Labor championed doctor co-payment fees

SENIOR Labor leaders have championed for years the introduction of the user-pays system for medical services.

SENIOR Labor leaders have championed for years the introduction of the user-pays system for medical services now vehemently opposed by the party, with the former Beattie government in Queensland going as far as proposing an $800 fee for overnight hospital admissions.

As Tony Abbott accused federal Labor frontbencher Jenny Macklin yesterday of being the “mother of the co-payment’’ — after advising the Hawke government on its plans for a $3.50 Medicare charge in 1991 — documents show that in 2005 the Queensland government considered billing patients $50 for same-day admissions and more for overnight hospital visits. The documents have emerged as the Abbott government struggles to win parliamentary backing to introduce a $7 co-payment on GP services.

Then premier Peter Beattie commissioned modelling “to increase cost recovery from patients’’ after a 2005 review of the state hospital system warned the system was financially unsustainable without new funding.

The push by Mr Beattie was blocked by then prime minister John Howard and Mr Abbott, then federal health minister, with the threat it would breach the Australian Health Care Agreement. The documents show the Beattie government ordered modelling for means testing and co-payments on a raft of free services, including non-urgent surgery, dental and specialist outpatient services.

Allen Consulting delivered a 140-page report, with the top being a “universal co-payment’’ of $50 for “same-day admissions’’ and $100 for “overnight admissions’’. Another option was to exempt concession card holders and bill higher-income earners up to $800 for an overnight admission.

In an email, Mr Beattie — who in 2010 reiterated his support for a hospital co-payment to be billed to patients with private health insurance — said he ordered the modelling after the hospital review by Peter Forster.

“My recollection is it was to apply in accident and emergency departments in hospitals to encourage patients with minor ailments to visit and use their GP to save taxpayers money,’’ he said.

“Tony Abbott was health minister and he threatened me with a breach of the Medicare agreement. How times have changed.’’

Queensland Health Minister Lawrence Springborg said the current Liberal National Party government had ruled out a hospital co-payment.

“What’s really worrying for Queenslanders is that one of the people that helped commission this report is currently Labor’s shadow minister for health (Jo-Ann Miller), which underlines why Labor in this state cannot ever be trusted to protect taxpayer-funded free hospitals,’’ he said.

In federal parliament yesterday, a row erupted between the government and Ms Macklin after Mr Abbott and Health Minister Peter Dutton accused her of being the “mother of the co-payment’’.

The Prime Minister and Mr Dutton also pursued Labor’s ­assistant Treasury spokesman, ­Andrew Leigh, who more than a decade ago wrote in support of a price signal on Medicare services, saying it should be a charge that would “hardly hurt at all’’ but make people “think twice before you call the doc’’.

Ms Macklin, the opposition’s families and payments spokeswoman, took repeated offence at the Coalition’s attack, saying Mr Abbott and Mr Dutton had “wrongly accused me of supporting a Medicare co-payment. This is completely untrue’’.

“As correctly reported in The Australian today, I was opposed to a Medicare co-payment in 1991 and I’m opposed to it today. And this was confirmed in the paper today by the then secretary of the department of finance, Dr Michael Keating,’’ she said. Mr Abbott told question time Labor members knew in their “hearts’’ a “modest co-payment is perfectly appropriate and sensible policy’’.

“Not only do we have Bob Hawke as the father of the co-payment, we’ve got the member for Jagajaga (Ms Macklin) as the mother of the co-payment. The real authors of the co-payment are over there,’’ Mr Abbott said.

Former health minister Brian Howe announced a $3.50 co-payment in August 1991, but it was ditched after Paul Keating toppled Mr Hawke as prime minister.

Mr Dutton said Mr Howe had explained that he was introducing the budget measure after receiving the preliminary findings of the ­National Health Strategy. “It says for further information about the advice to the then government in relation to the co-payment, contact Jenny Macklin, director of the National Health Strategy.’’

Mr Dutton and Mr Abbott also pointed out that Dr Leigh had previously voiced support for a co-payment in an opinion piece for The Sydney Morning Herald in April 2003. This month, Dr Leigh said his views had changed.