Page 1842 - Week 06 - Thursday, 5 June 2014
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What is the right co-payment rate?
Andrew Leigh said:
The key with any co-payment system is to set it at a level that deters frivolous visits, but doesn’t run down preventive healthcare. Catching diseases such as cancer and heart disease early dramatically improves the likelihood of survival, and is far less costly.
So it was Andrew Leigh that was arguing for this—your federal member, members opposite—quite convincingly and it was the federal Labor Party that first introduced the co-payment, in 1991. Mr Hawke—remember him, Bob Hawke—introduced a co-payment back then, $3.50. I am trying to think what the CPI was but I would imagine $3.50 back then was probably more than $7 now is. That was what Mr Hawke put in there. But that was later reduced to $2.50 and then—I think Dr Leigh intimated this—it was scrapped in March 1992 as a result of the battle between Hawke and Keating in those days.
The federal coalition was the best friend Medicare ever had, and the current coalition government will continue to be by making Medicare sustainable. And it is just remarkable that those opposite are criticising the co-payment because it is those opposite who have been advocating it and had previously introduced it at the federal level. Not only do we have on record the powerful support of this idea from Dr Andrew Leigh MP, but it is worth reflecting on the process by which the Federal Labor Party came to the policy conclusion:
As economists have shown, the ideal model involves a small co-payment … And the idea is hardly radical.
The Hawke government champion was Brian Howe, a leading member of the Labor left.
In 2003, Andrew Leigh clearly articulated Labor’s real position. He advocated an Australian co-payment and listed the OECD countries which had a similar co-paying public health system: Austria, Belgium, Finland, France, Germany, Greece, Iceland, Ireland, Italy, the Netherlands, Norway, Portugal and Sweden. And in 2003, Andrew Leigh said that co-payments were:
… widely recognised as effective in keeping down excess visits. Yet it was scrapped in 1992, an unlikely casualty of the Hawke-Keating leadership battle. Converting the 1991-92 scheme into today’s money would be equivalent to $3.50, it would be enough to deter frivolous GP visits, but not enough to limit genuine preventive care. Everyone, including pensioners, should pay it, with welfare benefits and pensions increased to compensate for the extra burden. Those who are chronically ill could receive an exemption …
In 2003, Andrew Leigh gave the pseudo medical observation:
The Government has correctly diagnosed two of our health system’s ailments—the lack of a co-payment and the lack of incentives for doctors to move to the bush.
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