Proposed changes to Medicare: undermining equity and outcomes in Australian primary health care?

Since the announcement of the budget bill on May 13, 2014, Australia's Coalition Government faced concerted criticism over the equity and coherence of proposed changes to Medicare, particularly regarding the introduction of a co‐payment for GP consultations, radiology and pathology services or, more latterly, reductions in Medicare rebates. The current surviving policy iteration, effective from 1 July 2015, cuts rebates by $5 for non‐concessional patients. The proposals continue to be debated: the Australian Medical Association proposed an alternative model designed to protect financially vulnerable populations and strategic interventions;1the Labor opposition, Greens and minority parties opposed the proposal. After failing to secure support in the Senate for the legislation, and objections to its proposed use of regulation to achieve the changes, the Government has re‐entered dialogue around this proposal. From 1 July 2015, “for non‐concessional patients, the Medicare Benefits Schedule (MBS) rebates for common GP consultations will be reduced by $5 from 1 July 2015. Doctors may choose to recoup this amount from the patient through an optional co‐payment.” 2Notwithstanding the nature of the eventual deal between the Government and minor parties, the general Coalition drive toward introducing co‐payments for access to primary health care is just one important element of a budget that had presaged an $8.5 billion cut to the overall health budget.In this paper we express a number of concerns about the impact and wisdom of introducing these changes, detailing their regressive impact on the less well‐off and on primary health care more broadly.