‘A much larger problem’: Why doctors are no longer bulk billing their patients
Free visits to the doctor are under threat, with fewer GPs bulk billing because of drastic cuts to Medicare rebates.
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Free doctor’s visits are under threat as Medicare rebates for pensioners and children are slashed by $3 for thousands of GPs and fewer doctors bulk bill.
Online medical directory MindTheGap, which surveys fees charged by 224 GP clinics every January, has found one in three GP clinics do not bulk bill their patients and charge them an average of $76 per visit.
The findings come as GPs in 14 regions warn they are abandoning bulk billing and charging pensioners $48 a visit after the Medicare bulk billing incentive was slashed for pensioners and children from $9 to just $6 on January 1.
The change was made to better direct bulk billing incentives to patients genuinely living in the bush.
About 7000 GPs in 14 regions including Newcastle, Canberra, the Sunshine Coast, Geelong and Gawler have lost the rural bulk billing incentive, which will cost them between $6500 and $12,000 in Medicare payments a year.
About 2100 doctors in four regions — Jam Jerrup (Victoria), Kiama (NSW), Russell Island (QLD) and Yanchep (WA) — will receive higher Medicare rebates under the changes.
Charlestown GP Dr Colin Pearce said bulk billing practices were already changing in areas such as Mayfield, Windale, Belmont and Raymond Terrace as a result of the cut.
“Pensioners who were previously bulk billed are being told to bring a $50 note and they will get back $37 from Medicare within 24 hours,” he said.
Newcastle doctor Dr Lee Fong told News Corp: “Yes, GPs have been reducing/stopping bulk-billing. I know one that has even been forced to shut down a practice that was directly servicing a disadvantaged area.”
Patients who could not afford to pay for a doctor would delay important care or might go to already overcrowded emergency departments, he said.
Royal Australian College of General Practitioners president Dr Harry Nespolon said the changes would impact how many patients were bulk billed.
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“However, these changes to bulk incentives do occur in the context of a much larger problem – Medicare patient rebates have not kept pace with CPI for over 20 years, and are now insufficient to fully cover the cost of providing the care that patients need,” he said.
Health Minister Greg Hunt said Medicare bulk billing rates were at record levels of 86.2 per cent of services and had increased by four full percentage points, from 82.2 per cent, since the government was elected.
However, the number of services bulk billed is not the same as the number of patients bulk billed.
Health Department data released to the Senate shows in 24 electorates fewer than half the patients are bulk billed by their GP, and nationally one in three patients are not bulk billed for all their GP visits.
The same data shows patients in 38 electorates now pay more than $40 in out of pocket fees to see their doctors because Medicare rebates cover less than half the bill.
The out of pocket cost of seeing a GP in 43 electorates has risen by over $10 since 2012-13.
James Gillespie said his MindTheGap survey this January found out of pockets costs at private GP clinics had increased by almost $3 on average for a standard GP consultation since July 2019.
He found there had been a small decline in the number of bulk billing clinics since 2018.
Three clinics had abandoned bulk billing altogether since 2018.
He rated the Government’s performance in the management of bulk billing rates for 2018-2020 as D+.
“With all States’ unnecessary emergency hospital admissions increasing to critical levels it is more important now than ever that people be able to quickly and reliably find affordable primary care at local GP clinics instead,” he said.