News Gabba Upgrade & Olympics News

[Perrip]

Its the same debate manifest in Brisbane. The new M2 Metro bus whatever launched and people are underwhelmed. We compare our "Metro" with the light rail that Sydney delivered without awknowledging that our M2 was funded by BCC rate payers where is Sydney was funded by NSW government. Brisbane has half the population of Sydney. If we want what Sydney has then we need to densify our inner city but we don't want to do that because then Brisbane will lose its so-called country town feel. Its crazy to expect Sydney/Melbourne level stuff if we also aren't willing to become Sydney/Melbourne level dense.

The discourse around Brisbane Metro is stupid. The reality is that Brisbane needs another public transport option, but BCC was too broke to get a better one, i.e. light rail, and Qld Gov was doing CRR.
The benefits of Metro won't be evident for most people until the project & the extensions are complete. Getting Victoria Bridge and CBD streets uncongested through the Adelaide St tunnel and a reworking of the BCC bus network, is one of the main benefits. The other one is the extension of metro to suburbs that lack good public transport like Stones Corner to Capalaba route.

 

[Johnny Bananas]

Nimbys and puppies. Send in the special squad with batons like when Joh was in charge. Spare the dogs though.

Yeah how dare people disagree with us, they should be violently assaulted for it.

 

[Gadzorks]

Next Saturday am I'm up for a YES protest. Dom and Mike we need you to get us galvanised and organised.

If we can get 301 there, we win. Simple.

 

[Section 5]

Next Saturday am I'm up for a YES protest. Dom and Mike we need you to get us galvanised and organised.

If we can get 301 there, we win. Simple.

I thought their protest spelt ON
So, i was not sure what they were on about

 

[Johnny Bananas]

Its the same debate manifest in Brisbane. The new M2 Metro bus whatever launched and people are underwhelmed. We compare our "Metro" with the light rail that Sydney delivered without awknowledging that our M2 was funded by BCC rate payers where is Sydney was funded by NSW government.

I agree with pretty much everything you've said except this. The "Metro" is indeed paid for by BCC, but it is just new vehicles that almost entirely use existing busways that have been paid for already by the Queensland government. The only properly new infrastructure being built is the tunnel under Adelaide St that Perrip mentioned.

Also, people are comparing the "Metro" with the actual underground/elevated metro that Sydney have built, and indeed that has a budget that only a state government could deliver (about $16 billion). The light rail in Sydney is a separate project that would probably be affordable for BCC (about $3 billion) but it's just much cheaper for them to use what already exists without having to disrupt it for years to install tracks and overhead wires. And this is how the Gold Coast will end up having a superior rapid transit system to Brisbane. If you start building the wrong thing in the first place, it gets harder and harder to change later. There's a lesson there about selecting the right stadium location when we have the chance.

The discourse around Brisbane Metro is stupid. The reality is that Brisbane needs another public transport option, but BCC was too broke to get a better one, i.e. light rail, and Qld Gov was doing CRR.

They're not broke, just cheap. It costs far less to buy new vehicles and use mostly existing infrastructure than to do the hard work of upgrading all that infrastructure to make a better system. And Schrinner has been getting back in office on the basis of keeping rates cheap so he doesn't want to lift them.

As for the state government, focusing on CRR is a weak excuse to distract from their failure to seriously increase our capacity to build more transport projects. They'll fail to get the line to Maroochydore built in time for the Olympics, and there are numerous planned projects that they've indefinitely delayed and probably won't bother with until well after 2032 (Beaudesert line, Springfield to Ipswich line, Sunshine Coast Mass Transit, Eastern Transitway, Brisbane Subway). It'll probably take another 30 years to complete it all and that's not good enough.

 

[briztoon]

Im a migrant that came to Australia as a young child and I grew up in an apartment. The modern discourse in Australia around population, migration, demographics, infrastructure and expectations is like talking to a dillusional schizophrenic.

