Debate on a GP Fee Policy

Debate on a GP Fee Policy stress Question What do you think about the prospect of a $5 fee to see a GP?The topic of a $5 patient co-payment for GP higgles is an ongoing debate that is currently existence argued from individuals to wellness c be providers. Under this device, pensioners and concession card holders argon exempted, and families are allowed 12 bulk calculate visits before co-payment applies. So, why would the government slug patients with a $5 co-payment for GP visits? The Australian Centre for wellness Research (ACHR, 2013) claims that by implementing this intention, the government would save an approximate $750 million over 4 years and that the co-payment proposal wouldReduce avoidable take away for GP servicesReduce incentives for GPs to over-serviceRemind tribe GPs are non freeReduce moral hazard risk by making people consider tour a GP for minor ailmentsRemind people that maintaining computable wellness is an individuals obligationHowever in order to take a stance, it is important to first understand wellness. Should wellness be a right, or is it a privilege? If Health is a privilege, wellness insurance would only digest emergencies and not day-to-day health apprehension maintenance, which would be detrimental to those in financial hardship (J L. Marshall, 2011). Hence, Health should be a right, a right based on need and not the ability to pay, where everyone keister urinate equal accessibility and treatment to health compassionate, which is why the $5 co-payment should not proceed (Public Health Association Australia, 2011).Expenditures and efficiencySo why does the government intend to cut expenses from the health sector through and through a co-payment? Are we spending too much? According to the Australian Institute of Health and public assistance AIHW (2013), total health safekeeping phthisis in 2011-2012 amounted to $140.2 billion, which is 7.6% higher compared to the previous year (AIHW, 2013). Since GP visits are co vered by Medicare, which is funded by the political science and through a levy, GP visits would be included in this $140.2 billion. However, it was reported that the total Medicare expenditure was $16.3 billion in 2010-2011, total meaning that it included GP visit along with various services covered by Medicare Benefits Schedule MBS (Australian Government Department of Human Resources, 2011). Thus, it is conceivable to consider that Medicare is only a small portion of the total expenditure.According to The Organisation for Economic Co-operation and using (OECD), Australias health expenditure stands at $3800 per person, which is 8.9% of the Gross Domestic Product GDP. In comparison, USAs health expenditure per capita was $8508 per person, or 17.7% of GDP. Does this perhaps mean that life expectancy in USA is fracture due to the extra live to health care? This does not seem to be the case, but or else statistics demonstrates that the highly privatised health care system is ine fficient as shown in Figure 1.From Figure 1, by comparing USA to Australia or Canada, it shows that USA has a slightly lower life expectancy, but the health spending is almost double the figures of Australia and Canadas. It should be noted that both Australia and Canada have widely distributed health care systems in contrast to the privatised health care in USA. presumption that a privatised system is evidently slight efficient but yet costs more for individuals, would it then be wise to implement the co-payment, a move seen by many as a means to slowly dismantle Medicare (C index, 2014)? According to Catherine King (2014), the government would reduce expenditure for health care by means testing Medicare, but Australians impart have to carry the tab. Means testing access to particular healthcare will lead to greater privatisation, which will restrict access to GPs for most Australians, more so on older people, the vulnerable ones in our race and families with children (C King, 2014). King (2014) states that GPs are the cheapest within health systems, experts at diagnosis and able to detect potential health issues in their infancy. Thus, if GPs are restricted, people would end up in hospitals, the expensive side of the health care system, increasing the expenditure rather than saving.Reduce avoidable demand for GP services alike the intention of cutting costs for health care, one of the reasons provided by the ACHR for the co-payment proposal was to reduce avoidable demand (over usage) of GP services. However, the solution to this issue would not be to introduce a $5 co-payment for GP visits, as there are concerns that the co-payment would jeopardise equitable access to clinically appropriate healthcare (J Swan, 2013). This can be explained with a few questions by considering the targeted audience and the effects of the solutionAccording to J Swans article John Glover voices fears GP fee will give birth poor suffer (2013), Professor Glover, who conduct Australias most detailed analysis on the relationship between a persons wealth and their willingness to visit a doctor, states that there is very strong evidence that poorer people are already under using healthcare in proportion to their level of illness. Through his analysis, it is shown that only 5% of residents who lives among Sydneys wealthiest neighbourhoods Mosman, Woollahra and Hunters Hill, claimed they had delayed medical cite due to financial issues. In contrast to less wealthy areas, Penrith had 13.5% Nambour 23.4% and Ballarat had 17.9% residents claiming they would delay visiting doctors due to cost.From these statistics, it is name that the poor would be most affected. John Glover, director of the public health information development whole at the University of Adelaide describes that the $5 co-payment for doctor visits would discourage the wrong group of people from visiting the doctor go doing nothing to dissuade those who are already over using GP services (J Swan, 2013). The co-payment would cause those apt(predicate) to get seriously ill to unreasonably avoid preventative care which is a step towards cut back what we have as a universal healthcare system privatisiation (J Swan, 2013).Disadvantage to certain group of people (delay seeking medical help)Would the $5 co-payment injustice certain groups of people? The co-payment would have dangerous consequences for the poorest and sickestThis then comes cumulation to the issue of cost and equity. Health Program director of Grattan Institute, Stephen Duckett states that In the healthcare system