Labor's shadow assistant treasurer Andrew Leigh was once a strong supporter of a compulsory fee for visits to the doctor - a policy now slammed by the opposition as a “GP tax” that would hurt the community’s most vulnerable.
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The Abbott government is expected to introduce a $6 Medicare co-payment for bulk-billed GP visits in the May budget, capped at 12 visits a year, in a bid to save $750 million over four years. The idea is opposed by Labor, the Australian Medical Association and other health groups, who say a fee would deter poor patients from seeking treatment.
But in a 2003 Sydney Morning Herald article Dr Leigh, then a PhD student in economics at Harvard University, argued a Medicare co-payment was “hardly a radical idea”.
“As health researchers have shown, cost-less medical care means that people go to the doctor even when they don't need to, driving up the cost for all of us," Dr Leigh and co-author Richard Holden wrote.
“But there's a better way of operating a health system, and the change should hardly hurt at all.
“As economists have shown, the ideal model involves a small co-payment - not enough to put a dent in your weekly budget, but enough to make you think twice before you call the doc."
Dr Leigh argued the fee should be enough to deter “frivolous GP visits”, but not enough to limit genuine preventive care. The fee should apply to everyone, including pensioners, except those who are chronically ill, he wrote.
Dr Leigh, who has opposed the proposal in media appearances over recent weeks, told Fairfax Media: "Since 2003, a lot has changed in the health care system, and I've changed my view on co-payments.
"As [opposition health spokeswoman] Catherine King has pointed out, a co-payment on top of the biggest increase in private health insurance premiums in almost a decade would be a big hit to families."
Former Howard government adviser Terry Barnes, who revived calls for a co-payment in a discussion paper last year, said Dr Leigh’s comments show support for a co-payment crosses party lines.
“A GP co-payment was originally a Hawke government proposal led by Brian Howe, a member of the Left faction,” he said.
“As long as it is applied fairly across the community, a co-payment is a perfectly valid policy measure. If Andrew Leigh, before he had to toe the party line, recognised that then I welcome his contribution to the debate. I respect Andrew Leigh as a sensible economist.”
A $6 co-payment is less regressive than other measures, such as the tobacco excise, Mr Barnes said.
On Saturday, Dr Leigh, a former professor of economics at the Australian National University, distanced himself from an article he wrote in 2004 supporting fee deregulation for universities – another policy opposed by Labor.