The Australian wants:
a) a 800sqm block for themselves, their partner, 2 kids and 2 dogs in a single detached house -> it has to be within 30 minutes driving distance from the centre of town + near work + near schools
b) wants world leading infrastructure in terms of health, education, transport,
c) wants all this to be afordable on a single income with also low taxes

If you do not get the above then its basically child abuse to grow up in a 'dog box' aka apartment

We want cheap publically funded healthcare and aged-care that is gold-standard available all across Australia including Whoop Whoop QLD; but we don't want to pay more taxes to pay for more workers and build more infrastratructure because of cost of living pressures; we don't have enough Australians available to pick up more work with our historically low unemployment rates; and we don't want more migrants because we don't have the infrastructure/housing and cost of living pressures. We don't have enough people to fund and build the infrastructre we want and so we don't import more people in because we don't have the infrastructure to accommodate those people.

Readling/listening to the news in the Australian election/political cycle I feel like Yossarian from Catch-22.

Its the same debate manifest in Brisbane. The new M2 Metro bus whatever launched and people are underwhelmed. We compare our "Metro" with the light rail that Sydney delivered without awknowledging that our M2 was funded by BCC rate payers where is Sydney was funded by NSW government. Brisbane has half the population of Sydney. If we want what Sydney has then we need to densify our inner city but we don't want to do that because then Brisbane will lose its so-called country town feel. Its crazy to expect Sydney/Melbourne level stuff if we also aren't willing to become Sydney/Melbourne level dense.

Its the same debate with all the NIMBY/YIMBY crap around the stadium. We don't want to build a big stadium supposedly anywhere in the city as apparently it will be a traffic nightmare and we supposedly don't already have the transport to accomodate such an establishment; but we also want the world to take us as seriously as Sydney and Melbourne. If I was an international act why would I bother with Brisbane when Sydney/Melbourne can deliver 100k crowds and then I can catch a 10 hour flight to Japan/South Korea/Singapore and perform for another 100k crowd within the same timezone without worrying about jet lag. How many international acts tour Auckland? We are as irrelevant as Auckland.

We want to infrastructure of London with the population of Toowoomba and the tax rates of the Cayman Islands. What a catch-22.

The biggest complaint a mate of mine who works for the government in the building sector has, is that he can't demolish and subdivide his land because of the stupid traditional building character overlay code applied to houses built before 1947. He has a raised Queenslander in Coorparoo, that's been renovated inside, but he can't move any more sideways on the block.

Yet out at Rochedale, they're building 5 bedroom McMansions on 360m2 blocks and selling for $2m+.

A lot of the (lack of) density issues with many inner city suburbs is that half the properties can't be demolished due to council or state zoning and building codes. can't densify if the government won't allow it.

 

[peetoo]

The biggest complaint a mate of mine who works for the government in the building sector has, is that he can't demolish and subdivide his land because of the stupid traditional building character overlay code applied to houses built before 1947. He has a raised Queenslander in Coorparoo, that's been renovated inside, but he can't move any more sideways on the block.

Yet out at Rochedale, they're building 5 bedroom McMansions on 360m2 blocks and selling for $2m+.

A lot of the (lack of) density issues with many inner city suburbs is that half the properties can't be demolished due to council or state zoning and building codes. can't densify if the government won't allow it.

VCAT keeps the street 6m setback but the two storey house is almost in the backyard behind it

 

[briztoon]

VCAT keeps the street 6m setback but the two storey house is almost in the backyard behind it

Very little of that made sense to this non town planner.

 

[Nunez]

Im a migrant that came to Australia as a young child and I grew up in an apartment. The modern discourse in Australia around population, migration, demographics, infrastructure and expectations is like talking to a dillusional schizophrenic.

