Just to clarify - I was asked today why not just direct the $3 billion straight in to public health? Well - I'd be all for injecting $3 billion into public health; But I say 'fix the public health system and people will come'; Fix the public system and the Private Health Insurance Rebate will wither away because consumers no longer see the need for it. But in the meantime we have a Conservative government. So first get rid of the blackmail against low income Australians in the form of the Lifetime Health Cover policy. That can benefit many low income Australians in the meantime. And drive down private health insurance expenses by restoring Medibank Private to a 'not for profit' footing...

I wonder, do people like Tristan ever come out of the inner city chattering zone, & have a look at the real world? I wonder if he can do any arithmetic? Could he ever have looked at the deficit left us by the similar thinking of the high spending lefty governments, & still written this bit of fluff?

I'm a pensioner, but can still see the necessity for a small cost to help reduce the waste.

My mother had a monthly doctors appointment. She would get all dressed up, then the taxpayer funded assistance car & driver would arrive, take her to the doctor, wait for her, take her for a coffee, then bring her home. This was purely a social outing, paid for by the taxpayer. I know, as the doctor would ring me, to advise if any treatment was prescribed. In her 90s, mum was not reliable with her medical treatments.

That doctor is very popular with the older ladies, they look forward to his monthly chats. All very nice, but can we afford such waste?

While we are wasting huge amounts of the health budget on such social activities, even cancer sufferers are having to wait for treatment, due to budget restraints. So come on Tristan, do you want to reduce waste, or are social doctors visits more important than real treatment?

spending $6 to go to the doctor will be $6 less to spend in alcholol and cigarettes for many. A very healthy outcome.

Has-been;

Firstly: Terry Barnes - the author of the report himself - suggests excluding pensioners himself.

Secondly: Many doctors already charge on top of bulk billing - for a great many there is already a 'price signal'

Thirdly: If elderly pensioners lack social engagement - rather than begrudging them this - provide OTHER channels of social interaction - eg: dinners, discussion nights, movie nights etc. Social isolation of the vulnerable is a serious issue and needs to be addressed.

Fourth: You don't seem to have anything to say about making private health insurance affordable for low income Australians.

FINALLY: Improving pensions and providing tax breaks for low income Australians could be a way of protecting our vulnerable - and could be combined with a 'price signal'. (but remember that for many such a 'price signal' already exists.

According to a doctor friend of mine when Hawke introduced co-payments the number of visits by his patients dropped by a third. Nearly all were psuedo-patients like Has-been's mother. In his opinion it was one the best things that Hawke introduced while Prime Minister because he then had the time to concentrate on the truly sick. The removal of the co-payment by Keating was yet another stupid non-rational uneconomic decision by a Labor government.

All pension benefits should be means tested, and I speak as a pensioner myself

Means tests for pensions are fine - so long as they're fair.

You don't want (genuinely) middle class welfare. Though there are arguments for socialised health, and the highest quality public education; as well as public provision of transport and communications infrastructure etc.

I think as means tests stand now, though - While there are grossly unfair superannuation concessions which favour the wealthy - many part-self-funded-retirees, disability pensioners etc - face means tests which are arguably too steep....

BUT if we're talking about means tests for the Private Health Insurance Rebate - I have no problem with that. It could save hundreds of millions a year.

And again: if you want a co-payment - exclude the chronically ill; and increase pensions so you have your 'price signal' - but do not disadvantage those in need of care.

And in any case pensions are so threadbare that they all could well do with significant boost.

FINALLY: If there are people suffering social exclusion - including Aged Pensioners - then there is a need for social inclusion policies - Again including movie nights, and outings of various kinds.