Medicare - and visit numbers !

Medicare - our universal health system - is forty years old and a few cracks are starting to show.  The most urgent of these - is finance !    Taxpayers pay a 1.5% surcharge on their income to fund Medicare and this brings in about $ 10 billion - roughly half the cost of Medicare and the economists expect that will increase the future deficit.

The statistics show that we made  115 million visits to our GP last year and that averages at about five visits per person each year.   The big question is - are we overusing the system ?  Is it possible to safely lower the number of visits to save money ?

Not without drastic changes to the system.   For a start, every person who needs at least one prescription medicine on a continuing basis is locked in to make two visits to their GP a year - simply to renew prescriptions.   Prescriptions come with five repeats and it would be possible to lower costs by making renewal a function of a trained nurse in place of the GP, but that would dilute the GP function of a regular review of the patient's progress.

Most patients present to their GP from time to time with symptoms that require further investigation by way of medical tests.   A followup visit to the GP is necessary to get the interpretation from those tests and often the GP will refer the patient to a specialist for specific care of the revealed ailment.   In most cases, the specialist refers the patient back to the GP for ongoing treatment and it is easy to see how an expanding visit count can accumulate.

We have a mix of people who rarely visit a GP and in that mix are the elderly and those with chronic ailments that need constant care.   There are probably many people in the community who see their GP less often than they should, either because of lack of a bulk billing GP where their finances are tight, or because they live in a country town that completely lacks a local resident doctor.

Every doctor probably encounters the occasional hypochondriac - the type of person who suffers from imaginery illness and is a regular patient in his or her waiting room.   They are impossible to satisfy, but fortunately they represent a very small percentage of those presenting for treatment and are usually given a very brief consultation.

Comparing our Medicare with systems operating in overseas countries generally rewards it with a high mark.   It is head and shoulders better than the system in place in the United States of America and it compares at least equally with the systems in place in Britain and the EU.   Sadly, a decent medical system is almost non-existent in many small countries of the world.

Our problem seems to be purely a matter of money.   We have a system that works well - and we need to increase the finance to keep it running.   No doubt all functions would be the better for a close examination to avoid waste, but the real question concerns raising more funds - and that means either we pay more tax in an indirect way - or we raise the Medicare levy on income.

The only remaining question - is which one we choose !