The Australian wants:
a) a 800sqm block for themselves, their partner, 2 kids and 2 dogs in a single detached house -> it has to be within 30 minutes driving distance from the centre of town + near work + near schools
b) wants world leading infrastructure in terms of health, education, transport,
c) wants all this to be afordable on a single income with also low taxes

If you do not get the above then its basically child abuse to grow up in a 'dog box' aka apartment

We want cheap publically funded healthcare and aged-care that is gold-standard available all across Australia including Whoop Whoop QLD; but we don't want to pay more taxes to pay for more workers and build more infrastratructure because of cost of living pressures; we don't have enough Australians available to pick up more work with our historically low unemployment rates; and we don't want more migrants because we don't have the infrastructure/housing and cost of living pressures. We don't have enough people to fund and build the infrastructre we want and so we don't import more people in because we don't have the infrastructure to accommodate those people.

Readling/listening to the news in the Australian election/political cycle I feel like Yossarian from Catch-22.

Its the same debate manifest in Brisbane. The new M2 Metro bus whatever launched and people are underwhelmed. We compare our "Metro" with the light rail that Sydney delivered without awknowledging that our M2 was funded by BCC rate payers where is Sydney was funded by NSW government. Brisbane has half the population of Sydney. If we want what Sydney has then we need to densify our inner city but we don't want to do that because then Brisbane will lose its so-called country town feel. Its crazy to expect Sydney/Melbourne level stuff if we also aren't willing to become Sydney/Melbourne level dense.

Its the same debate with all the NIMBY/YIMBY crap around the stadium. We don't want to build a big stadium supposedly anywhere in the city as apparently it will be a traffic nightmare and we supposedly don't already have the transport to accomodate such an establishment; but we also want the world to take us as seriously as Sydney and Melbourne. If I was an international act why would I bother with Brisbane when Sydney/Melbourne can deliver 100k crowds and then I can catch a 10 hour flight to Japan/South Korea/Singapore and perform for another 100k crowd within the same timezone without worrying about jet lag. How many international acts tour Auckland? We are as irrelevant as Auckland.

We want to infrastructure of London with the population of Toowoomba and the tax rates of the Cayman Islands. What a catch-22.

On the topic of healthcare, I would much rather pay money to Medicare and support public health but am forced to get private health insurance as it is cheaper than paying the Medicare levy. I don't for the life of me understand why such a stupid mechanism is in place. Don't shoehorn people into paying for private health, give people the ability to put that money into public without having to pay a huge chunk more.

 

[briztoon]

On the topic of healthcare, I would much rather pay money to Medicare and support public health but am forced to get private health insurance as it is cheaper than paying the Medicare levy. I don't for the life of me understand why such a stupid mechanism is in place. Don't shoehorn people into paying for private health, give people the ability to put that money into public without having to pay a huge chunk more.

I'm missing something here.

You're not forced to get private health.

You could pay the medicare levy, that would support public health.

If you can jump the public system ques, I don't understand why you wouldn't want private health.

 

[martinson]

On the topic of healthcare, I would much rather pay money to Medicare and support public health but am forced to get private health insurance as it is cheaper than paying the Medicare levy. I don't for the life of me understand why such a stupid mechanism is in place. Don't shoehorn people into paying for private health, give people the ability to put that money into public without having to pay a huge chunk more.

I think in a stealth way healthcare here is heading the same way as the States.

I pay 115 for a GP visit here in Melbourne because I want the best care /history I can get. The rebate is somewhere around 35. I know for a fact that the GP's in the clinic I go to are working their clacker off and don't earn much more than a middle level IT person in the public service. After studying for up to a decade and some of them with over 30 years experience.

I don't have any answers , just sayin' the world is moving beyond the reach of Governments to fund and pay for things that a lot of people want for granted. At my age I'm getting the opportunity to have lots of tests /hospital visits /seeing many people my age going through the system and my observation is that it's really stretched.

My wife's been a nurse in palliative care for over 50 years ( yes she's still at it a couple of days a week ) and she comes home from her shift really angry a lot of the time. Just at the way the level of care has changed and how the most crucial thing for hospital CEO's are the budgets.

 

[scoman]

I think in a stealth way healthcare here is heading the same way as the States.

I pay 115 for a GP visit here in Melbourne because I want the best care /history I can get. The rebate is somewhere around 35. I know for a fact that the GP's in the clinic I go to are working their clacker off and don't earn much more than a middle level IT person in the public service. After studying for up to a decade and some of them with over 30 years experience.

