then a supposedly tiny fee will do nothing to stop the people who really want to go. But apparently there is this group of people in society who spend all their time in waiting rooms – incidentally, waiting is probably the biggest deterrence there is to seeing a GP – in order to see the GP about non-existent problems, and waste huge amounts of taxpayers’ money, but are completely horrified by the prospect of paying $6. The only people I can imagine who have this ailment are poor mentally ill people, who probably do need the treatment anyway.

P.S. Don’t forget that they’re also potentially going to introduce $6 fees for emergency rooms too, because apparently people go to the emergency rooms for minor issues and not for emergencies, despite the eternally long waiting times and the triage system. The funny thing is that I always said that emergency room lines would get longer if you had to pay to go to the GP, because people would feel invited to go to the free service. Then charging to see the emergency room? That’s just an invitation to die.

P.P.S. There’s also the whole problem of creating a consumer-business relationship with doctors but I can’t really be bothered to go into it right now so maybe some other time – watch this space!

Q: But queues to see the doctor are too long because of misuse, right?

A: I don’t buy this, and stop making statements that end in a question for the sake of it. I haven’t seen much evidence of a ‘clogged up’ medical system asides from anecdotal evidence of waiting times, which, incidentally, are a deterrence to see the doctor, whether that’s a good thing or a bad thing. But say there was. Then the strategy here is to cut demand by increasing prices. I can understand how that works in the marketplace, that there is a pool of goods and if there’s too much demand you try to tone it down by increasing prices to meet its increasing demand and therefore value.

But this isn’t a commodity, it’s a public service. If prisons become full, no one cuts laws in order to reduce the amount of prisoners (although prisons are terrible and there are laws that we should cut, like drug laws, not to reduce prisoners but because the laws are ineffective, discriminatory, and unethical, but that’s another story). What I’m trying to get at is that the solution to too much demand for doctors is to increase the supply of doctors – increase training for doctors and spend more money in hiring them. The answer to a high patient:doctor ratio is more doctors, not less patients.

The reason for this is because healthcare is not a luxury item, it’s – as said before – a public service. This means more than just as a distinction of property relations. One analogy I’ve heard is that it should be like plastic bags at supermarkets, where you need to pay x amount in order to use one, in order to deter you from using plastic bags and make you think about how much you use it. The difference is we shouldn’t be trying to cut down on healthcare, we should be inviting people to use more healthcare. There’s no such thing as a fruitless visit to the doctor. Sure, hypochondriacs maybe go to the doctor when nothing’s wrong, but surely one of the points of the GP is to tell you that…nothing is wrong, if nothing is wrong. That’s the problem – conservatives tend to think going to the doctor when you’re fine is a waste, when in actual fact it’s a key purpose of a GP.

Also remember that most people don’t like going to the GP. If anything, we should encourage more people to go to the GP because people aren’t doctors who know if they’re sick or not. The reason why GPs are free is because they’re meant to be our first point of contact. It’s because if you’re feeling like you have the cold, you aren’t meant to ask your mum or the Internet what is wrong, you’re meant to go to the GP. 99/100 you’ll just need to rest. 1/100 times, as happened to someone I know, you actually have swine flu.

Q: It’s just trying to combat middle- and upper-class welfare.

Ditched the question mark, eh? Some people argue that this is to make people who can afford it pay for their healthcare, as pensioners, young people, and the poor are exempt from the fee. But why add a regressive flat fee to see the doctor instead of, I don’t know, increasing the already in existence means-based Medicare Levy on people’s incomes?

This is often followed by asking why the rich should be able to access welfare services that should be for the poor. The way the posit this is that if rich people stopped accessing Medicare than there’d be more for the poor. Firstly, this is wrong, there’d just be two healthcare systems, one that is better for the rich, and one that is underfunded for the poor, mainly because the rich will have no interest in the universal healthcare system being any good because they aren’t affected by it. But this is a bit of a digression.

Q: Healthcare isn’t a human right anyway.

Here we come to the truth of the conservative argument: that healthcare is not a human right. Instead of arguing the usual ‘why healthcare is a human right’, let’s instead accept that it isn’t a human right, that nothing about being human suggests that we have a right to healthcare. However, it is a social right in the sense that throughout time our society has recognised that healthcare is a right deserved by those within the society, which is why it is serviced by the public service as opposed to the private sector in case the private sector blocks access to it.

However, and what I haven’t mentioned yet, is that healthcare is not simply a right in order to preserve the health of the individual, but is a right in order to prevent widespread epidemics and pandemics. A universal healthcare system is not just one that cures ailments, but one that is designed to prevent disease by catching issues before they become a problem. This is what conservatives, and namely, the Liberal Party, just does not realise, or realises but chooses to ignore.

So, in the previous example of the swine flu, two situations could’ve happened. One, that the person goes to the GP, finds out they have swine flu, and takes the necessary precautions to make sure that it does not get worse and that it does not spread. The other option is to not go to the GP, it getting worse, and also spreading as the person continues to go about their daily life.

This is why it isn’t just that we remove access to GPs, but that the purpose of the universal healthcare system is we invite access to the GP. It’s a bit like education: just removing barriers to education isn’t good enough if people still don’t choose attend. It’s meant to be completely skewed to inviting people into it, without any deterrence.

This isn’t just a problem with physical health. In Australia, you need to see the GP before you go to bulk-billing psychological services (I think ten or twelve per year, which is a disgrace, by the way). People are even less conscious of their mental health. There’s less of an epidemic scare about mental illness, of course, but an increase in our mentally ill population is not something we should be trying to encourage.

And what if this continues to sexual health clinics that are receiving more patients than the expect? Are we going to charge money to get yourself checked out for STIs? That would be a disaster.

Final point: the GPs job is to point you in the right direction. The healthcare system should want us to see our GP so we don’t go on WebMD instead and self-medicate. We rely on doctors because of their knowledge in the field. Letting go of a preventative healthcare model would be a fatal mistake and would encourage epidemics. This would be a burden on our society; it would especially be a burden on our finances and economics. Preventative healthcare might sound more expensive, in the sense of always being ready to treat anyone who wants it, but there is ample proof that it’s far more cost-effective to treat minor ailments and educate people about healthy living than for the entire population than it is to treat major illnesses and injuries for some people. It also means that it protects people who don’t have easy access to GPs (another disgrace), in the same way vaccinating the population protects people immune to vaccinations.

Q: Well, fuck you then?

A: Huh? Anyway, I think I covered most of it, but maybe not. Hopefully I did.

Also like this Facebook page: https://www.facebook.com/saveourmedicare

Rafi Alam
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