Below is a copy of the email I’ve sent to the above three MPs. A slightly modified version will be sent to my Liberal and National State Senators, after which I will probably draft an email for my various non-coalition senators urging them to stand firm against Medicare co-pays. Because once you start writing letters, it’s hard to stop!
It’s far from perfect, and that’s exactly why I’m posting it here – for the benefit of anyone who would like to write something to their MP or Hockey or their Senators about this, but doesn’t know where to start. Feel free to borrow or steal any points that appeal to you.
And remember – letters and emails don’t have to be perfect, they just have to be sent!
Dear Mr Dutton,
I am writing to urge you to reconsider the plan to add a charge of $6 to bulk billed doctor’s visits. This charge will disproportionately affect those who are poor or who have chronic health issues, and it is likely, in the long term, to increase spending on healthcare in Australia. The proposal to charge for ‘non-emergency admissions’ to Emergency Department is equally dangerous and short-sighted.
It has been stated that a $6 fee will not prevent people going to the doctor if they need to. I believe, however, that this is a false assumption, based on two incorrect premises. First, it assumes a sufficiently stable income or living situation that one still has $6 in one’s pocket the day before payday, and second, it assumes that people are readily able to distinguish between a medical problem that will go away on its own, and one that is potentially dangerous.
Many people in Australia live from payday to payday, and none more so than people on small, fixed incomes, or those in low-paying jobs. Many families are a single pay packet away from poverty. While I’m in full-time employment now, there have certainly been times in the past when I simply would not have had $6 to visit the doctor until after payday, if then. Even now, I know that if I became unable to work for any length of time, I’d quickly run into trouble. For those on pensions, the margin between affordability and unaffordability is narrow. For those with dependents, it’s narrower still.
While $6 for an individual may not be much, some people have multiple family members requiring care. If mum, dad and both kids all come down with the same bug, that’s $24 for the first round of visits, and $24 again if they need further care – or just another certificate – later in the week. That’s going to add up fast. People with chronic illnesses, who are likely to be on fixed incomes and visit the doctor more often than those without, will also be disproportionately affected, even if the number of co-pays is capped.
The $6 charge must also be added on to the other costs of being ill – medication or equipment, lost time (and sometimes wages) from work, travel to and from the doctor, and so forth. If someone’s income is marginal already, even a tiny amount can make a difference.
The second presumption, that people know when they are sick enough to need a doctor and when they should just stay home, is even more dangerous. A number of life-threatening diseases, such as meningococcal disease, can start off looking like ordinary viruses. Broken limbs can be mistaken for sprains and accrue more damage if people continue to use them. Minor scratches can become dangerously infected. Most non-medical people aren’t all that good at recognising the point at which medical intervention is essential, and this is exactly why we encourage people to go to the doctor when they are sick.
Any measure that deters people from visiting the doctor when they are sick also has worrying public health implications. When we had the flu epidemic a few years ago, everyone with cold symptoms was encouraged to visit the doctor, who could then determine which people needed to be quarantined and which people just had a cold. This is not a situation where it benefits the public to have people put off doctor’s visits until they can afford them.
From an economic standpoint, this levy is equally short-sighted. People on low or fixed incomes may decide to skip preventative care visits and ignore minor problems until they become severe – and more expensive to treat. We then have the choice of everyone paying more to make sure these people are treated, or going down the USA’s route of allowing people to be bankrupted by their medical costs. Neither of these are good options.
Finally, I would like to note that this policy, and the way it’s framed as being about discouraging people from making unnecessary GP visits, demonstrates a lack of familiarity with the way employers work. Most employers require you to provide a doctor’s certificate if you take a sick day. So, in fact, did Centrelink, last time I checked. This may not be a particularly good use of the average GP’s time, but it’s not exactly the fault of the patients.
Getting rid of free primary health care is a terrible idea. It harms those who are financially vulnerable, and creates an extra tax on those who are in poor health. It is potentially dangerous to our society, and in the long term, it doesn’t even benefit us economically.
If you’re worried about the costs of Medicare, raise the levy. It makes far more sense to tax people like me, who can afford it. But please, don’t start charging a flat fee to everyone who walks into the doctor’s office. It’s harmful on so many levels – and in the end, we’ll all wind up paying the costs.