I don't have any answers , just sayin' the world is moving beyond the reach of Governments to fund and pay for things that a lot of people want for granted. At my age I'm getting the opportunity to have lots of tests /hospital visits /seeing many people my age going through the system and my observation is that it's really stretched.

My wife's been a nurse in palliative care for over 50 years ( yes she's still at it a couple of days a week ) and she comes home from her shift really angry a lot of the time. Just at the way the level of care has changed and how the most crucial thing for hospital CEO's are the budgets.

I'd be very surprised if these doctors you speak of are not making 300-500k per year gross. If they are 'working their clacker off' as you say they could well be seeing a 30 people a day. At $115 a pop they are generating $828000 a year for their clinic. Most clinics pay at the very least 50% of total billings. So I'm a bit confused how they could be paid less than mid level IT staff. Are we talking 150k here? If so, those docs need to find a new clinic. I'm a bit confused here.

 

[martinson]

I'd be very surprised if these doctors you speak of are not making 300-500k per year gross. If they are 'working their clacker off' as you say they could well be seeing a 30 people a day. At $115 a pop they are generating $828000 a year for their clinic. Most clinics pay at the very least 50% of total billings. So I'm a bit confused how they could be paid less than mid level IT staff. Are we talking 150k here? If so, those docs need to find a new clinic. I'm a bit confused here.

You obviously have no idea what it costs to run a clinic. It's barely viable. When the Gov. wanted to put payroll tax on certain services it would've closed had it gone through.

30 people a day ??? So you're multiplying 30 a day for 50 weeks by 115 . Plus all the paperwork ,follow up. They're not seeing people who come in for a common cold most of the time. They bulk bill patients who can't afford it.

Your post is ridiculous. My guy is trying to get out of the business and there's no one who'll take it on. And he works very hard trying to do the best and give a thorough service to everyone he sees. . And with basically older patients in my area , often stressfully.

I can assure you being a GP in a practice is nothing like it was even 10 years ago. Not where I go nor with any of the medicos I know. The population is ageing. The costs of doing business have gone up exponentially. Certainly in Melbourne.

 

[scoman]

You obviously have no idea what it costs to run a clinic. It's barely viable. When the Gov. wanted to put payroll tax on certain services it would've closed had it gone through.

30 people a day ??? So you're multiplying 30 a day for 50 weeks by 115 . Plus all the paperwork ,follow up. They're not seeing people who come in for a common cold most of the time. They bulk bill patients who can't afford it.

Your post is ridiculous. My guy is trying to get out of the business and there's no one who'll take it on. And he works very hard trying to do the best and give a thorough service to everyone he sees. . And with basically older patients in my area , often stressfully.

I can assure you being a GP in a practice is nothing like it was even 10 years ago. Not where I go nor with any of the medicos I know. The population is ageing. The costs of doing business have gone up exponentially. Certainly in Melbourne.

So what does a mid-level IT guy earn? is it 120K, 150K even? Is he really only earning that kind of money?

Edit: Might want to get on to a new gig. Maybe send him this:

Gp Jobs in All Brisbane QLD - Feb 2025 | SEEK

Find your ideal job at SEEK with 429 Gp jobs found in All Brisbane QLD. View all our Gp vacancies now with new jobs added daily!

www.seek.com.au

Seems the going rate for a GP in Brisbane is $200 plus an hour or $250 - 500K.

 

[BigCat2]

I'd be very surprised if these doctors you speak of are not making 300-500k per year gross. If they are 'working their clacker off' as you say they could well be seeing a 30 people a day. At $115 a pop they are generating $828000 a year for their clinic. Most clinics pay at the very least 50% of total billings. So I'm a bit confused how they could be paid less than mid level IT staff. Are we talking 150k here? If so, those docs need to find a new clinic. I'm a bit confused here.

I'm a specialist physician, and have many friends who work as GPs.

