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You’d be surprised by this but there are doctors who honestly don’t find any problem with the government forcing poor people and pensioners to pay $6 out of pocket for GP visits.  Or forcing everyone to pay $300 out of pocket for specialist appointments.

There are plenty of people who need to see their doctor 3 times a week and are too sick or old to work. For these people, $20 a week is a lot of money. They are being punished for being sick. $300 is also 1.5 weeks worth of dole or pension money. What happens if you need to see more than one specialist?

The answer is that you don’t go to your doctor. You just turn up to emergency in extremis.

The evidence is clear about these things: not only does this sort of nonsense make society sicker, it is also incredibly cost-ineffective. Just look at the US, the most inefficient and backwards health system in the “developed” world. 16.5% of GDP in government spending for what are inexcusably shit health outcomes. Then there’s Japan which spends half that percentage – about 8% of GDP – with one of the top 5 outcomes in the world! The bottom line is that an accessible and well organised public health system has benefits for all – including the rich.

So this stuff – health economics and sociology – is compulsory material in med school. It’s appalling then, to see doctors complain that “the poor” spend “all their money on junk” and that they should all be spending on exorbitant medical fees instead.

I’ve had community members – all employed – tell me that they think the AMA is guilty of anticompetitive collusion with those sorts of AMA suggested rates for private doctors’ fees. The community perception is that when it comes to out of hospital costs they are being screwed.

And they are. In most states, there is no public outpatients service. Outside major cities, there are no bulk billing GPs. Patients’ only choice is seeing a private GP – often charging $75 in total (Medicare rebates $40 of this) per consultation – and private specialists who usually charge $200 or more out of pocket. GPs at least will often bulk bill the poor (healthcare card holders), children and pensioners. But with the $6 “copayment” this discretionary service is now a tax on the poor. It’s appalling.

And yet despite the fact that patients will be sicker, GP practices will lose significant business and emergency departments (already overwhelmed) will be overrun, there are doctors who continue to insist that this is somehow a “good” or “necessary” move. Necessary for whom? For doctors who have 10 mortgages that they’re negative gearing and renting at ridiculous rates as property developers and yet can barely afford to pay for? For members of the Liberal and Labor Party who are already scamming money from public coffers? It makes me sick.

People who have never had to struggle a day in their lives, who grew up with a silver spoon in their mouth, who were spoon-fed all through private school, who were the entitled descendents of generations of “doctor families”, of course “born to rule” and who met their first poor (or lower middle class) person as a medical student and were horrified by their “lack of breeding”, their coarse words and unfashionable clothing, their disgusting teeth and awful health, their lack of refinement and their inability to understand medical terms.

Are these my colleagues? This sort of attitude makes me ill.

You know what I hope happens to them? I wish upon them an efficient public system and outpatients, enough doctors and nurses, rural coverage with public subspecialists, bulk-billing GPs and a government that supports the public sector. I wish them a future where they can’t possibly compete in the private sector and where patients refuse to accept being talked down to. I wish them adequate competition and adequate public jobs. I wish them healthier, happier patients. I wish them being forced to live through the “horror” of health equity.

And most of all I wish them no more fucking negative gearing and mortgages and $50k weddings and $20k wedding rings and private school fees, because let’s face it, deep down no-one likes that shit.

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