Lives would be put at risk by "radical" National Commission of Audit reforms to Australia's health system that would begin an Americanisation of Australia's health system, furious doctors say. They have warned the Abbott government not to go ahead with proposals such as compulsory fees for visiting the doctor, which they say would lead to a massive worsening of the burden of chronic disease in Australia. They have described other proposals, such as asking busy hospital emergency departments to charge fees, as "fantasies" that could not possibly work. Australian Medical Association president Steve Hambleton said the recommendations were designed by "bean counters" with no idea of how the health system works. "It puts saving money ahead of saving lives," he said. "It is shifting more and more health costs onto patients, including the most vulnerable – working families, the elderly and the chronically ill. "The new, high co-payment proposal for GP visits would see sick people abandon or delay visits to the doctor, which would ultimately cost the health system more as these patients eventually require much more expensive hospital treatment." He said the GP co-payment would add red tape for GPs, contrary to stated government policy. Doctors Reform Society of Australia president Con Costa said the proposals would start an "inflationary spiral" that would lead to GPs charging up to $300 for a visit as they do in the US, which would be out of reach for all but those with private health insurance. "This will let the cost genie out of the bottle," he said. "Once you start doing that, prevention, things like the ads you see that you should get checked for cancer, goes out the window. "The really needy people . . . this is going to make things a lot worse for them and they will end up calling the ambulance and yo-yoing back and forward out of hospital." He said it was "fantasy land" to expect hospitals to collect fees in emergency. "Hospitals aren't geared to collect money and they aren't geared to chase debts," he said. Public health expert Mike Daube said it would be a mistake to merge the Australian National Preventive Health Agency with another body. He said it would be a signal that prevention was no longer a high priority. "It will be immensely disappointing if a perceived need for short-term savings means that Australia's prevention efforts stall," he said. "It is vital that whatever happens to [the agency], the important prevention programs continue." Key audit recommendations: • Individuals earning above $88,000 and families earning above $176,000 to pay 2 per cent more in tax if they do not take out private health insurance. • $15 fee to visit the GP, to drop to $7.50 after 15 visits in a year. Concession card holders to pay $5 per visit for the first 15 visits and then $2.50 per visit. • States to be encouraged to charge fees for less urgent treatment in emergency departments. • Fee for prescription drugs to rise by $5, from $36.90 to $41.90. Fee to remain at $6 for concession card holders. • Private insurers to be able to charge higher premiums to smokers and others with unhealthy lifestyles.