I can tell you for a fact that many of them even those working very long hours (60+ hours including paperwork, admin etc) bill less than 300k. Once the practice takes 40ish percent for running costs, they get gross pay of ~160k, and of course less after tax.

Not to mention the ever increasing stress of looking after old, frail patients with lots of co-morbidities and unfixable problems. Once you factor in ever increasing unrealistic expectations and troublesome family...you get the picture.

GP used to be the default for graduates who don't end up doing another speciality, or for those who want a good work/life balance, those with kids etc. No longer. Many graduates are staying away from GP because of all those issues I talked about. Many who end up becoming GPs only work minimal (eg 1-2) days, and spend the rest of their time doing other non-GP work, just to get away from the endless stress.

Getting back to the original point. Free, universal healthcare where people are treated to the absolute limits, where patients and family can demand to pursue crazy expensive (sometimes think 1+million per year) treatment where as a doctor there is little you can do if they are insistent...is not sustainable, and has not been sustainable for years.

Decades ago, things were cheaper. Treatment was limited. Mostly people either got better or they died, only a minority would continue living for many years requiring ongoing care. These days, wirh ageing population and increasing co-morbidities but with better treatment, even fairly sick people can be kept alive for many years, and most of them are kept alive for many years, regardless of their quality of life or care burden. It's like people are not allowed to die any more.

When I started out 15+ years ago, I had these big ideals re universal care for all, care for the vulnerable, patient care before the dollar...I realised after a few years that this is utopia, not the real world. At the end of the day, someone has to pay for all of this. If not the government (ie taxpayer) then it'll require individual contribution. Not saying I like any of this, it's just the reality.

 

[lionraven]

Off-topic post:

As a doctor I think our primary care services will become an American style system over time.

80-odd years ago you could practice GP as soon as you got your medical degree. You would buy yourself a little kit bag and set up shop. Patients would pay you per service and that was it. You could start your tertiary education at 18, become a doctor at 22 and work wherever you could rent a room.

The medicare model of paying per service reflects this. In the interim we as a society have expected better from our doctors. We expect more training and hence doctors have had to fund their own further education through specialist colleges (including the college of GPs) + ongoing professional development. Patients have also rightly demanded better protection from bad doctors. This has manifest in the form of increasing medical indemnity costs/insurance. We also have greater standards in medical practices. No more can you rent out an old Queenslander with maybe an admin staff. You now need specially designed, council approved medical practice with its own specific supplies and staffed by appropriate staff including receptionists, practice managers and nurses. With increasing IT infrastructure you are also expected to fund your own practice managing software that can connect to hospital/pathology providers and you have to have IT staff deal with all the information protection laws you have to rightfully abide. Not to mention now that there is all this information flowing, GPs are now responsible for reading/interpreting huge amounts of information (and also fill out a bunch of assessments for super companies, NDIS etc) that also isnt getting billed appropriately as it is out of clinical hours.

What all this means is an 18 year old wanting to be a GP will now be in their mid to late 20s by the time they can practice as a GP. They will not be able to work anywhere they want. They will have to most likely be an employee at an established practice somewhere. If they ever want to own their own practice they will need to take on a few million dollars in debt just to get the necessary kit to safely practice. They are also now responsible for paying for all these staff wages.

Medicare rebates being frozen for a decade whilst the cost of staff wages, rents, consumables etc inflating has meant its even more untenable for new GPs to own their own practice. Large private investors are the ones who can afford to open new clinics. Now that GPs are employees, they are not incentivised to devleop a relationship with their patients and grow their books. Just like any other employee, you are a fungible asset/disposable.

What really drove through how unvalued GPs were was COVID. GPs were expected to pick up the slack and deal with this new highly contagious virus that we new nothing about and all the government/exectuive leadership groups could do was offer them some virtual claps whilst the rest of society got to stay home for their protection. It didn't matter if you were a GP with vulnerable family members. It didn't matter that there was no budget for increasingly scare PPE. It didnt matter that you weren't vaccinated. You just had to deal with it.

