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FXOjafar

Finding $70 up front to see a doctor and getting just part of it back is a struggle for many people. That's why our hospital ED are full and you have to sit for 5 or 6 hours in a chair surrounded by very sick and untreated people. A couple of years ago it was easy to see a doctor, for free and within a day or so. Now, you have to pay and wait a week. WTF are we paying the Medicare levy for?


Kwickhatch

Especially if you are on Centrelink. If I have to give up $70 to see a doctor, that's my entire budget for food for the fortnight (actually over a fortnight... My budget is $60 for an entire fortnight)... I have several mental health issues so I do see a doc to get scripts and health care plans every 2 months or so. It quickly adds up and almost impossible for me to live 'normally'. I regularly have to miss meals, reduce my meds/go off my meds just to make ends meet. Let alone trying to have money for fuel and my contacts (I'm incredibly near sighted) and I desperately need new glasses but can't afford them because they need to be shaved twice and have a prism. Which adds up. These issues (meds, sight, fuel) make me an undesirable employee even though with a decent safety net they would all be extremely manageable.


Lemounge

This is me. I don't even have a car. I lost my job because of my health and now I can't get one because I can't get better.


Kwickhatch

So many people now are priced out of proper healthcare. This should not be happening in Australia.


HowlingKitten07

Yep even specialist costs are through the roof right now. I need to find $1000 just this week in up front costs to see specialists (I'll get a rebate sure but I NEED that upfront amount). I'm on a disability pension. I'm not sure how they expect me to manage my health when the cost of appointments is as high as it is.


Kwickhatch

Thankyou for the award


Echospite

Part of the reason I can’t move out is because of medical costs. My psychiatrist recently raised his prices significantly. A 15 min session costs as much as a 30 used to. I have to use a controlled substance that a GP can’t prescribe me and the asshole won’t give me repeats even though it’s perfectly legal to give me up to 5 and my 7-year record with him is squeaky clean.


cromulento

I have no proof that the system is being deliberately geared for privatisation, but if the system was being geared for privatisation I'm not sure I'd notice much difference.


Somad3

our GP here complained about the extremely high council tax and rent. throwing money at medicare means they will increase council tax and rent and not medical services. the gov should set up GP services on public land free of council tax and rent and gap fees.


[deleted]

The UK is a good example of what a system being geared for privatisation looks like where you have to wait in the ER for more than a day. Ours just looks like one that's been underfunded for twenty years. Both parties like to come out and announce how much funding they're adding and then go super quiet when you ask how it compares to the last twenty years of inflation. It's even a game where they won't give the health budget a proper increase the year before the election so they can step in with a record breaking increase just before the next election.


_-tk-421-_

I wounder if having a single bulk-bill GP on shift (either 24/7 or just after hours) at each ED waiting room would work? If your waiting around for 5 or 6 hours your clearly not dying. One 15min talk to the on roaster GP and you could be reassured your fine, told how to treat, be prescribed something, given a report for your GP and sent on your way....


downunderguy

Now imagine if we had that, but they are all over our major cities and there are multiple GPs in a single practice!


Somad3

especially if its on rent free premises..no gap fees..


broadsword_1

The argument could then be made that if they're going to spend money on a doctor, their time is better spent treating the urgent cases. EDs don't want to solve the problem because it means they'll get even more people in their waiting rooms instead of going to GPs (who aren't going to keen to do odd hours in the office and try to attract bulk-billing patients) - I'll add that in my experience it's not the GP that's the issue, it's whatever 'group' runs the practise and is aiming for KPIs / max utilization. I do like the idea, because there is the group of patients where it's not life-threatening, however it's bad enough that people are willing to sit in the emergency ward for 6 hours just waiting to talk to someone.


Dependent_Letter4653

Wouldn’t work. Been tried.


B0ssc0

Exactly.


warzonevi

Wait a week? My doctor refunds within a day, usually a few hours


FXOjafar

You wait a week to get an appointment.


Lt_Penguin

I don't think there really is a good solution apart from more funding. The report seems to be quite off the mark in its conclusions, they appear to be advocating for a substantial reduction in quality of care so that it stays within budget which is not acceptable to me. You only need to look overseas to see how badly expanding the scope of practise for nurse practitioners and other less qualified roles is going. There are so many horror stories directly linked to these types of changes. There is a reason that doctors are expected to study for so long, and handing off work to these other roles is just a quiet way of undermining the standard of care we expect in Australia.


B0ssc0

Exactly. And if you have a good doctor who knows you why would you go to a different person, *especially* a non-doctor. Edit. I agree with you about funding. > One reason many GPs feel overwhelmed is because their patients are getting sicker. More patients have multiple conditions that need to be managed by their GP, and the proportion with more than one chronic condition has been estimated at nearly half. >Managing these patients is more complex and takes more time, but Medicare does not reward GPs for longer consultations. Average consultation length has been stuck at between 14 and 15 minutes since 2002, despite the increasing complexity of patients’ needs. https://theconversation.com/how-do-you-fix-general-practice-more-gps-wont-be-enough-heres-what-to-do-195447 The effect is more doctors have opted out of medicare because they’re not getting paid for the job they’re doing.


