Go to the doctor or pay the rent?

posted in: Life and things | 0
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Time was we could make an appointment with the local GP and see her/him within a few days. And they bulk billed (meaning the Government covered the cost). That was then. Now we have long wait times to see the doctor and the vast majority of practitioners can no longer afford to bulk bill. Which is fair enough. Doctors have to pay for electricity, rates, drugs etc etc like any other business and those costs are all going up. The Government fee for a visit no longer covers the costs of providing the service. Which means GPs are charging a fee which in some cases is as much as much as the government fee (that is, the doctor charges $80 and the government covers $39.95 of it).

The result of the rise in costs of course trickles down to the end user, you and me. What with rising costs for everything else, the less well off among us are faced with a choice of going to the doctor and something else like paying the rent. If the doctor’s visit can’t be delayed, they front up at the nearest public hospital. The hospitals are already overcrowded and overworked. Ambulances are almost always ramping (acting as accommodation for a patient until they can be transferred to a ward). That means the waiting times for ambulances have increased, which in some cases results in people dying before the ambulance arrives.

Meanwhile, the politicians wring their hands and blame everybody else. States provide health infrastructure, but they point the finger at the Federal Government, which provides the funds, for not giving them enough money. The Federal Government blames the mob that was in power before they took over. Certainly, the health situation has been deteriorating for years so, too often we hear, “Oh dear, but what can we do? It’s their fault.”

Look, I know it’s not my area of expertise but I’d like to make a couple of suggestions.

Increase the government co-payment to GPs. It has been static for years and GPs like everybody else are subject to cost of living increases. They can’t be expected to wear the costs forever. That should help take the pressure off the public hospitals because people will be able to afford to go to a GP. Do it right now.

How do we pay for it?

In Australia all taxpayers pay the Medicare levy. [1] At the moment for most people who also have medical insurance it is 2% of taxable income. (It’s a little more complicated than that, but it will do for what I’m talking about here.) That is, if your taxable income is $20,000, you pay $400 for Medicare. That rate has been static for a long time. How about increasing the levy to 2.5% or 3%?

Raising taxes won’t be popular but sometimes Governments have to do unpopular things.

Recently the Queensland Government has talked tough about GPs paying payroll tax. Excuse me while I have a little rant. Payroll tax is the tax you pay when you have the temerity to EMPLOY A NUMBER OF PEOPLE. You know, give them jobs and pay them so they can pay income tax. And what do you get for paying payroll tax? As far as I can see, absolutely nothing. Like stamp duty when you buy a property, payroll tax is just a revenue raising exercise. (I’d better stop now).

Back to GPs.

The Australian Medical Association (AMA) explains that:

  • GPs usually work under service agreements with practices.
  • The practice provides a service – the premises, plant and equipment, billing services, reception, and administrative and allied health staff, but does not pay GPs wages, superannuation, leave or other entitlements or benefits, or provide professional development and training.
  • Following a NSW Civil and Administrative Tribunal ruling, the Queensland Revenue Office (QRO) deemed GPs to be employees for payroll tax purposes.
  • It sought to retrospectively tax individual practices for up to five years with a 75 per cent liability.
  • 81 per cent of Queensland general practices would have been affected. [2]

This idiotic decision could lead to the closure of GP practices. Some of them would owe millions in back tax.

You have to wonder what brain-dead bureaucrat in an office tower in Brisbane CBD thought this was a good idea. Interesting to note that our Premier, with a wary eye on her popularity polls, is maybe re-thinking that decision.

When I was growing up the world was living through the Cold War, the on-going tensions between the Soviet Union and the American-led West. Make no mistake, that was a time of very real fears when the threat of a nuclear war was the press of a button away. The Cuban Missile Crisis in 1962 was the pinnacle of what might have been and thankfully was not. When the USSR finally collapsed at the beginning of the 1990s we all rejoiced, expecting Peace and Harmony, and the Age of Aquarius.

That was before Xi Jingping.

The Chinese have taken over from where the USSR left off. Now Beijing has taken exception to the US shooting down of an ‘off-course’ weather balloon. These Chinese weather balloons seem to have very faulty guidance systems. They’ve popped up in lots of places other than China – Canada, the US, South America, strangely drifting above prime military targets. If they have appeared in Australian skies (of course they have) my guess is they’d be off course above Exmouth and Pine Gap, our two joint US/Australia comms stations.

Still, every now and then Mother Nature turns over in her sleep and proves to the world that all of the petty machinations of Humanity are no match for her. A couple of tectonic plates have shifted in Turkey and Syria and thousands of people are dead, and even more are injured. The scenes from this catastrophe are terrible to see, with many people trapped in the rubble. The earthquake’s shocks and after shocks caused blocks of housing apartments to collapse like stacks of cards. Of course the much-maligned, decadent West will move to help. It always does. I wonder if the Saudis, Iran, and the filthy rich Gulf states will be as quick to support their fellow Muslims?

via Midjourney

On a lighter note, I read a fun science fiction book recently. Catalyst stars a sentient, smart-mouthed, up himself, arrogant cat called Pumpkin. I loved him. Read my review here.

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