Now GPs treat their job just like any other job. Most GPs have started private billing and I doubt they will go back to taking it on the chin and accept being underpaid again. I think in the future you are going to see GP fees going up. This will result in private companies who run GP practices hiring a bunch of non-GPs to do GP work (you can already see nurse practitioners and pharmacists wanting to prescribe and practice pseudo-adjacent medically). You will see patient's getting harmed as these non-doctors simply don't know what they don't know and the market will correct through litigation/lawyers/indemnity insurance. You will essentially see 2 levels of care - the rich being able to afford GPs and the rest who will go to their local nurse practitioner run urgent care clinic (or emergency department when the issue gets serious).

Its a damn shame but it shows what society values. We don't value health as much as we love a good tax cut. We have voted for decades for this and there is no real way to course correct now.

 

[scoman]

I'm a specialist physician, and have many friends who work as GPs.

I can tell you for a fact that many of them even those working very long hours (60+ hours including paperwork, admin etc) bill less than 300k. Once the practice takes 40ish percent for running costs, they get gross pay of ~160k, and of course less after tax.

Not to mention the ever increasing stress of looking after old, frail patients with lots of co-morbidities and unfixable problems. Once you factor in ever increasing unrealistic expectations and troublesome family...you get the picture.

GP used to be the default for graduates who don't end up doing another speciality, or for those who want a good work/life balance, those with kids etc. No longer. Many graduates are staying away from GP because of all those issues I talked about. Many who end up becoming GPs only work minimal (eg 1-2) days, and spend the rest of their time doing other non-GP work, just to get away from the endless stress.

Getting back to the original point. Free, universal healthcare where people are treated to the absolute limits, where patients and family can demand to pursue crazy expensive (sometimes think 1+million per year) treatment where as a doctor there is little you can do if they are insistent...is not sustainable, and has not been sustainable for years.

Decades ago, things were cheaper. Treatment was limited. Mostly people either got better or they died, only a minority would continue living for many years requiring ongoing care. These days, wirh ageing population and increasing co-morbidities but with better treatment, even fairly sick people can be kept alive for many years, and most of them are kept alive for many years, regardless of their quality of life or care burden. It's like people are not allowed to die any more.

When I started out 15+ years ago, I had these big ideals re universal care for all, care for the vulnerable, patient care before the dollar...I realised after a few years that this is utopia, not the real world. At the end of the day, someone has to pay for all of this. If not the government (ie taxpayer) then it'll require individual contribution. Not saying I like any of this, it's just the reality.

I might be making myself look like an idiot here. But 60 hours a week and billing under 300k? Wouldn't that need to be almost exclusively bulk billing?

Anyway I agree, we have gone off track. 'Free health care ' isn't really a reality any more. I agree with that. I'm sure many don't get to the doc as often as they should if they can't access bulk billing. I know I question the need to return for results/ get stitches taken out, often ensuring the follow up is at least bulk billed. Im often getting biopsies done on dodgy looking skin blemishes/ moles and cancers. Last three years have seen three fairly expensive (2-5k) trips to the plastic surgeon. Very little of any of those costs have been returned by way of medicare.

On the flip side I think my son could well have had millions spent on him during his time with us. Cost to us directly was basically nothing except for parking fees and minimum medication charges. So for that we are very lucky to have our health system that's for sure.

 

[Johnny Bananas]

The medicare model of paying per service reflects this. In the interim we as a society have expected better from our doctors. We expect more training and hence doctors have had to fund their own further education through specialist colleges (including the college of GPs) + ongoing professional development. Patients have also rightly demanded better protection from bad doctors. This has manifest in the form of increasing medical indemnity costs/insurance. We also have greater standards in medical practices. No more can you rent out an old Queenslander with maybe an admin staff. You now need specially designed, council approved medical practice with its own specific supplies and staffed by appropriate staff including receptionists, practice managers and nurses. With increasing IT infrastructure you are also expected to fund your own practice managing software that can connect to hospital/pathology providers and you have to have IT staff deal with all the information protection laws you have to rightfully abide. Not to mention now that there is all this information flowing, GPs are now responsible for reading/interpreting huge amounts of information (and also fill out a bunch of assessments for super companies, NDIS etc) that also isnt getting billed appropriately as it is out of clinical hours.