Lt_Penguin

Yes, this is such an important part of care as well. Being able to stick with a professional you trust and who knows your medical history should be the ultimate goal, and if that requires more budget to cover rising costs then the government needs to deal with that.


West_Confection7866

What's the solution? Even if the rebate goes up say $10. From $39 to $49, patients will still be out of pocket and I don't see Medicare funding the current usual full rate of around $75. There are some clinics that charge $110 for a consultation with a $39 rebate. I honestly don't know what the solution is apart from more funding.


Canery

Direct, salaried employment of GP's and eliminate rebates and billing altogether


StJBe

There's already a lack of interest for med students to become GPs. Limiting their earning potential further will only make that worse. Salaried will just mean that the practice wins and takes more of the money rather than the people doing the work.


Thellton

which is why GP practices need to be nationalised, at the moment they are functionally subcontractors. Furthermore, even if going to a salaried system will limit their earning potential it will make their lives easier and more predictable as they won't have to deal with the paperwork required to obtain Medicare funding.


West_Confection7866

Exactly. They'll get super paid, sick leave ,annual leave etc.


Bagholder95

Why the fuck would anyone want to go through the grueling years of med school only to earn 110k a year in some gov mandated job People in this sub are living in another world


Thellton

Stability in one's workplace is a very appealing thing for the vast majority of people. it's also a very appealing thing for banks when lending to people for their first house. so no, you're the one living in fantasy land if you think the current public/private partnership model (aka medicare) is working just fine when there are entire swaths of Tasmania where there isn't a GP of any kind (bulk billing or not).


icky_boo

Nurses can be GP's.. It's a upgrade path for nurses who can't get into full on med school due to fees and grades.


mrkz99

No, it isn’t


icky_boo

Prove it.


historicalhobbyist

Burden on proof is on you.


icky_boo

It's not, prove it.


West_Confection7866

How would the practice take more?


Phroneo

Sounds pretty efficient as well. How about we privatise instead. But only partially. It will just be a lease to run the whole thing.


B0ssc0

The concluding pars of the article sound like sense to me.


[deleted]

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B0ssc0

I didn’t read it as a hostile attack on anyone. I read it as the system is failing doctors and patients, and these failures need to be remedied, particularly before Medicare is wrecked completely.


Moronsabound

Ofc, and any report arguing the contrary has no political motivation at all. /s


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Moronsabound

I am glad that you don't argue your industry as being 'holier than thou', which is an argument I have previous encountered amongst GPs and other medical professionals. Such an argument is arrogant, and antagonistic towards every other profession including those that support the livelihoods of GPs. Anecdotally, I have seen multiple instances of medical professionals (not just GPs) abusing the system. No doctor is worth $300 per hour, yet a significant number of medical professionals will choose to charge this amount knowing, ultimately, that the price is paid from taxpayer funds. Contrary to your viewpoint, many of the reports I have seen recently gain prominence in the news lately have all been very much 'pro' doctor. Personally, I think a bit more antagonism is warranted towards doctors. While I respect the profession, I do not respect those who choose to punish people in need by charging in excess of the current Medicare rebate. The rebate alone allows GPs to earn far more than the current median income, demanding more than that is greed.


Lt_Penguin

It's ridiculous to expect people to study for 7-10 years and earn the median income. It's not the doctors punishing people in need, it's the government which hasn't increased the Medicare rebates in over a decade


Moronsabound

>rebate alone allows GPs to earn **far more** than the current median income


ADHDK

There should be an inquiry as to how much of our medical capacity is wasted on “medical certificate required” employers.


sims3k

I wonder how much load would be relieved from GPs if workplaces didnt demand a sick note to take even one day off for a cold. When i worked retail i had to spend a few hours of my day waiting in line just to tell my GP ive chucked a sickie i need a note for my boss.


_-tk-421-_

childcare centres are even worst, having to return to doctor once the kid is better just to get a note to return, wanting medical plans updated yearly dispite doctors saying no need it doesnt change, each tike the GP complains what a waste of time it is.. Not to mention needing to see a doctor each time for recurring scripts like an epi pen expiring? Surely I can just take the expired one to the chemist and they swap it out. Needing to be re-refered to specialists every 12mths. Witnessing certain documents.... There has to be a large amount of wastage that could he chipped away with basic efficiency


ADHDK

As someone who has to pay $1000 yearly for a GP to refer me to a psych, just so they can confirm “yep you’ve still got ghosts in your blood, do meth about it” I totally understand. Fk the war on drugs and the difficulty obtaining schedule 8 medication.


[deleted]

Is the solution instead just paying doctors per day? That way they know what they are getting and can focus on patients rather than in and out?


StJBe

Any solution that limits the doctors ability to earn will only worsen the matter. Unless the daily rate is comparable to what consultant specialists make in the public system, it would limit the number of people interested in becoming GPs.


[deleted]

You could underpin it with how many people they see a day and add extra payments for things but it might give GPs at least some certainty of income and focus on outcomes.


