A former health department boss has rejected calls by the head of the powerful doctors' lobby that GPs be given the power to decide which patients pay for consultations.
Australian Medical Association president Michael Gannon believes patients who can afford to pay for GP visits should, suggesting a rethink of the federal government's deeply unpopular co-payment.
The problem with previous attempts at a co-payment - declared "dead, buried and cremated" by the government last year - was that GPs weren't empowered to decide who could afford to pay.
Stephen Duckett, now health program director at the Grattan Institute, says while doctors have many skills, replicating the Department of Human Services isn't one of them.
"Why on earth would you think that doctors are good judges of people's financial means?" he told AAP.
"Do you really think that a general practice is a good place for patients to have to disclose all of their financial problems and what their income is?"
Dr Duckett was scathing of any push for patients to pay for GP visits.
Medicare is a universal scheme that everyone should have access to.
"It shouldn't be means-tested, it shouldn't involve co-payments at all."
Dr Gannon insists GPs are in touch with the needs of their patients and should have the ability to protect the neediest in the community.
His call for some patients to pay comes as he lobbies Health Minister Sussan Ley to lift the government freeze on the rebate paid for GP visits, warning doctors can no longer keep up with rising costs.
Dr Gannon is demanding a serious timeline on when the government will lift the freeze following a meeting with Ms Ley on Thursday, insisting he would be "gobsmacked" if the government was game enough to go to another election before lifting it, having almost suffered defeat at the hands of Labor's Medicare scare campaign.
Dr Duckett agrees the freeze should be lifted, describing it as "lazy", untargeted policy.
The government's defence that bulk-billing rates have been rising despite the freeze have more to do with the low inflation rate, he said.
It's inevitable that bulk-billing rates will drop and people will delay going to the doctor as a result, which means they could end up in emergency hospital departments instead.
"We need to actually ensure people have good access to primary care otherwise it's, as they say, penny-wise and pound-foolish."