What all this means is an 18 year old wanting to be a GP will now be in their mid to late 20s by the time they can practice as a GP. They will not be able to work anywhere they want. They will have to most likely be an employee at an established practice somewhere. If they ever want to own their own practice they will need to take on a few million dollars in debt just to get the necessary kit to safely practice. They are also now responsible for paying for all these staff wages.

Medicare rebates being frozen for a decade whilst the cost of staff wages, rents, consumables etc inflating has meant its even more untenable for new GPs to own their own practice. Large private investors are the ones who can afford to open new clinics. Now that GPs are employees, they are not incentivised to devleop a relationship with their patients and grow their books. Just like any other employee, you are a fungible asset/disposable.

The situation you describe really makes it sound like a hole has developed in the market and it's best for everyone if the government fills it. If individual doctors cannot operate their own clinics anymore due to the costs being too high, the government should run clinics themselves. They can benefit from economies of scale with regard to clinic construction, IT/payroll systems and medical equipment.

Of course, as you say later on, the public have never met a tax cut they don't like and that hamstrings the ability of the government to do things like this. But I don't think there's no way to course correct now. If a government explained to the people that taxes would go up and exactly what they're going to fund, I think they'd be able to get away with it if people thought it was worth the benefit. But that would take a skilled politician who actually wants to make a change like that. I don't see any desire from either major party for it at the moment.

 

[Nunez]

I'm missing something here.

You're not forced to get private health.

You could pay the medicare levy, that would support public health.

If you can jump the public system ques, I don't understand why you wouldn't want private health.

The problem is, the cost to opt out of private and pay the levy far outweighs the cost of basic private health. In terms of why not private health: I have had no issues with public even when I've had health issues and am healthy, therefore don't personally see the benefit. Maybe one day that would change, but at this stage of my life I'd rather pay more money into public than some private health insurance company, but not at the expense that's required due to the levy. There is no happy medium.

 

[briztoon]

The problem is, the cost to opt out of private and pay the levy far outweighs the cost of basic private health. In terms of why not private health: I have had no issues with public even when I've had health issues and am healthy, therefore don't personally see the benefit. Maybe one day that would change, but at this stage of my life I'd rather pay more money into public than some private health insurance company, but not at the expense that's required due to the levy. There is no happy medium.

Probably need a better accountant.

 

[Nunez]

Probably need a better accountant.

You're hired!

 

[briztoon]

You're hired!

Woohoo, slush fund top up.

 

[martinson]

Off-topic post:

As a doctor I think our primary care services will become an American style system over time.

80-odd years ago you could practice GP as soon as you got your medical degree. You would buy yourself a little kit bag and set up shop. Patients would pay you per service and that was it. You could start your tertiary education at 18, become a doctor at 22 and work wherever you could rent a room.

The medicare model of paying per service reflects this. In the interim we as a society have expected better from our doctors. We expect more training and hence doctors have had to fund their own further education through specialist colleges (including the college of GPs) + ongoing professional development. Patients have also rightly demanded better protection from bad doctors. This has manifest in the form of increasing medical indemnity costs/insurance. We also have greater standards in medical practices. No more can you rent out an old Queenslander with maybe an admin staff. You now need specially designed, council approved medical practice with its own specific supplies and staffed by appropriate staff including receptionists, practice managers and nurses. With increasing IT infrastructure you are also expected to fund your own practice managing software that can connect to hospital/pathology providers and you have to have IT staff deal with all the information protection laws you have to rightfully abide. Not to mention now that there is all this information flowing, GPs are now responsible for reading/interpreting huge amounts of information (and also fill out a bunch of assessments for super companies, NDIS etc) that also isnt getting billed appropriately as it is out of clinical hours.

