Gone is the $7 co-payment he sprung on the electorate after the election and instead doctors will now be forced to charge $5 more for a visit to compensate them for a $5 cut in their Medicare rebate.

It’s that or accept $5 less for most patients they see. 

On top of that a freeze on rebates until 2018 means doctors will have little choice but to recoup the $5 rebate cut by passing it on to patients.

With the exception of pensioners, concession card holders and children under 16, the reduced rebate will apply to most patients and GPs will have to decide who can afford to pay and who can’t.

The justification for reducing the rebate in regional Australia is just as flawed as the prime minister’s first attempt to introduce a $7 charge.

The co-payment was designed to make going to the doctor more expensive and thus discourage people from making unnecessary trips to the doctor. 

The fallacy in that argument is that country people are not frequent visitors to doctors in the first place.

If there are pockets of hypochondriacs in the population they tend to be in the wealthier suburbs of Sydney not regional and rural Australia where doctors are scarce outside of centres like Orange.

There is also the question of asset rich but cash poor families on the land finding the extra $5. 

The only logical consequence of this policy in the bush is to further discourage people from going to the doctor when they need to.

It will have adverse impacts on rural health but the silence from rural MPs is deafening.