Working Australians are paying more to see a GP than a year ago, hit with higher gap fees and fewer fully covered appointments even as the Albanese government pours record levels of funding into encouraging doctors to bulk-bill.
Children and older Australians were better off in 2024 under the government’s $3.5 billion investment to boost bulk-billing rates. But adults aged 16 to 64 are paying more out of pocket, analysis of Medicare data shows, and a growing number of Australians have delayed seeing their doctor due to cost.
As Labor heads to the election pledging even bigger investments in bulk-billing and urgent care, the Coalition will point to the fact that visits to the doctor are more expensive and fewer GPs bulk-bill than when Labor came into government in 2022 as it seeks to rebuff a renewed “Medi-scare” campaign.
Health Minister Mark Butler said on Thursday that he had always been clear that “fixing the mess we inherited in Medicare” would take more than one term of parliament. “What we’ve already done has made a meaningful difference,” he said.
“[But] there are cohorts who are still really doing it tough. We know there’s more to do on bulk-billing, and we’re committed to doing more.”
The Albanese government’s headline 2023 budget policy tripled the bonus paid to doctors when they bulk-billed children, pensioners and concession cardholders. Bulk-billing means patients have appointments fully covered by Medicare rebates and don’t have to pay extra fees.
About a year later, the government has delivered 5 million extra free GP visits to children, pensioners and concession cardholders, turning around a sharp decline in bulk-billing after rates peaked with telehealth and vaccine appointments during the pandemic.
But an Australian Institute of Health and Welfare breakdown of that data shows adults aged 16 to 64 – who make up 54 per cent of all doctor’s appointments – have not reaped the benefits.
General adult patients were getting about 80 per cent of their GP services bulk-billed in 2022. This dropped to an average 70 per cent in 2023 and 69 per cent in the months to October 2024 – an 11 per cent drop since the Albanese government was elected.
Medicare data also shows their average out-of-pocket payment for a doctor’s appointment has risen from $43 to $47, making adult patients financially worse off.
Children and concession cardholders – the targets of Labor’s bulk-billing boost – fared better. The bulk-billing rate for children’s GP services rose from 88 per cent in 2023 to 90 per cent in 2024. The rate for older Australians rose from 86 to 87 per cent.
But even in those groups, bulk-billing is rarer than it was when Labor came into government. Despite the recent rise, rates have fallen about 2 per cent for children since 2022, and dropped 3 per cent for over 65-year-olds.
At the same time, the number of Australians who say they have delayed doctor’s visits due to cost has risen from 3.5 per cent in 2022 to 7 per cent in 2023 and 8.8 per cent in 2024.
Butler said his focus had been on Australians “with most significant financial need” and they had benefited.
Health Minister Mark Butler says the government’s changes to Medicare have helped the people who need it the most. Credit: Alex Ellinghausen
“[But] we’re keeping a very keen eye on what’s happening with patients who aren’t covered by the bulk-billing incentive, what’s happening in areas of general practice where the incentive is not being taken up,” he said.
“Although there is a very marginal decline in bulk-billing [for adults], according to the AIHW data last year, frankly, those rates were in freefall before we tripled the bulk-billing incentive.”
Royal Australian College of General Practitioners president Dr Michael Wright said the initiative had been a game-changer for select groups, but across-the-board funding boosts were needed to improve the situation for everybody.
“It has been helpful for the people who are targets: under 16, seniors, other concession cardholders ... but it didn’t help a lot of the population,” he said.
He defended doctors who had raised fees and emphasised that most GPs still bulk-billed most patients.
“There’s been a lot of additional costs and the care is more complex – people are needing more time with their GP to work through multiple and complex issues,” Wright said.
“There’s been a recognition by many practices, but also patients, that high-quality care is not sustainable with Medicare rebates at their current level. General practice has shown great restraint in managing the fees.”
Coalition health spokeswoman Anne Ruston said Medicare was weaker under the Albanese government, despite Labor’s rhetoric. “Australians can feel the truth of Labor’s Medicare record every time they go to pay the bill at their GP reception desk,” she said.
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