What all this means is an 18 year old wanting to be a GP will now be in their mid to late 20s by the time they can practice as a GP. They will not be able to work anywhere they want. They will have to most likely be an employee at an established practice somewhere. If they ever want to own their own practice they will need to take on a few million dollars in debt just to get the necessary kit to safely practice. They are also now responsible for paying for all these staff wages.

Medicare rebates being frozen for a decade whilst the cost of staff wages, rents, consumables etc inflating has meant its even more untenable for new GPs to own their own practice. Large private investors are the ones who can afford to open new clinics. Now that GPs are employees, they are not incentivised to devleop a relationship with their patients and grow their books. Just like any other employee, you are a fungible asset/disposable.

What really drove through how unvalued GPs were was COVID. GPs were expected to pick up the slack and deal with this new highly contagious virus that we new nothing about and all the government/exectuive leadership groups could do was offer them some virtual claps whilst the rest of society got to stay home for their protection. It didn't matter if you were a GP with vulnerable family members. It didn't matter that there was no budget for increasingly scare PPE. It didnt matter that you weren't vaccinated. You just had to deal with it.

Now GPs treat their job just like any other job. Most GPs have started private billing and I doubt they will go back to taking it on the chin and accept being underpaid again. I think in the future you are going to see GP fees going up. This will result in private companies who run GP practices hiring a bunch of non-GPs to do GP work (you can already see nurse practitioners and pharmacists wanting to prescribe and practice pseudo-adjacent medically). You will see patient's getting harmed as these non-doctors simply don't know what they don't know and the market will correct through litigation/lawyers/indemnity insurance. You will essentially see 2 levels of care - the rich being able to afford GPs and the rest who will go to their local nurse practitioner run urgent care clinic (or emergency department when the issue gets serious).

Its a damn shame but it shows what society values. We don't value health as much as we love a good tax cut. We have voted for decades for this and there is no real way to course correct now

Regulations, admin costs, the changing demographic and the responsiblities have made private practitioner clinics uneconomic.

The large majority of GP'S in private practice are earning less than 25OK whist the admin /follow up/monitoring side of the job has ballooned. They're under a lot of pressure particularly if they're trying to provide any sort of holistic ,comprehensive service as their client base has aged and require more attention.

Insurance costs for GP's and particularly specialists is astronomic.

Governments of both persuasions have sat back and watched this situation develop as the electorate demands free health care . Medicare is a bit of a joke compared to what most people think it is or should be and something's gotta break sooner or later.

 

[dlanod]

Woohoo, slush fund top up.

Rort that baby!

 

[lionraven]

The situation you describe really makes it sound like a hole has developed in the market and it's best for everyone if the government fills it. If individual doctors cannot operate their own clinics anymore due to the costs being too high, the government should run clinics themselves. They can benefit from economies of scale with regard to clinic construction, IT/payroll systems and medical equipment.

Of course, as you say later on, the public have never met a tax cut they don't like and that hamstrings the ability of the government to do things like this. But I don't think there's no way to course correct now. If a government explained to the people that taxes would go up and exactly what they're going to fund, I think they'd be able to get away with it if people thought it was worth the benefit. But that would take a skilled politician who actually wants to make a change like that. I don't see any desire from either major party for it at the moment.

I don't know what's best for the patient or consumer. Having the federal government invest in an NHS like national urgent care service would give new GPs a reduced stress salaried option for them to take. However it would essentially pull away GPs working in private service. Those private businesses may pull out leaving more work for the urgent care services. Public funding is also not infinitely sustainable. You can see that with the NHS. They are trying to service their GPs with a bunch of non doctors ie nurse practitioners. As a doctor I am biased. I feel if nurse practitioner training is deemed perfectly adequate and safe then they should get accredited with a medical license and practice completely independently and manage their own risk. If there training is not sufficient then why are we hiring them to replace GPs? At present you currently have Schroedingers nurse practitioner. They are really good and should work independently but they are also not a doctor so they need a doctor to take responsibility for the decisions they make.

Fundamentally we need Australians to decide what they want at the ballot box. Too bad half of us are worried about welcome to countries or wokeness of sport so we don't hold our political class to task on healthcare.