theres a trade-off between costs and equity, the government might save money in the short-term at the cost of equity, but Emergency departments would soon fill up with patients delaying to visit GPs (J Swan, 2013).Clogging up ED (caused by delay in seeking aid from primary health care)Potentially preventable hospitalisations (PPH) have been define as those hospitalisations which could have bee n avoided with access to quality primary care and preventative care. Rates of PPH for selected conditions, such as chronic conditions and vaccine preventable conditions are being used nationally and internationally as an indirect measure of problems with access to care and effective primary care.In contrast it is well established that hospital admissions can be prevented by primary care. Australian data show that there are most 33 hospitalisations per 1000 people per year or 10% of hospitalisations could be prevented by effective primary care5. These primary care preventable hospital admissions are increasing in recent years. The ACHR report suggests that the accounting entry of a co-payment will reduce all GP attendances, both those regarded as necessary, and those that are perceived as unnecessary1. There are inadequate data to know how this will affect hospital admissions. However, the co-payment whitethorn amplification rather than reduce overall government health expenditur e.I support the reasoning provided by ACHR for the submission of co-payment to remind people that maintaining good health is an individuals responsibility, which requires investments in comprehensive primary health care (Public Health Association Australia (2011). I also support the overall aim that health care expenditures must be properly managed, to ensure an accessible, equitable, safe, effective and efficient health service provision (Public Health Association Australia, 2011). However, introducing co-payments for GP visits is just one of many solutions available to reduce Health expenditures. Is it a good solution for the reasons provided by ACHR? In my opinion, I do not think it is a good solution. The co-payment would disadvantage the poor, ill and families with children greatly. It is an inefficient method not only to growth health care funding, but otiose mechanism for reducing demand. The introduction of a co-payment for GP visits is a regressive move towards a privati sed system. Given that a privatised system has been shown to be inefficient, means testing and privatisation would only spell the end of Medicare and its not how the government should manage health expenditure (C King, 2014). It is my belief that this proposal has been inadequately investigated and more research would let out better options to constrain health expenditure while encouraging individual responsibility for health. If further probe are to be carried out, I would strongly recommend the government look into the management of successful countries with universal health care system such as Canada or they could make slight adjustments to the Medicare levy, which would help increase health funding as well.ReferencesJonathan Swan (2013, declination 31). John Glover voices fears GP fee will make poor suffer. Retrieved 13 March 2014, from http//www.smh.com.au/federal-politics/political-news/john-glover-voices-fears-gp-fee-will-make-poor-suffer-20131231-304go.htmlixzz2p8w8aZ3vAs Australian Centre for Health Research (2013, October 18). A object FOR AFFORDABLE COST SHARING FOR GP SERVICES FUNDED BY MEDICARE Retrieved March 18, 2014, from http//www.cormorant.net.au/images/18%20oct%202013%20achr%20gp%20copayment%20paper%20final.pdfSue Dunlevy (2013, December 29). Health groups fear $5 GP will hit hospital emergency departments. News potbelly Australia Network. Retrieved 18 March 2014, from http//www.news.com.au/lifestyle/health/health-groups-fear-5-gp-fee-will-hit-hospital-emergency-departments/story-fneuz9ev-1226791543887John L. Marshall (2011, February 3). Is Healthcare a Right or a Privilege?. Retrieved 20 March 2014, from http//www.medscape.com/viewarticle/736705Public Health Association Australia (2011, September). Policy-at-a-glance Primary Health do Policy. Retrieved 20 March 2014, from http//www.phaa.net.au/policyStatementsInterim.phppAustralian Institute of Health and Welfare (AIHW, 2013). Health expenditure Australia 201112. Health and welfare exp enditure series no. 50. Cat. no. HWE 59. Canberra AIHW.Australian Government Department of Human Resources (2011, July 8). Medicare Australia Annual Report 2010-11. Retrieved 25 March 2014, from http//www.humanservices.gov.au/spw/corporate/publications-and-resources/annual-report/resources/1011/medicare-australia-annual-report-2010-11-full-report.pdfOECD (2013). Health at a Glance 2013 OECD Indicators. OECD Publishing. Retrieved 5 April 2014, from http//dx.doi.org/10.1787/health_glance-2013-enCatherine King (2014, February 24). GP co-payment would man the end of Medicare. Retrieved 7 April 2014, from http//www.alp.org.au/gp_co_payment_would_mean_the_end_of_medicareWhat are the equity arguments against the proposal? Unfair to poor and frequently ill peopleWhat are the literatures from overseas on this topic? financial support evidenceUniversity of Adelaide expert on health inequality Professor John GloverReport The cost of careOne in seven Australians has delayed seeking medical hel p because of cost, with Queenslanders more than twice as likely to find cost a barrier than people in NSW.Increased Ambulatory look at Copayments and Hospitalizations among the ElderlyAmal N. Trivedi (M.D., M.P.H)increasing the patients share of the cost for ambulatory care may not reduce (or may even increase) total health care spending and may result in worse health outcomes. Elderly patients may be particularly sensitive to cost sharing because they have lower incomes, are more likely to be in poor health, and have greater out-of-pocket spending on health care than non aged(a) populationsIn conclusion, increasing copayments for ambulatory care reduced the use of outpatient care among elderly enrollees in managed-care plans, but this decline was offset by an increase in hospitalizations, particularly among enrollees with low socioeconomic status and those with chronic disease. Increasing copayments for ambulatory care among elderly patients may have adverse health consequences an d may increase spending for health care.http//www.nejm.org/doi/full/10.1056/nejmsa0904533t=articleTop accessed date 13/3/2014intro (250)para 1 (650)para 2 (650)para 3 (650)conclu (350)(2550)