Emergency Medicine College warns co-payments “counterproductive”

Emergency Medicine College warns co-payments “counterproductive”

Wednesday 9 April 2014


As speculation continues over whether the federal government will introduce a $6 Medicare co-payment in the May budget – a change which some fear would encourage use of emergency departments (EDs) as after-hours GP clinics – the Australasian College for Emergency Medicine (ACEM) is warning that such a move is unlikely to provide an adequate solution to the growth in demand for, and cost of, health care.


According to ACEM WA Faculty Chair and AMA (WA) Immediate Past President Associate Professor Dave Mountain, “Ready access to high quality emergency care is a fundamental element of our health care system. Any co-payments will act as a disincentive to patients seeking care and may result in poorer outcomes as patients may delay seeking medical care for illnesses that could have been prevented or better managed at an earlier stage.”


A/Prof Mountain said ACEM does not support the idea that a co-payment will “unclog” the ED of people seeking to inappropriately access medical care in EDs.


“There is, in fact, very little evidence to support the argument that people inappropriately seek emergency care. There are very few “GP-type” patients “clogging our EDs”, as is claimed, and their care is relatively quick and simple. It is patients awaiting appropriate care on hospital wards that causes ED overcrowding. Furthermore, distinguishing patients who appropriately or inappropriately use emergency care resources would, practically speaking, be impossible to implement and monitor.”


He said an ED co-payment would be unlikely to have any meaningful impact to offset overall ED expenditure, particularly once the costs of collection are taken into account.


Instead of ensuring the provision of quality and evidence-based care across the lifespan, such co-payment proposals may actually lead to a devaluing of the worth of that care.


“The co-payment initiatives are also likely to have a greater impact on the disadvantaged in the community.


“These underprivileged people already suffer poorer general health outcomes and require more health care across the lifespan. Further exacerbating differential health access and outcomes on the basis of socio-economic status will be of no benefit to the community.”


ACEM is urging the government to focus on improved efficiency and ensure equity in treatment availability and, most importantly, safe and high quality patient outcomes.

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