WIMMERA health leaders have blasted a proposed $6 doctor's fee as an administrative nightmare.
They say the fee would deter people from seeking medical help, and would cost small regional health services more to administer than to collect on behalf of the Federal Government.
The fee proposal is in a submission to the Federal Government's Commission of Audit by former health adviser to Tony Abbott, Terry Barnes.
Mr Barnes wrote the submission on behalf of the Australian Centre for Health Research.
It suggests bulk-billed patients be charged $6 to visit general practitioners, saving the Federal Government $750 million over four years. A report in The Age yesterday said Mr Barnes also suggested extending the charge to GP-type services provided by hospitals, to prevent people deterred by the fee from clogging emergency departments.
Rural Northwest Health chief executive Catherine Morley said it would be difficult for small rural health services to collect the money.
"It would not be worth us collecting it," she said.
"I couldn't ask a nurse to do it I don't know how they could add that to their already busy days."
Edenhope and District Memorial Hospital relieving chief executive Anne Bates said the proposal would create a whole array of administrative processes.
"Larger centres would have existing administrative processes, but that's not what would happen here," she said.
A similar proposal came to her attention about 15 years ago, but Mrs Bates said it was unsuccessful because the cost of implementing the scheme would have outweighed the benefits.
"Another thing I find quite interesting is that, in health, we have spent more than 30 years telling people to see a doctor early if they have health concerns," she said.
She felt charging people who had previously been bulk-billed could be a disincentive to seek medical help.
"People would just stop going to the doctor as often, and the patients with conditions that would benefit from early medical attention could end up with a much more serious illness, and therefore much worse health concerns," she said.
"I'm talking about people whose length of life might be shortened, such as people with a cancer that is too far progressed to get remedial treatment."
But she said it remained to be seen how the proposed fee would work in practice, if the government chose to implement it.
"Would anybody who doesn't just walk in on their own two legs be asked to pay the fee?" Mrs Bates said.
"Does that mean more people would call ambulances?"
West Wimmera Health Service chief executive John Smith said the proposal was appalling.
"There is a Medicare levy that has been struck to cover these costs, and there are provisions for bulk-billing which some doctors use - others do not," he said.
"And of course, I would have thought the majority of Australians relying on GP services are those in rural and remote communities.
"In cities, people consult a GP and are then referred on to specialists for a great number of ailments, whereas in the bush a general practitioner is just that.
"They carry many responsibilities and wear many hats."
He urged the Federal Government to review all aspects of billing for medical services, ensuring any proposed changes affected metropolitan and regional patients equally.
Tristar Medical Centre Horsham diabetes educator Megan Preusker said there were too few details about the concept to fully understand the potential impact.
"People are used to paying a small fee for health care, in some respects," she said.
"Six dollars is not unaffordable, depending on how often you see your doctor."
She hoped the submission included a spending cap so people who needed to see a doctor often could afford to do so.
"I'm sure there would be a provision that we don't refuse services because someone can't afford to pay," she said.
Health Minister Peter Dutton declined to comment on whether the government was considering the idea.