The health minister has left the door open to extending private health cover to include GP visits, prompting criticism it could create a two-tier health system.
Peter Dutton flagged a greater role for the private sector and private insurers in primary care as the government wanted to “grow the opportunity for those Australians who can afford to do so to contribute to their own healthcare costs” in a speech on Wednesday.
“We have to look at the next 10 years where we we’re going to have millions of people who will go onto the age group of over 65,” he told ABC’s 7.30 later that evening.
“I want to make sure that we can provide for those and we do have to have a national discussion about who pays for what and how the government pays going forward and how consumers pay for those health services.”
Dutton also confirmed the government was considering introducing $6 “co-payments” for visits to the GP, an idea the government had played down in the lead-up to the byelection for the Queensland seat of Griffith.
Mark Metherell from Consumer Health Forum (CHF) said a review of Medicare was welcome but the forum was opposed to extending private healthcare to cover GP visits.
“We do still believe in the principle of a universal healthcare system,” he told Guardian Australia. “If you introduce private healthcare into GP visits then you are immediately setting up a two-tier system.”
Metherell said it could push GP visit prices up and give preference to wealthy people. “We think it would be counter-productive,” he said.
Tony Abbott maintained his lukewarm attitude to the $6 co-payment idea on Thursday. “I think it’s very important to do what we can to fix the budget as quickly as we can but we have to do it in a way that is consistent with our pre-election commitments and again, I said we were going to be a no-surprises, no-excuses government,” the prime minister said.
Abbott referred to his time as health minister in the Howard government and said: “I want this government to be likewise the best friend Medicare has ever had.”
Dutton argues health spending is rising at a “staggering” rate, which is not sustainable, and it is important to “start a national conversation about modernising and strengthening Medicare”.
He said total spending on healthcare in Australia had increased 122% in the 10 years to 2011-12, when it totalled $140bn. This equated to about $6,200 a person a year on average.
The commonwealth component of health spending was forecast to rise from $62bn now to $75bn by 2016-17.
The president of the Australian Medical Association, Steve Hambleton, said extending private health insurance to cover GP visits had been specifically excluded by all previous governments and he had seen no proposals from this government canvassing such a move.
“The AMA would be very interested in talking to the minister about it if it’s on the table,” he said.
The AMA is opposed to the co-payment. Hambleton said it “would break the healthcare system” if it was introduced. “It is a blunt instrument that would have adverse outcomes,” he said.
Hambleton said the policy would have the greatest impact on low-income earners, who were also more likely to have health problems. If more people went to hospital emergency departments or failed to seek medical help it would end up costing the government more in the long run.
He said more focus should be put on preventive health care if costs were to be reduced and repeated his call for a national alcohol summit, saying liquor was responsible for $36bn of lost productivity and healthcare costs.
Dutton said there had been a “shrill” response to some of the government’s proposals and the “1980s model” of a health system needed to change.
“There’s been talk about simply increasing the Medicare levy to solve the sustainability issue. Let me just say here [that] if we were to increase the Medicare levy to cover the entire cost of the commonwealth’s health budget, it would have to increase to 9.5%. That’s $7,220 per year on an average salary of $77,000,” he said.
“Either way, individuals end up paying for their healthcare – whether it is directly or indirectly through pay-as-you-go or through higher taxes otherwise. To reap the benefits, there’s always a cost, and I think most Australian taxpayers understand this.”
The opposition leader, Bill Shorten, has criticised the proposed changes, saying Australians should get the healthcare system they need, not the healthcare they can afford at a particular time.
“The prime minister promised before the election he wouldn’t introduce any new taxes, but now he is trying to sneak in a new GP tax that will hit families every time they visit the doctor,” Shorten said.
“He promised before the election he would protect Medicare, but now he is trying to destroy our universal healthcare system.”
The opposition health spokeswoman, Catherine King, said Dutton’s claims about rising health costs were “hysterical”, because Australia spent 9.1% of its gross domestic product on health compared with 17% by the United States.
