US-style: government changes could create a two-tier health system.
US-style: government changes could create a two-tier health system. Photo: iStockphoto

An Abbott government push to allow private health insurers to
cover GP visits would create a US-style two-tier health system and
drive up doctors' fees, experts warn.

The Sun-Herald has learnt Health Minister Peter Dutton
told senior health sector sources in private meetings he is keen on
the idea of allowing private insurers into GP clinics. However, any
change would require amendments to legislation.

Under the current Medicare system, all Australians - whether they are
public or private patients - can expect similar quality of care when
they visit their doctors.

Experts say changing this to create two classes of GP patients would
revolutionise Australian healthcare and potentially undermine Medicare
more than the government's proposed $7 co-payment.


The revolution has begun quietly through controversial trials undertaken in Queensland.

Medibank Private members are receiving guaranteed appointments within 24 hours and after-hours home visits.

An expansion of such trials which would provide superior GP services to
private patients could endanger Australia's world-class healthcare
system, Australian Medical Association president Brian Owler said.

"It would be a fundamental change in the way that general practice is
funded," Professor Owler said, adding the AMA was open to insurers being
more involved in primary healthcare but the government needed to
proceed with caution.

"If people go too far or the role of private health insurers is
unchecked then, yes, it could have very significant consequences and
produce greater inequity. We have a good healthcare system in Australia
and the US model is not one we should be trying to emulate.''

The health program director at the Grattan Institute, Stephen Duckett,
said if private insurers were allowed to team up with GP clinics
"there'll be an increasing number of GPs charging higher fees,
increasing costs both to consumers and the taxpayer".

In its Queensland trials, Medibank has effectively been exploiting a
legal loophole to expand private insurance to GP clinics. Instead of
subsidising fees for GP services - which is against the law - Medibank
has been working around the Private Health Insurance Act by funding
''administrative'' costs at clinics.

Mr Dutton suggests this means the law would not need to be changed, but
the Health Department has said only that Medibank ''appeared'' to comply
with the legislation.

A spokesman for Mr Dutton said: "The minister has made it clear he wants
to see the outcomes of the trial before considering what, if any, role
private health insurers can play in primary care."

But senior sources in the health sector, speaking on condition of
anonymity, said Mr Dutton had been privately laying the groundwork to
revolutionise the system.

When asked about these private conversations, Mr Dutton's spokesman
said: "The minister has made it very clear he supports Medicare and
will never go down the path of a US-style health system."

A Medibank spokesman denied the company's customers were getting
preferential treatment to public patients, adding: "We have sought legal
advice and are confident that this arrangement complies with all
Medibank's legal obligations."

"The pilot is not about displacing other patients, or creating a
two-tier system," said Andrew Wilson, Medibank executive general manager
of provider networks and integrated care. "Medibank members are not
prioritised over other patients."