TY - JOUR T1 - International primary care snapshots: Australia and Brazil JF - British Journal of General Practice JO - Br J Gen Pract SP - 198 LP - 199 DO - 10.3399/bjgp15X684517 VL - 65 IS - 633 AU - Leon Piterman AU - Matthew Harris AU - Fabiana C Saddi AU - Sandro Rodrigues Batista AU - Raquel Abrantes Pego Y1 - 2015/04/01 UR - http://bjgp.org/content/65/633/198.abstract N2 - Australia has enjoyed a universal health insurance scheme, Medicare, for 40 years. Introduced by a Labor government in 1974, no successive Labor or Conservative (Liberal) government has been brave enough to tamper with this scheme fearing electoral backlash. This is no longer the case. The newly-elected Conservative government proposes to change all this, provided its bills pass the Senate or Upper House. Faced with concerns about a budget deficit and fears that an ageing population with increased incidence of chronic and complex disease will make Medicare unaffordable, they have introduced a mandatory A$7.00 patient co-payment for GP consultations and out-of-hospital pathology and radiology, concurrently reducing the Medicare contribution by A$5.00. Specialists are unaffected. The government proposes that the A$5.00 saving will go into a A$20 billion medical research ‘future fund’ designed to support research to find cures for chronic disease, with dementia being singled out. These changes are supposed to come into effect in July 2015 and will be accompanied by an extra A$5.00 payment for pharmaceuticals. These changes have been universally opposed by the Royal Australian College of General Practitioners (RACGP), Australian College of Rural and Remote Medicine, the Australian Medical Association, Doctors Reform Society, senior medical academics, the majority of public opinion, and, of course, the opposition parties. The changes are seen to discriminate against the most vulnerable in the community, namely the poor and low-income earners who may think twice about going to the doctor. The link between the A$5.00 saving and a medical research fund has been considered spurious.Australia’s population of 23 million is ageing. Between 1973 and 2013 the number of people aged >65 years has tripled from 1.1 million to 3.3 million, comprising 14% of the population (tipped to rise to 22% by 2035), and … ER -