A lack of support in the Parliament and the electorate may not be enough to kill the unpopular price on GP visits.
Despite widespread speculation that the co-payment has been dumped, senior government figures have publicly reaffirmed support for some kind of upfront fee, but flagged a change in tactics.
Health Minister Peter Dutton said on Thursday morning he was “determined” to set a “price signal” for Medicare, a position backed by Prime Minister Tony Abbott in Question Time.
The Health Minister’s press secretary clarified to The New Daily on Thursday afternoon that the Government would push on with the co-payment “and look at other options”.
“The proposal to the Senate remains on the table and the government will look at other options,” the spokesperson said.
The spokesperson would not elaborate on what these “other options” might entail, but an article published in The Australian declared with certainty that Mr Abbott hopes to bypass the Senate veto by using regulations.
The Opposition has previously described this tactic as a “sneaky backdoor move”, despite having used it several times the last time it was in power, most notably to implement the Alcopops Tax.
Political expert John Wanna of the Australian National University told The New Daily it is rare to use subordinate legislation to get such a controversial measure around Parliament.
“They do it more often than you think, but not usually with contentious issues,” Professor Wanna said.
The Prime Minister’s office reportedly briefed journalists at various media organisations on Wednesday that the co-payment policy had been forsaken, but Treasurer Joe Hockey disputed this.
Speaking in Canberra on Thursday, Mr Hockey said “our policy stands”, making no mention of a backdoor move.
“We will take it [to the Senate] when we are able to take it. There’s lot of work before the Parliament at the moment,” he said.
A Senate committee responsible for scrutinising legislation has already criticised the Government for avoiding Parliamentary appraisal of its financial advice (FoFA) reforms.
The Scrutiny of Bills committee said in its ninth report for the year that a supposed need for urgent policy change was “not a sufficient justification” because this argument could be used “with respect to any proposal”.
Australian Medical Association president Brian Owler told the media on Thursday that bypassing Parliament would conflict with the wishes of the Australia public.
“Any move in that direction would go against clearly what the Parliament wants, but also what the Australian people have actually said,” Mr Owler said.
“They don’t like this proposal because it’s bad policy and there are not the protections there, and that need to be there, for vulnerable patients in our community.”
Sources suggest it might be possible to indirectly ‘induce’ GP clinics to charge clients the extra $7 by reducing the Medicare rebate, but the Health Minister probably cannot directly enforce a co-payment.
ANU’s Professor Wanna suggested that social security payments could even be cut to factor in the co-payment.
“You could take most of your pensioners who go [to their GP] ten times a year and just take $70 of their pension once a year, which would be a lot easier than making them fork out $7 every time they go to the doctor,” he said.
Both houses of Parliament would eventually need to ratify the move, but this approval could be delayed for up to 12 months, allowing time for a deal to be negotiated with the Palmer United Party and crossbench senators.
These negotiations would need to pick up at least one extra vote than usual, as at least one Coalition backbencher in the upper house, Senator Ian MacDonald, has threatened to cross the floor to vote against the fee.