Australians under 35 should have their GP visits bulk-billed, according to the country’s doctors, who are pushing Health Minister Mark Butler to introduce bonus payments for doctors who choose not to charge young patients out-of-pocket fees.
As Labor and the Coalition prepare to fight over health policy at the federal election, the Royal Australian College of General Practitioners wants the next government to extend bulk-billing incentives to under-35s because they are the group most likely to delay doctor’s appointments because of cost.
Mark Butler says he is looking at ways to increase bulk-billing. Credit: Chris Hopkins
Bulk-billing incentives – which are bonuses paid to GPs who don’t charge their patients any gap fees – are currently only available for children under 16, pensioners and concession card holders.
New data shows a massive drop-off in bulk-billing rates once children turn 16. The average bulk-billing rate for Australian children falls from 90 per cent, for under 16s, to 72 per cent for 16- to 18-year-olds, which is when the bulk-billing bonuses cease to apply.
Michael Wright, the president of the GPs college, said young people struggling financially were the most likely to put off medical appointments. “The last thing we want is for people to have to choose between seeing a doctor and putting petrol in your car,” he said.
The college’s analysis said extending bulk-billing incentives to under-35s would save young people $42 a visit in average doctor’s fees, while stopping 9000 hospitalisations because people would stay healthier through better preventative care, earlier diagnosis and chronic disease management.
“The cost-of-living crisis is impacting the health of young Australians … When young people delay healthcare, serious health conditions can go undetected, which means that when they do require healthcare it is often more complex and expensive,” the college said.
The college’s analysis calculates that expanding bulk-billing incentives for under 35s would cost the government between $390.6 million and $557.8 million a year, depending on demand.
The Greens have promised to go even further, and expand the tripled bulk-billing incentives to all Australians, which the parliamentary budget office said would cost an extra $3.8 billion over three years.
But doctors have proven clout when it comes to getting policy reform. The GPs’ original push to boost bulk-billing by tripling incentives became the Albanese government’s $3.5 billion budget announcement in 2023, and the policy has since led to the first turnaround in bulk-billing rates since they started falling after the pandemic.
Latest data from the health department shows bulk-billing rates have lifted 1.9 percentage points, from 75.6 per cent to 77.5 per cent, since the policy took effect in November 2023.
But middle Australia has not reaped the benefits, analysis by this masthead has shown, with general patients aged 16 to 64 paying more out of pocket than they were a year ago.
Butler has since said he is looking for ways to improve bulk-billing. “We’re keeping a very keen eye on what’s happening with patients who aren’t covered by the bulk-billing incentive,” he said earlier this year. “We know there’s more to do on bulk-billing, and we’re committed to doing more.”
The college is also calling for a 40 per cent lift to Medicare rebates for longer visits, which could cost up to $1 billion a year, as well as a 25 per cent increase for GP mental health items and more funding to train new GPs.
Wright said boosting rebates for long visits would cut gap fees from $59 to $25, on average, while lifting the national bulk-billing rate to 85 per cent. He also wants funding to train 1500 new doctors.
“What we’re trying to present is a range of solutions that improve affordable access for patients,” he said.
The doctor’s lobby will meet politicians in Canberra this week, as both parties seek to win over voters on the cost of living and health policy.
Labor’s major women’s health announcement from Sunday – which includes $537 million in support for contraception and menopause treatment – was immediately adopted by the Coalition.
The Coalition is also talking up its health record to fend off Labor attacks. Opposition Leader Peter Dutton on Monday guaranteed in an Instagram video that a Coalition government would grow Medicare funding.
“Labor has been running this same scare campaign since 2016. It wasn’t true then, and it isn’t true now. Under my leadership, we will protect and grow Medicare, support bulk-billing, and bring more GPs into communities,” Dutton said.
Meanwhile, Butler continues to paint Dutton as risky by highlighting his push for compulsory patient co-payments as health minister in 2014.
“When Peter Dutton was health minister he tried to end bulk-billing with a GP tax and then started a six-year freeze to Medicare rebates that the AMA says took billions out of Medicare,” Butler said on Monday.
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