Medicare copayments: time to move on

Friday, November 28, 2014

After almost a year of vigorous public debate, with lack of Senate support, and consumers and the health sector largely united in opposition to Medicare copayments, the Australian Healthcare and Hospitals Association (AHHA) urges the Government to move on.

“Australia’s health system needs strong leadership, with the Commonwealth working with the states and territories and the health sector in a united manner to ensure all Australians can access the best healthcare possible,” says Alison Verhoeven, AHHA Chief Executive.

“Australia’s health expenditure is around the OECD average, and government funding for health fell for the first time in a decade during 2012-13 (by 0.9% overall and by 2.4% for Commonwealth funding, according to the Australian Institute of Health and Welfare)[1].

Nonetheless, it is incumbent on all in the health system to ensure taxpayers get the best value possible for their investment in health.  A sustainable Medicare and investment in medical research are important, but should not be at the cost of accessible and affordable primary care, and shouldn’t be traded off against each other.

“While the international evidence on the impact of copayments is mixed, what is clear from a systematic review of the literature is that ‘individuals with low income and in particular need of care generally reduce their use relatively more than the remaining population in consequence of copayment’[2].

“It’s time to move on from a policy that is clearly unacceptable to much of the Australian electorate and our health leaders, and look at alternative strategies for savings in the health sector.  As a starting point, the AHHA suggests the Commonwealth look at opportunities to rein in expenditure on low-value care through Medicare.  For example:

  • Consideration could be given to looking at rationalising employment and study-related requirements for sick leave certificates and streamlining mechanisms for 12-monthly referrals to specialists. 
  • Implementation of a clinician-led Choosing Wisely program in Australia would assist health providers to identify and reduce the use of care, tests and medicines that are low-value, but sometimes come at high costs. 
  • Increased use of advanced care plans would reduce costs associated with end-of-life care[3].
  • Speeding up the review of items on the MBS to ensure they are appropriate for continued government subsidy is also necessary – and is something for which the Commonwealth Government has responsibility and could provide immediate leadership.


“The AHHA is hopeful that the Government will seize the opportunity to be proactive in looking at these savings measures, rather than continuing to seek ways to implement an unpopular policy,” says Ms Verhoeven.

For more information on the AHHA, visit

The Australian Healthcare and Hospitals Association is the national peak body for public and not-for-profit hospitals, community and primary healthcare services, and advocates for universal, high quality and affordable healthcare to benefit the whole community.

[1] AIHW 2014. Health expenditure Australia 2012-13. Health and welfare expenditure series no. 52. Cat. no. HWE 61. Canberra: AIHW.

[2] Kiil, A, Houlberg, K. 2013. How does copayment for health care services affect demand, health and redistribution? A systematic review of the empirical evidence form 1990 to 2011.  Eur J Health Econ.

[3] Scott, I. 2014. Ten clinician-driven strategies for maximising value of Australian health care. Australian Health Review, 2014, 38, 125–133.

Media enquiries:

Alison Verhoeven

Chief Executive, The Australian Healthcare and Hospitals Association

0403 282 501