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ALTERNATIVE GOVERNMENT POLICIES FOR GENERAL PRACTITIONER LOCATION: INFORMATION, PRICES AND INCOMES
Abstract
The Commonwealth Government has recently implemented a scheme which involves financial incentives for general practitioners to relocate from urban areas to rural/ remote areas of Australia. The purpose of this scheme is to redress differential provision and utilisation of general practice services across space. This paper describes systematic differences in the prices and quantities of general practitioner services and general practitioner incomes provided in different regions of the State of Queensland for 1991–92. More specifically, it is found that prices and incomes are higher in more remote regions of the state. The paper concludes with a consideration of an alternative policy, i.e. relocation could be effected by the dissemination of information on the regional differences in prices and incomes.
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NOTES AND REFERENCES
General Practice Consultative Committee, The Future of General Practice: A Strategy for the Nineties and Beyond, General Practice Consultative Committee, Canberra, 1992.
Commonwealth of Australia, Health Care for All Australians: 1992–93 Reforms, Budget Related Paper No. 8, AGPS, Canberra, 1992, pp.37–8.
Commonwealth Department of Human Services and Health, Rural Doctors: Reforming Undergraduate Medical Education for Rural Practice, AGPS, Canberra, 1994.
Ibid., p.3.
Department of Community Services and Health, Medicare Benefits Schedule Book Operating from 1 May, 1990, AGPS, Canberra, 1990.
Bator F. M.. 1971. . “The Anatomy of Market Failure’. ”. In Readings in Microeconomics . , 2nd Edn. , Edited by: Breit W. and Hochman H. M.. p. 518––37. . New York : : Holt, Rinehart and Winston. .
Arrow K. J.. 1963. . ‘Uncertainty and the Welfare Economics of Medical Care’. . American Economic Review . , Vol. LIII((5)): 941––73. .
See R. H. Coase, “The Nature of the Firm:’, reprinted in K.E. Boulding and G.J. Stigler (eds), Readings in Price Theory, George Allen and Unwin, London, 1953, pp.331–51, and O.E. Williamson, The Economic Institutions of Capitalism: Firms, Markets, Relational Contracting, Collier Macmillan, London, 1985.
Stigler G. J.. 1971. . “‘The Economics of Information’. ”. In Economics of Information and Knowledge: Selected Readings . , Edited by: Lamberton D. M.. p. 61––82. . Harmondsworth : : Penguin. .
Ibid., p.79.
Phlips L.. 1986. . The Economics of Imperfect Information . , p. 9 Cambridge : : Cambridge University Press. .
Department of Human Services and Health. . 1994. . Rural/Remote Areas Classification . , Canberra : : Department of Human Services and Health. .
Doessel D. P.. 1994. . ‘Medicare and Public and Private Medical Practice: Utilisation and Substitution’. . Economic Analysis and Policy . , Vol. 24((1)): 1––21. .
For an account of this system see D. P. Doessel, ‘General Practice in Perspective: A Descriptive Analysis of Prices and Other Outcomes Under Medicare’, mimeo, Brisbane, The University of Queensland 1995. For a somewhat similar treatment of Medicare see J.R.G. Butler, ‘Cuts in Subsidies and Supply Restrictions under Medicare: A Positive Political Economy Analysis’, in M.R. Johnson, P. Kriesler, and A.D. Owen (eds) Issues in Australian Economics, Allen and Unwin, Sydney, 1994, pp. 109–24.
This book was formerly called the Medicare Benefits Schedule Book. It had its origins in the “most common fee” arrangements associated with the Gorton Government's response to the Nimmo Report. See Committee of Enquiry Into Health Insurance, Report, Commonwealth Government Printing Office, Canberra, 1969.
For a discussion, see Commonwealth Department of Human Services and Health and the Australian Medical Association, ‘Towards a Relative Value Study: A Joint Discussion Paper’, mimeo., Canberra, 1994.
At the time Medicare was introduced on 1 February 1984, this amount was $10. From 1 November 1986, the gap was set at $20, and a further increase occurred in January 1991 to $26.
The financial year is relevant as such expenditures, inter alia, if summed to $1000 or more, are subject to a rebate at 20 per cent, under a provision of the Income Tax Assessment Act.
The remaining services comprise emergency attendances, attendances in nursing homes and hospitals, and attendances classified as “other”. See General Practice Branch, “General Practitioners - An Overview”, mimeo., Department of Health, Housing and Community Services, Canberra, 1993.
For an overview of vocational registration, and associated procedures such as continuing medical education and quality assurance, see D. P. Doessel, ‘Editor's Introduction’, in D.P. Doessel (ed.), The General Practice Evaluation Program: The 1992 Work-in-Progress Conference, AGPS, Canberra, 1993, pp.xiii–xviii.
For an account of the conceptual basis of time prices and some empirical results see J. P. Acton, ‘Non-Monetary Factors in the demand for Medical Services: Some Empirical Evidence’, Journal of Political Economy, 83, 3, 1975, pp.595–614.
Op. cit., p.62.