The Coalition’s health agenda: protect doctors’ incomes

What’s at stake in health in this year’s election is summed up neatly in an article in the Brisbane Times this morning on the performance of one of the government’s GP super clinics, operating in Strathpine on Brisbane’s northern outskirts.

Local doctors are complaining that they’re losing patients because the centre bulk bills. It’s political, claim the medicos. Local MP Peter Dutton, the opposition’s shadow on health, wants to see the centre shut down.

Update: In other news, Tony Abbott promises parents a tax rebate on private school fees.

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Posted in federal election 2010, health
32 comments on “The Coalition’s health agenda: protect doctors’ incomes
  1. “We’ll help you pay more for GP access” doesn’t sound like the world’s most winning campaign slogan, but then I’m not a Liberal Party political strategist.

  2. kimberella says:

    Update: In other news, Tony Abbott promises parents a tax rebate on private school fees.

  3. Sam says:

    Says one of the doctors who claims to be losing business to the super-clinic:

    “It is just not fair.”

    There we have it. Health policy according the pre-schooler’s standard, catch all, complaint.

    And Dutton agrees.

    You’ll not see a finer example of a politician captured by producer interests.

  4. Repeal the Monocle Tax!

  5. John D says:

    Peter Dutton comes from a marginal electorate that is not particularly affluent. Not every voter will be enthusiastic about losing one of those rare treasures that offers bulk billing!!!

  6. Spana says:

    Perhaps, but let’s not ignore the fact that the ALP has been propping up the massive big business of private health care for years. It supports using tax payers’ money to subsidise profitable private health companies whilst Medicare crumbles.

    We need to face the fact that Labor has endorsed a two tier system of health, one subsidised for the rich and a safety net for the poor. By al means attack the Lib’s health piolicy but let’s not forget that the ALp continues to destroy Medicare in favour of big business.

    This is what ALP voters are endorsing – the destruction of Medicare.

  7. Sam says:

    Spana, how is Medicare “crumbling”? Do you have a datum to support this claim?

  8. Mindy says:

    @ Spana – how is this any different to what the Liberal government did in power? Also, how will shutting down this clinic help the poor who are supposedly relying on this safety net?

  9. Howard Cunningham says:

    One of my least favourite policies of the party of which I am a member.

    I worked for a allied health professional peak body for a short time, and the doctors are the law in this area. What they want, they get, especially from the Liberal Party.

    What we really need is comprehensive teams of health professionals of a wide range of specialties, working in a complimentary fashion. But that may mean less money and prestige for doctors.

  10. mbahnisch says:

    What we really need is comprehensive teams of health professionals of a wide range of specialties, working in a complimentary fashion. But that may mean less money and prestige for doctors.

    Spot on, Howard, couldn’t agree more.

  11. Spana says:

    Sam, bulk billing has declined, the gap between what is paid and what people get back has grown and waiting lists for work that should be done quickly are appallingly long. That does not mean much to the middle class but to working class families in poor areas it is huge. Medicare should provide universal access in a quick manner to all. At the moment those in private health get seen more quickly for some medical issues. Is this what a national health system shouls be about?
    Taxpayers money should be put into Medicare so there is a world class system for all. We should not be propping up big business.

    Mindy, I am no fan of the Liberals health policies either – I am just sick of the ALp being let off the hook for doing what the Liberals do. Medicare should not be a safety net for the poor. It should be a world class system for everyone.

  12. Mindy says:

    @ Howard, I wish!

    @ Spana, I can see where you are coming from now. I agree they are both as bad as each other.

  13. adrian says:

    And now Abbott’s pledged to subsidise private school fees. These people have no shame.

  14. Mindy says:

    The Greens health policy would tick most of those boxes. Could be a couple of ideological issues.

  15. jane says:

    …..the ALP has been propping up the massive big business of private health care for years.

    Er, Spana who introduced the 30% private health rebate? As I recall Kevin Rudd had a crack at means testing it and the squealing from high income earners. But don’t let the facts get in the way of your prejudices.

  16. Sam says:

    “bulk billing has declined”

    Happily, this assertion is easily checked. The latest data can be found in the publication by the Australian Institute of Health and Welfare, Australia’s Health 2010. Data on bulk billing can be found in Table 8.16, p439. The latest year for which there is data is 2007-08, which shows bulk billing at 73.4%, an 11 year high.

    Therefore, on your assertion that “bulk billing has declined”, I call bullshit.

    I’m going to go out on a limb and call bullshit on your other assertions too.

  17. Rain says:

    @Sam – What the national *average* bulk-billing figures don’t tell you, is the wide variation by geography. Doctors, like everybody else, want to live and work in the nice leafy urban pretty burbs of the cities.

    There are locations where there are far too many GPs for the local population’s needs – so they have to compete with each other’s pricing, and hence they bulk-bill.

    The irony is, the majority who bulk-bill are working in richer high-SES postcodes. The poorer suburbs, outer urban developments, and rural and regional areas etc don’t have access to the same level of bulk-billing.

    and, ALP did want to try and reverse the 30% PHI rebate, at least partially if necessary to form a workable compromise, but were up against a hostile Senate.

    And probably a hostile electorate too – seems many Australians stupidly think its a good idea. Idiots. 2-3 billion a year, uncapped and growing, going into the pockets of private sector companies.

  18. Sam says:

    Rain, that is an interesting hypothesis about more bulk billing in the leafy suburbs. Can you point to some data which supports it?

  19. Paul Burns says:

    I suppose if the complaining doctors bulk-billed they wouldn’t lose patients?

  20. silkworm says:

    Nice bit of push-polling at the end of the Brisbane Times school fees article.

    Poll: Do you think students should be able to claim a rebate on private school fees?

