Appropriately, the possible end of the government’s bid for a general practice co-payment scheme has been accompanied by confusion and miscommunication.

Is the co-payment, as reported in one backgrounded news report, about to be scraped off as one of those pesky barnacles slowing the progress of the Good Ship Abbott? Or will it, as foreshadowed by Health Minister Peter Dutton today, be implemented via regulation rather than legislation — an outcome so appalling in prospect that Coalition backbenchers have already emerged to warn against it?

We have never had a rational explanation of this policy from the government. On one hand we were told it was designed to address the unsustainability of healthcare spending — but Australian Institute of Health and Welfare data showed growth in national medical expenditure slowing; indeed spending actually fell in 2012-13. On the other we were told it would fund a vast new medical research fund — belying the entire point about unsustainable health spending.

Dutton, a politician never renowned for his profile or powers of communication, has simply never been able to articulate a consistent argument for the co-payment beyond a robotic insistence that health spending was unsustainable.

There is, potentially, an arguable case for a price signal in primary healthcare to minimise over-use, but it raises equity concerns that any well-considered co-payment scheme could have addressed. The mechanism put forward by the government simply failed to do this. This has not merely been a failure of communication on behalf of the Abbott government, but one of substance as well.

Peter Fray

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