May 23, 2014

Nicht nachmachen! Lessons in Germany’s failed GP co-pay

Germany recently scrapped a GP co-pay similar to the one being brought in by the Australian government. Crikey intern Danielle Thompson asks: will Australia's work out any better?

Crikey Intern — The next generation of <em>Crikey</em> journalists.

Crikey Intern

The next generation of Crikey journalists.

The federal government has raised hackles with its $7 GP co-pay plan, announced in the federal budget, but it’s been light on details as to how the scheme will be administered and run. Recently scrapped German legislation may offer a hint as to how the Australian scheme might work — and whether it might be more trouble than it’s worth.


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9 thoughts on “Nicht nachmachen! Lessons in Germany’s failed GP co-pay

  1. Monicas Wicked Stepmother

    “Another goal of the scheme is to cut down on “unnecessary” doctors’ visits.”

    If this is really a goal, then the Government is tackling the problem the wrong way. If you want to stop frequent doctors’ visits, you charge a co-pay AFTER a set number of visits, not a co-pay that stops (for benefit recipients) after 10 visits/year. A “frequent flyer” will only have to pay $70/year, after that all visits are free – so how would such a co-payment REDUCE doctors’ visits?

    If the Government wants to stop “frequent flyers” they need to identify WHY these people are visiting, and provide resources to treat the problem – support services for the lonely, psychological services for hypochondriacs etc. A flat fee, not based on a proportion of a person’s income, will do little to address this problem.

    In addition, who will be counting up the 10 visits/year before the co-pay stops? Medicare? How will Medicare communicate to every medical provider which of their patients need to pay? Or will it be a Medicare “rebate” and returned to the patient after they have provided each co-payment, and what are the Medicare administrative costs involved?

  2. Pedantic, Balwyn

    One minor detail forgotten in the discussion of co-payments is how the Health Service will keep track of the number of visits etc.
    As there appears to be some policy dissension, at least at Ministerial level, about the exact rules to be applied, it’s a sure bet that no has started on the major project to develop the internal systems, or reporting packages required for each doctor and so on.
    As the track record for the development and implementation, within budget, of systems at Federal and State level is pretty abysmal, the Government may well be hoping that the legislation doesn’t pass the Senate.
    One suspects that maybe only IT gurus around the country are waiting eagerly for the go-ahead and for very attractive compensation packages that will accompany it for their work.

  3. Harry Held

    The Liberals hate Medicare and have done so for 40 years. This is just their latest attempt to kill it off through a slow acting poison How can they talk about Medicare being unsustainable when they are not even putting the money they want to collect into the system, meanwhile the private section has to be subsidised to the tune of 30% to survive.

  4. Steve777

    I think much of the discussion misses the point. The purpose of the ‘co payment’ is to force doctors out of bulk billing, as a first step in the long standing Coalition ambition to dismantle Medicare.

    As for the ‘Medical Future Fund’, that makes no sense at all if there really was a ‘budget emergency’. It’s either another Abbott eruption like ‘Direct Action or his Parental leave scheme, or it’s intended as a tool in getting this ‘reform’ through the Senate. I can see the headlines now in the Daily Telegraph “Labor blocks funds for kids with cancer”.

  5. AR

    Surely a cash box at the reception desk is the last thing needed by a GP dealing with some of the more ..unstable.. patients at the bottom of the dungheap?

  6. Marc Lane

    In the UK, where a similar idea has been touted, one compelling argument against it has been that it would put further pressure on emergency – from people who should be seeing a GP. The UK is already struggling with GP services wrongly being delivered by A&E because GP appointments are administratively difficult (though free).

  7. Mick Handcock

    Honestly …what would the pesky Germans have to teach us…we are Australia mate…obviously they were doing it all wrong and we have the ability to something completely different!!! Said with tongue firmly in cheek…But in reality – Germany – all jokes aside does have a reputation for doing things right and with a high degree of organisation, if they can’t do it can this bunch of bungling, self praising wannabe’s of THE Establishment achieve anything? I mean they can’t even rort the system without getting caught quite regularly…Good Grief!

  8. Heath Mitchell

    I took my daughter to the doctor this week. They had no trouble processing the $35 gap payment. There are no bulk billing doctors in regional towns. $7? I dream about a $7 co-payment.

  9. Neil

    I work in a rural medical practice and we still bulk bill over 80% of our patients. We havn’t seen a drop in patients over the past two weeks and we have no real idea how this will affect us.
    I have it on very good authority that it will cost the local health service $300K per site to administer the co-payment so I can’t imagine a whole amount of enthusiasm there either.
    What we will probably do is suck it up and see the sick an really poor at a lower fee. We do however have all the infrastructure to cope with the payment and I hope that realtime communication with Medicare which occurs already will inform us of the 10 visit threshold being reached.
    Have to love the German name for co payment.

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