BILL Shorten has described a radical Federal Government plan to overhaul Australia’s health system as an “Abbott government thought bubble”.

Medicare would be means-tested with access to bulk-billed doctor’s visits and medical tests limited to those on lower incomes, under the proposal being considered by the Abbott Government.

“The Abbott government keep flying kites to test community reaction to justify breaking promises,” the Opposition Leader told reporters in Geelong today.

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“In order to have a discussion about the future of healthcare in this country the Abbott government must come clean,” he said, challenging the Coalition to reveal any “secret plans”.

In an exclusive interview with News Corp, Health Minister Peter Dutton has questioned if high income earners should be able to see a doctor without dipping into their pocket.

“I question whether someone on an income of $200,000 can have an expectation of going to the doctor for free, that is one of the discussions, one of the conversations we have to have,” he said.

The minister’s proposal for means-testing on bulk-billing extends beyond GP visits and also includes blood tests, X-rays and other diagnostic services.

Deputy Opposition Leader Tanya Plibersek said Australia spends “a lot less” on health care than other comparable countries.

“When I was Health Minister of course I had to find savings, but I always looked for savings that didn’t affect patient care,” she told Channel Nine today.

“You shouldn’t be listening to the Commission of Audit, you should be listening to doctors.”

media_camera Guessing game ... the Abbott Government has refused to rule out speculation it will introduce the $6 GP fee.

Government frontbencher Malcolm Turnbull said there was “a lot of speculation going around”, insisting no decision has been made.

“What Peter Dutton has said … is the Commission of Audit has looked at it and will no doubt make some recommendations,” Mr Turnbull told the Today Show this morning.

“We’ll look at them, but we have made no commitment to make any changes at all.”

Treasurer Joe Hockey had a starker message than Mr Turnbull.

“We are ringing an early warning bell about the sustainability of these things, about the sustainability of our health care system, the sustainability of our welfare system,” Mr Hockey told Sky News.

“If we want to maintain a reasonable quality of life we need now to have a good and proper and well informed discussion about whether we can afford what we have,” he said.

“If we can’t, we’ve got to find ways to ensure that we can have a system that delivers what Australians expect.”

In a headline speech in Brisbane this week Mr Dutton declared that Medicare was “unsustainable” and needed to be modernised to cope with an ageing population and expensive new medical treatments.

He told News Corp that as part of the overhaul he is considering allowing health funds to move into covering GP-type care. At present they are prevented by regulations from doing this.

“I’m not opposed to having private insurers involved in the primary care space, that is a discussion we can have,” he said.

Insurers have welcomed the potential move claiming five per cent of their members account for more than 40 per cent of their costs and better primary care could stop them going to hospital.

media_camera Health spending ... GP costs are not the problem, says Australian Medical Association president Dr Steve Hambleton.

As part of his push for more private involvement in health, Mr Dutton on Wednesday unveiled a $40 million plan that will see up to 400 medical interns trained in private hospitals.

He is also considering changing the way the government pays doctors to treat people with a chronic illness, switching from a fee-for-service model to one that pays doctors for a health outcome.

The government has refused to rule out speculation it will introduce a $6 GP fee being considered by its Commission of Audit.

Mr Dutton told News Corp that “people have obviously made arguments for and against a co-payment” and it was up to the commission.

Questioned about the $6 GP fee on Wednesday, Prime Minister Tony Abbott appeared to downplay the charge, claiming he was leading a “no surprises, no excuses government”.

Mr Dutton said plenty of people pay to see a doctor now and access to some health services is already means tested.

Pensioners and health card holders pay just $6 for a subsidised prescription while general consumers must pay up to $36.30.

Opposition Health spokeswoman Catherine King has accused Mr Dutton of trying to introduce a “two-tiered” health system by undermining universal access to Medicare.

“What Peter Dutton appears to be doing is trying to soften people up for saying the Federal Government wants to spend less and wants to transfer as much as those additional costs on to patients,” Ms King said.

Australian Medical Association president Dr Steve Hambleton said GP costs were not the problem because the amount spent per person on GP care had only risen from $301.60 a year in 2006-07 to $304.40 in 2011-12.

The biggest growth in health spending was in hospitals, he said.

Catholic Health Australia’s chief Martin Laverty has backed a means test that protects low income earners from higher health costs.

“We say with health costs escalating either you’ve got to raise taxes or you have to say to those who have the capacity to pay to do so,” he said.

The Australian Healthcare and Hospitals Association has welcomed debate on an overhaul of Medicare but rejects a $6 GP fee.

AHHA chief Alison Verhoven said public and private hospitals should be able to compete for the same pool of money, with the most efficient carrying out surgery and services.

Medicare should stop paying for many medical procedures that aren’t efficient or effective, she said.

Originally published as Abbott ‘must come clean’ on Medicare