“[The Government] has no authority to control the amount doctors charge for their services as this would amount to civil conscription. Doctors are free to determine their own value of the health service they provide.” The Australian Department of Health and Ageing, 2009
This presentation focuses on the degree to which doctors use their freedom to set and differentiate their fees to different patients. In the context of the Australian health care system, fees have a direct bearing on the out-of-pocket costs faced by patients. The first part of this seminar shows that in an unregulated fee-setting environment, general practitioners (GPs) and specialists discriminate their fees on the basis of patients’ income status. The second part focuses on the impact of the 2004 Strengthening Medicare reforms. Whilst these reforms have been widely credited with increasing levels of bulk-billing among GPs, our findings suggest that there is considerable variation in GP responses to the reforms. As a result, the OOP costs incurred by different population groups have changed substantially, with direct implications on the barriers to access of GP care. Understanding the degree of fee variation among doctors is an important issue in terms of understanding the potential variable impact that a policy change may have.
Associate Professor Kees van Gool is a health economist and has extensive experience in international, national and regional health policy research. He is the Deputy Director of the Centre for Health Economics Research and Evaluation, based at the University of Technology Sydney. He leads a team of researchers working on the financing and economics of the Australian Health Care system, including a special focus on primary care. Kees was a lead investigator in two independent reviews of the Extended Medicare Safety Net conducted for the Department of Health and has been a chief investigator on a number of competitive grants. He has worked extensively on cancer care, screening, cystic fibrosis and policy evaluation. In 2011 he completed his PhD at the University of Technology Sydney, looking at the out-of-pocket costs faced by patients under Australia’s Medicare system. Kees has previously worked at the Department of Health, NSW Health and the OECD where he led a project on international policy analysis on cardiovascular disease care and outcomes.
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