Tony Abbott could not have been clearer about the likelihood Australians will have to make a co-payment when visiting the doctor.
"Free services to patients are certainly not free to taxpayers," the prime minister said in a pre-budget speech.
That's being taken to mean the much flagged co-payment - possibly as much as $7.50 - is almost a certainty.
But it could have been much worse.
The government's commission of audit recommended general patients pay $15 after 15 "free" visits. Concession card holders such as pensioners should pay $5.
The co-payment fits neatly into Treasurer Joe Hockey's pledge to end the age of entitlement and with his "early warning bell" about the sustainability of Medicare.
The cost of the taxpayer-funded universal health scheme has spiralled in the past 10 years, from $8 billion in 2002-03 to $19 billion.
As the population ages that spending is projected to increase to $80 billion.
Australians will have to wait until budget day to see if the government adopts any of the audit's other recommendations including an increase in co-payments for taxpayer-funded medicines, and a more than doubling of the Medicare surcharge paid by high-income earners.
Medicare Locals could be in the government's sights, despite a promise not to scrap the bodies that coordinate local health services.
The coalition has long opposed the Labor initiative as unnecessary bureaucracy, and after the federal election launched a review of the $1.8 billion scheme.
Labor's GP Super Clinics also face the axe, after years of criticism from the coalition.
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