    1. Yes, it helps provide choice in education.
    2. No

  21. I can’t find confirmation of this yet, but as well as rebates for school fees, you can claim your kids’ music lessons and costs of their violin or trumpet on the tax rebate.

    Much and all as I am grateful to my parents for paying for my music lessons as a kid, this stuff is middle class welfare, pure and simple.

    On equity and simplicity grounds it would be far better to simply give the rebate to every family with appropriately aged children.

    More important than this pseudo tax cut for the middle class gimmick, Chris Pyne was promising to maintain the SES private school funding formula. You know, the one that classes Scotch and Kings as serving underprivileged communities.

  22. Chris says:

    Robert – its cheaper for the governnment and opposition this way though as firstly its means tested and secondly lots of people don’t know to apply for it.

    Chris Pyne was promising to maintain the SES private school funding formula. You know, the one that classes Scotch and Kings as serving underprivileged communities.

    Well vouchers based on household income and to an extent individual need would fix that problem 😉

  23. …lots of people don’t know to apply for it.

    That’s a bug, not a feature.

    Well vouchers based on household income and to an extent individual need would fix that problem

    You may note the complete absence of an education voucher policy from the Coalition.

  24. silkworm says:

    Paul Bongiorno was disingenuously asserting that the school fees rebate applied to everyone, but that it would be especially welcomed by parents of kids going to private schools.

  25. Chris says:

    That’s a bug, not a feature.

    From the government and opposition’s point of view its a feature. They get a promise a lot without actually having to deliver.

    You may note the complete absence of an education voucher policy from the Coalition.

    yes, neither the ALP nor Libs want it, though for completely different reasons.

    silkworm – it does apply to public school fees as well doesn’t it? With such broad criteria I’d imagine pretty much any family that qualifies with the income test would be able to claim the full amount.

  26. silkworm says:

    On the other hand, Paul Bongiorno could have been telling the truth about Abbott’s policy. It may have been the Brisbane Times that was being disingenuous by claiming the rebate applied only to private school fees. Can anyone put this straight?

  27. Chris says:

    silkworm – I’m pretty sure it applies to public school fees – I heard an Abbott interview on radio and he was saying that it does.

  28. jane says:

    @Rain, as I remember, Rudd proposed means testing with a cut off at $150,000 joint income. I also remember all the stuck pigs trying to convince us that $150,000 is a very moderate income with some clowns whining about the mortgage payments on their own mansions as well as the handful of housing stock they’d bought for their adult children!

    Oh and don’t forget the Merc SUV wifey needs to run the kiddies to the nearest upmarket kindy and the college fees and we’ve only had one holiday in the south of France this year, so we can’t possibly afford 2-3 grand to PAY OUR OWN F’CKN” PRIVATE HEALTH INSURANCE!!!!!!!!!!!!

  29. silkworm says:

    Chris – Yes, it applies to all schools. I just heard SBS news report it (so apologies to Paul Bongiorno). The Brisbane Times has a barrow to push, and starts off saying:

    Parents will be entitled to claim generous fee subsidies for sending their children to private and independent schools as part of the Coalition’s expanded education rebate policy.

    The key word is “expanded.” It’s only when you get well into the article that you discover that

    Under the Coalition’s policy, the current 50 per cent rebate would be lifted to $500 a year for each primary school student and $1000 for each high school student – and extended to private schooling.

  30. robbo says:

    A bulk-billing doctor is but a dream when you live in the bush, and I reckon that the doctors in my town would welcome any help from a bulk-billing doctor,to reduce the enormous strain that they are under.We have a relatively new hospital that is not manned by a doctor on weekends, so any one requiring medical attention has to be transported to Cooma or Bega,100kl one way trip.
    And a handfull of greedy medicos in Brisboring worry about a loss of income because they won’t bulk bill, and the liebrals want to axe this service that provides medical assistance to the less well off. These people are unconsionable r soles.

  31. MichaelP says:

    Plenty of kneejerk anti-doctor sentiment here. Why the assumption that GPs are automatically ‘Greedy Doctors’ more concerned about their incomes than in looking after people? For a start, about 80% of GP consults in Queensland are bulk billed. The doctors in Strathpine are making the point that the GP Super Clinic is not doing what the government said the Super Clinics were supposed to do – ie fill the gaps in service. If the new clinics have to poach patients from existing practices then what’s the point in setting them up in the first place? Bear in mind that the operators of these Super Clinics are not altruistic Good Samaritans – they are private businesses just like other medical centre owners. The only difference is they have been given a very generous bricks and mortar grant by the Dept of Health (in a secret tender process), and in many cases they have been granted exemptions to rules that have hampered recruitment of overseas-trained GPs by other doctors in the area.
    Doctors in areas that have had Super Clinics set up are angry because their many years (in some cases generations) of service in an area seems to count for nothing when it comes to investing in local primary care services. Who needs a family doctor when you can have a 24/7 bulk-billing walk-in centre run by an outside consortium and staffed by casual doctors and nurses? It’s a recipe for Mc Medicine – one of the few Super Clinics operating is already telling patients they will be restricted to “one problem/five minute” consultations. If you’re really sick you’ll have to go see one of those not-so-super real GPs.
    I’m no Liberal supporter, but someone has to see this Labor policy for the sham that it is. It’s not about equality or improving care, it’s just a carrot for marginal electorates.

  32. pablo says:

    Yeah robbo you’re on the money about bulk billing in the bush. I was a reporter on a local paper in a sizeable town in the Riverina where there was no bulk billing. A new (Indian) GP came to town and I did an intro for him, noting his assurance that he would bulk bill. The guy was inundated and the paper’s editor took a lot of flak from established medicos. It just wasn’t the question you were supposed to ask I was told. I’ve lived in a couple of other country NSW towns since and no one universally bulk billed.

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