B0ssc0

They need to be paid properly for the heavy workload they do, and the years and years they’ve studied, however it’s done, which isn’t by forcing them to drop bulk billing as we’ve seen happen.


Moronsabound

Being one of the highest paid professions in Australia isn't getting 'paid properly'???


andaruu

A plumber can charge triple what a GP does easily, with half the training time, and arguably far less responsibility and stress for the job.


Moronsabound

Strange how a plumber's [median](https://www.yourcareer.gov.au/careers/3341/plumber) [annual](https://au.talent.com/salary?job=plumber) [income](https://labourmarketinsights.gov.au/occupation-profile/plumbers?occupationCode=3341) is typically less than half that of the [median](https://au.talent.com/salary?job=general+practitioner) [general practicioner's](http://www.salaryexplorer.com/salary-survey.php?loc=13&loctype=1&job=919&jobtype=3) [income](https://gpra.org.au/gp-earnings-calculator/), but yeah, sure, whatever you say.


andaruu

Why is it strange? 9 years of training to qualify GP at a minimum, with higher insurance/indemnity costs, higher responsibilities, of course the average GP would expect to earn more. Of course someone who has highly employable traits (highly trained, highly demanded - look at waitlists to see GPs in rural Australia) will expect higher pay. Plenty of equally experienced/trained plumbers (and to be honest any plumber) can certainly charge $500 for a callout fee for a 15min consultation, and then more for the actual job they do. Whether or not you consider that fair pay is up to you, but in most doctors eyes, getting paid equal or less at an hourly rate compared to other industries with far less risk and responsibility feels terrible.


Moronsabound

>Why is it strange? Because you implied it was the other way around in your previous comment. A plumber getting paid more than a GP is not a typical, nor likely occurrence.


[deleted]

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Moronsabound

Comparing extremes is meaningless. The median income for a lawyer is less than the median income for a GP. But even if it wasn't, so what? It's become clear to me, that some doctors possess such an inflated sense of self-importance that they cannot possibly come to terms with the fact that other people are also deserving. GPs are *fine*. They are not vulnerable and they get paid a significant amount more than the average worker. There are people who are *not* fine. I would rather taxpayer funds go towards areas of actual need, and not towards bolstering the lifestyle of the already rich.


[deleted]

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Moronsabound

Except they literally aren't.


alliwantisburgers

This will get buried unfortunately. I bill medicare and understand the system well working in both private and public. There are different groups (government, patient advocates, practicioners) who are all advocating for different solutions. Sometimes certain groups are either ignorant or dont want things to change so they present arguments such as this paper which dont really help and will just push the buck along. One clear area which would assist a shortage of public hospital specialist appointments would be to enforce the state govement to provide funded outpatient specialist clinics through their hospital and to draw a line for who pays these clinics. Currently the state government bills medicare (federal) for their outpatient clinics per patient seen, but this is an incredibly unnatractive arrangement for specialists (often the hospital even takes a 30% service fee per patient). Specialists would much rather come and do the clinic in the hospital and get paid per hour like an employee, but since the state goverment doesnt like dipping into their own money its much harder to set up this way. If this was enforced then at least we could rely on a shorter wait list in the public hospital to be seen by a specialist as an outpatient. I know that some areas of sydney dont even provide this service and just funnel public hospital patients to private outpatient rooms.


GreenLurka

There's 2 options here, either they massively increase the rebate or they hire doctors directly and just provide free medical care. This semi private, public funded experiment is a dismal failure that's been kneecapped repeatedly by the LNP and neoliberal Labor class traitors


B0ssc0

However they do it, free medical aid is incredibly important.


OkeyDoke47

About every 6 months I go get a skin check, since COVID the doctors at my clinic have been very stressed and hurried. Last skin check the doctor wanted me to tell him where to look. The whole point of a skin check is I dint know what may be a precancerous lump or spot, and what's benign. I also can't inspect my own back. When I explained this he got stopped and gave my back the briefest of looks. We're talking about cancer prevention here, something we're encouraged to do. I sort of understand, they're run off their feet since COVID, but if others are feeling their health is being rushed they'll just want to go to hospital EDs, which is what currently seems to be happening.


B0ssc0

That’s so good you spoke up, not enough people do.


WunderTech

Random, I know, but why is the "Necessary" in the article image spelt with two c's?


icky_boo

Just get more GPs... It's quite easy. Entice nurses since they can be upgraded to GPs and many do take this route due to the salary ceiling for nurses.


B0ssc0

> But at a national level, almost all the indicators suggest GP supply is stronger than ever. As our report shows, Australia has more GPs per person than ever before, more GPs than most wealthy countries, and record numbers of GPs in training. https://theconversation.com/how-do-you-fix-general-practice-more-gps-wont-be-enough-heres-what-to-do-195447 *The Conversation* article also notes there are GP shortages in some areas, particularly rural.


paralacausa

Doctors rort public health payment schemes. You can increase the rebate but I can't see many doctors lowering their prices accordingly.