The BBPIP makes quick medicine more lucrative. I don’t do quick medicine. No amount of ‘carrot and stick’ leverage will change that.
There has been a relentless campaign, that reminds me somewhat of the “pester power” campaign advertisers use to persuade parents to buy things for their children.
The current government has been assuring the public that GPs will be “free” post 1 November due to their largesse.
Last week, Minister Mark Butler upped the ante, as they say, by announcing that he is happy to influence the market by using the government’s considerable spending power to force GPs to yield to this new policy direction.
However, I doubt this will be a win for the public overall, and I doubt we will see 90% of GPs take up this “offer”.
Why?
We do not behave like retail owners
There are a lot of people out there who are talking about healthcare as though GPs will behave like any other small business.
We are used to people talking to us, about us and for us without talking with us. It happens to me ALL. THE. TIME.
I do not agree with Professor Stephen Duckett’s economic argument of what I think or what I will do. I do not think GPs will behave like a market.
GPs are, frustratingly I’m sure, a bit like cats when you try to herd them.
We serve communities. Not all communities are the same. Like representative governments, we hold different views for different reasons. We have a history of behaving like the professionals we are and doing things we think are right.
Which is why public hospital doctors hung around for so long when there were so many other lucrative things they could be doing.
This change to universal bulk billing comes with caveats that are not right. Universal bulk billing I can agree with, the caveats I can’t.
The corporates will behave corporately. The others? Perhaps not.
Medicare is designed to privilege quick medicine
Six minutes is optimal. It works to bulk bill if you move the complex stuff off your books, elsewhere.
The corporates will argue this is not true, however, we have seen Cohealth, a bulk-billing clinic serving the most needy in Melbourne, close its doors, because it couldn’t manage to remain financially sustainable.
So did the Interchange in Canberra, for the same reason. So did Hobart Place, which served the LGBTIQA+ community.
Related
The evidence suggests that universal bulk-billing clinics which tackle the complex have enormous difficulty managing their financial sustainability.
It’s even harder now.
Why? The “simpler things” that were comparatively better paid (no idea why, Medicare) are now with pharmacy, nursing etc, etc) meaning the GPs have the harder, less lucrative, complex medicine.
So, GP is less sustainable. MyMedicare does nothing to fix this. In fact, it makes quick medicine more lucrative.
Associate Professor Louise Stone is a working GP who researches the social foundations of medicine in the ANU Medical School. She tweets @GPswampwarrior.
