In reply: Arnold regrets that the debate about copayments is restricted to fee-for-service methods of paying general practitioners.
This is true. The Minister for Health has intimated an overhaul of the whole general practice system, but this was not addressed in the recent federal Budget. This is a pity. It would be good to have a debate about different systems, ranging from our current blended model of fee-for-service with grants to practices for achieving quality indicators, through to capitation systems (eg, the United Kingdom's National Health Service) and salaries (common in public hospitals and in primary care in some countries).
Perhaps this is also a good moment to try to bridge the great divide between state health (mostly hospitals) and federal health (mostly general practice and private health care), which obstructs much of integrated care.
Tinkering at the edges with copayments seems too trivial.
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