The Abbott Government have floated a $6 co-payment to see a bulk-billing GP. You can read below Shadow Health Minister Catherine King's piece on how a GP tax would mean the end of Medicare.
If the changes to Australia's health system being signalled by the Abbott government are enacted, Medicare will exist in name only.
Thirty years ago this month Medicare was established on the principle that all Australians should have equal access to healthcare. Universal healthcare is a cornerstone of our social safety net and central to the commitment we have for each other's health and welfare.
If Peter Dutton wants to have a conversation about health expenditure, let's do it with facts, not as a political tactic by those who have opposed universal health care from the beginning.
When Medicare was introduced Australia didn't have a universal healthcare system. Bob Hawke as prime minister warned that without it 2 million people ''faced potential financial ruin in the event of major illness''.
The challenges in health that Australia is facing today are common across most developed countries: an ageing population, a significant rise in chronic diseases such as diabetes and obesity, as well as increasing costs as new drugs and technologies become available at an increasing rate.
But it is important to keep this in context.
Australia spends 9.1 per cent of its gross domestic product on healthcare, which is comparable to Sweden, Britain and Spain. New Zealand, Canada and France all spend more and the United States spends much more, at 17 per cent of its GDP.
We also get very good value out of what we do spend. Australia has one of the highest life expectancies in the world, we have good access to new medicines and medical procedures, and our survival rate for cancer is one of the highest in the world.
Visits to doctors are paid for through the Medical Benefits Schedule. The biggest growth in Medical Benefits Schedule expenditure has been in specialist services, not to GPs. So why should GPs and the people who visit their local GP be the government's focus of attack?
These are issues that can be managed without the dismantling of Medicare.
Means testing access to healthcare will lead to greater privatisation, and all the data shows that the more privatised systems are, the higher the cost to individuals and the more you move to a system with two classes of care.
By means testing Medicare, the government will pay less for healthcare but the tab will be picked up by ordinary Australians.
Taxpayers already contribute to Medicare according to their capacity to do so.
This has been the case since Medicare was introduced and it has evolved over the years just as Medicare has. We have a Medicare levy and high-income earners pay more again through the Medicare levy surcharge or must take out private health insurance.
Leaving aside the fact that $6 is not an insignificant amount of money as the Health Minister argues, for a lot of Australians, introducing a fee to visit your GP will do much more than just send a ''price signal'' to the market. It will restrict their access to GPs - in fact that is exactly what the measure is designed to do.
GPs are actually the cheapest end of the health system. They are experts at diagnosis and it is their job to pick up on potential health problems in their infancy. If this does not happen and people end up at the expensive end of the system - hospitals - there won't be any actual savings.
The most recent statistics on bulk billing show the rate is 82 per cent - the highest ever. This is particularly important for older people, families with children and the more vulnerable of our population.
Introducing a $6 co-payment, means testing bulk-billing, or attacking the Medical Benefits Schedule rebate on GP items destroys incentives for GPs to bulk-bill.
If more and more medical practices are given less incentive to encourage access for vulnerable people, their access will be increasingly restricted.
Governments have a role to make sure populations remain healthy.
Value for money is not just about cost but what people get from Medicare. The success of our health system is proof we are getting good value. If we had poor outcomes our costs would be higher.
Means testing and privatisation are not the answer to questions about how we manage health expenditure.
If the Abbott government has its way, rather than being ''the best friend that Medicare has ever had'', the Prime Minister will have succeeded in doing what none of his predecessors have been able to do in 30 years: dismantle Medicare.