Which direction should Australian health system reform be heading?
This commentary considers lessons that should have been learnt from rejection of GP co-payment proposals. It points to where health reform should be heading to improve system efficiency and the Federal Budget bottom line. Lessons highlight the need to look at population-level access, effectiveness and cost impacts across the health system over time allowing for provider incentives and responses, rather than shortterm localised impacts. These lessons do not support freezing GP payments for bulkbilled services, but rather point to removal of the private health insurance rebate in improving the budget bottom line without compromising Medicare objectives.