Instead Ergas is seeking to justify it by praising the "moderating" effect of the number of doctor visits.
But wait a minute: what evidence is there that Australia suffers from an overuse of doctors because of the lack of such a price signal?
I have heard it said that in fact Australian rates of doctor visits is entirely within the normal range for similar countries. Unfortunately, I don't have a link for that at the moment.
If there is no convincing evidence that Australia is suffering from a public overuse of GPs, why would you want to save money by trying to persuade them to go to the doctor less? (The fact that the mere news of a co-payment coming has led to doctor's waiting rooms in some parts of the country being unusually empty is no good evidence of overuse - although I noticed that the likes of Andrew Bolt thought so, taking the line that if a $7 co-payment puts you off a doctors visit, you can't be so sick. The point is, you would have to work out how many hospital admissions have been caused by delay in seeing a GP to work out whether the costs savings of reducing GP visits had really been worth it.)
As Ergas himself admits, the effect on population health is not clear, with the Rand study being of highly uncertain application to this country. And as Peter Martin notes:
And general practitioners are cheap compared to other forms of medicine. They account for just 6 per cent of health spending. They act as gatekeepers, directing Australians to hospitals and more expensive specialists only when needed. They are not where the costs are rising. They are among the last places costs should be cut back.Ergas makes one valid point - that countries with what we consider "socialised" medicine do sometimes impose a co-payment and do not consider it ideologically wrong.
But the rest of his contorted argument - that the Coalition plan for one is worthwhile in Australia because it will reduce the number of GP visits - is not justified at all, and is prepared to take a "lets see what happens to the poor when you impose this in Australia" that is typical of the Right at the moment.
The Coalition case for a co-payment would be at least half way plausible if they were going to use it to fund the hospital services that a visit to the GP may result in. But to simply take the money and hide it away and hope it works by reducing the number of GP visits - no, this is just an experiment about price signals that is unwarranted.
3 comments:
will cut future costs by finding a cure for cancer and dementia (honestly, this is his extremely improbable argument)
True, there is widespread opinion that any cure for dementia will be by recognising risk factors 10-20 years before symptoms emerge. Even if that were currently possible there is no obvious approach to addressing dementia.
A cure for cancer is a misnomer. There will be some cancers we can treat but it is decades away before we can treat the big ones in a cost effective fashion.
So any claims that increased medical research is somehow going to reduce costs in the medium term is absurd. Even over the long term it remains problematic because the cost of these treatments are typically 5 and 6 figure sums.
Here's a brutal truth: 80% of the average person's medical cost are incurred in the last 3 months of life. Future treatments for cancer and dementia will probably add to the total cost of treatment prior to those 3 months, not decrease it.
Enry Argus is the used car salesman of the economics field in every inch of the word.
The cost effectiveness of primary health care has been established and the govt needed evidence they could easily consult with the public service. The argument that a copayment will reduce costs has no evidence and must therefore be poor policy.
The govts strong points are its political skills over the opposition, who by comparison are pretty weak. Abbott appears to be determined to crush the opposition with any device available, which again is poor policy.
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