AMA: System could "break under pressure"

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The public health system would "break under pressure" if the number of Australians with private health insurance is allowed to drop away, says AMA vice president Dr Chris Zappala.

Dr Zappala was speaking on ABC Radio Sydney in response to the ongoing controversy over high out-of-pocket medical fees.

According to Dr Zappale, maintaining a balance between the public and private health systems "helps us all as a community because it means that those people who are able to top up and pay for private health insurance, that they are actually contributing funding to the system as a whole."

He said it is important to differentiate between care delivered in different settings "because private hospital insurance has nothing to do" with care provided outside a hospital "and the benefit the patient receives is obviously all in the Medicare rebate from the Commonwealth."

"I think the AMA and doctors in general have been saying that that rebate is inadequate, and that it disadvantages patients and should be increased. And both political parties have had their fingers on the freeze of the Medicare rebate for many years now. And, of course, with medical costs going up and the rebate staying rock solid, gaps are going to increase," said Dr Zappala.

"And that's in the purview of the Federal Government to change, and they have said, as you know, that there is going to be a slight indexation of those rebates for GPs starting shortly. But it's not going to make up for that. So, there is a system problem there that absolutely needs to be fixed."

Dr Zappala said he was "very worried" at the suggestion patients are not being given the opportunity to have fully informed financial consent.

"I think it's an important principle of medicine, part of our ethical practice, that patients are told how much something is going to cost, what their alternatives are, and there is time for reflection on that, and that the patient can come back to the doctor and say, ‘hey listen, I don't think I'm going to be able to afford that’.

"And what I hope will happen, and what I do think happens in many cases, is the doctor will say ‘fine, well we'll discount this, and we'll see if we can make it a little bit easier."

Dr Zappala said patients can also seek a second opinion. "And we're fortunate that we've got enough depth in our medical system that patients are always able to do that. And, so, if they're struggling with a bit of information, even if it's the cost of something, please go and get a second opinion."