As a family doctor I’ve been thinking about the co-payment to be made for bulk-billed visits to the GP. It has taken me weeks to come to some sort of appreciation of what is going on. A surprisingly long time, really given that I have average intelligence and a keen direct interest. Let me tell you what I have discovered – three things.

The first is no-one has a very clear idea of how the system will work. Will it work like the GST where the provider of the service acts as the government’s tax collector? Will the literally penniless who attend a GP be seen and treated, or must the GP send that person to a public hospital? Or will we be permitted (thanks Messrs Abbott and Hockey) to treat that person gratis? WHAT IS CLEAR HERE IS OBSCURITY. OBSCURITY FATHERS CONFUSION, WHOSE OFFSPRING IS ANXIETY. THE POOR WILL GET SICKER.

I work both in middle class clinics where we bill patients privately and in outback Aboriginal communities where bulkbilling is universal and absolutely and literally lifesaving. Privately billed patients will hardly blink. Aboriginal patients will revert to the traditional healer. If you aren’t appalled at this thought please consider the case of your own child, 500 kilometres from a hospital, feverish, endangered, and effectively unattended. Dickens wrote of this plight in the London of his day. Messrs Hockley, Abbott – go bush, sit down, listen and reconsider!

Finally, I gather the bulkbilled will enjoy a safety net. After ten co-payments, the system bulk-bills them again, free of charge. Ten times seven equals seventy, equals 1 and a smidgeon dollars a week, equals less the cost of one icy pole every five days. Where’s the gain? The gain is derisory: that means BUGGER ALL help to the bottom line. The gain comes at the cost of derision. Messrs A and H hold us in derision. Where’s the pain? The pain is in the deterrence. Don’t go the doctor if you are poor. It’s not government policy. Where’s your mateship? Your citizenship? Your sense of responsibility? The age of entitlement is over. Get real. Get rational. Harden the f-up.

I know how hard hard can get. That condition is called rigor mortis.