Much ado about nothing

Stuff reports:

Not all children will receive free GP visits as promised by the Government, according to documents revealed by the .

That’s because they have never promised it. It is impossible to promise it as GPs do not work for the Government and the Government can not set their fees for them – unless you nationalise the entire primary healthcare sector.

Minister Nikki Kaye has set the funding level at a rate that will only cover an estimated 90 per cent of doctors’ visits for children who are injured, Radio NZ has reported.

At last year’s election the Government campaigned on making doctors’ visits and prescriptions free for all children under 13 from July this year.

However the Green Party has called out Kaye for deciding 90 per cent coverage was close enough.

This shows a misunderstanding (either deliberate or not) of how the funding level is set.

GPs around NZ will currently charge a wide variety of fees for under 13s. For example some may charge $10 and some may charge $30. Each GP practice can be different to reflect their costs – rent, salaries etc. These are different in Epsom and in Rotorua, for example.

The Government set the funding at the level at which 90% of GPs are currently charging. Now this doesn’t mean that 10% of GPs will still charge a fee. If for example the subsidy is $30 and your charge was  $32, you may well decide that it is not worth the hassle, or the bad publicity, to charge a $2 part fee.

Over time more and more GPs will not charge a part fee, because if they do it is bad publicity, and patients may move.

Coleman and Kaye point out:

“We expect levels of uptake by general practices of the free under 13s scheme to be similar to uptake of the under 6s scheme,” says Dr Coleman.

“Currently 98 per cent of general practices offer free doctors’ visits for under 6s. Initial uptake was 70 per cent in January 2008, and it has steadily increased to current levels. There are only around twelve general practices in New Zealand that are not offering free under 6s doctor visits.”

So the fact the funding is set slightly below the level at which the 10% most expensive GPs charge, doesn’t mean you don’t get close to universal coverage.

But less us look at what the Greens are actually arguing for, and you will see that they are actually arguing for an incredibly appalling waste of scarce dollars.

They are saying that the level of subsidy should be set at the level above which 100% of GPs currently charge.

Now think about that. The Greens are saying that the subsidy to GPs should be based on what the most expensive GP in NZ charges.

This would result in a massive wealth transfer to GPs. 99% of GPs would get a higher subsidy from the Government, than they were previously getting from patients. This would cost tens of millions of dollars.

And what would be the benefits to families? Well possibly it could result in no part-charges to the families who live in the areas with the most expensive GPs. These are generally the very wealthy suburbs such as Epsom, Wadestown etc. So the richest families in NZ would be the ones who benefit by not having a small part-charge.

I don’t have the exact numbers, but a ballpark estimate is that the cost per additional family subsidised to taxpayers and levypayers would be over $1,000!

You would be spending tens of millions more to eliminate part-charges for a handful of the wealthiest families.

The losers would be every family in NZ who pays tax and ACC.

The winners would be every GP in NZ, and the families who live in the wealthiest areas.

A huge transfer of wealth from middle income and low income NZ to the wealthiest. What the Greens call income inequality – and they are demanding it.

So I’m glad the Greens aren’t in Government, and that the subsidies are set at a sensible point such as the 90% level, rather than having the most expensive doctor in NZ determine the subsidies for the entire country.

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