AI inevitable solution to tax-funded GP visits

Prime Minister Anthony Albanese holds up a Medicare card during a press conference. Picture: Andrew Henshaw

The 2000s are calling and they want their hackneyed political bribes back. How depressing to see supercharged Medicare spending become the first big promise of the shadow election campaign.

In a period of stagnant or falling living standards, rising public debt and an ever-tightening income tax noose around Australian workers, the government has announced it will borrow $8.5bn (largely from foreigners) to subsidise spending on visits to the GP over the next few years.

I didn’t see any street protests for such extra spending, but it looks like we’ll be getting it anyway. Terrified of opposing free stuff, the Coalition has matched it and added $500m for good measure. Such promises might have been forgivable, if unwise, a generation ago, when public finances were in much better shape and real incomes among low- and middle-income earners were lower. But they certainly aren’t now.

Even before this latest cash splash, spending on Medicare was forecast to surge almost 22 per cent to $47.2bn over the next four years alone to June 2028, according to last year’s budget papers.

Federal spending as a share of GDP is the highest in a generation outside the madness of the Covid years, while combined federal and state government debt is approaching 50 per cent of GDP.

It’s not only the reckless total cost, but the contempt the Medicare plan reveals for prudent public spending. This additional expenditure on “GP visits” will almost entirely go into the pockets of doctors given the overall (already high) rate of bulk billing won’t increase all that much, while incentives will pertain to all bulk-billed visits.

You can see this from the government’s similar November 2023 policy, which tripled bulk-billing incentives for most patients over 67 and under 16, at an estimated cost of $3.5bn. Bulk billing increased little and doctors enjoyed a bonanza.

Matthew Lilley, an economics lecturer at Australian National University, has crunched the numbers. “Over 90 per cent of the spending immediately goes into higher incomes for GPs, rather than helping patients,” he tells The Australian.

“On my calculations, the incentive was paid for 20 consultations that were already bulk-billed, in order to induce one extra bulk-billed appointment,” he adds.

Put differently, taxpayers forked out roughly $300 to induce one appointment to switch to being bulk-billed, a figure that dwarfs the existing rebates to GPs of $42 for consultations of at least six minutes, and $83 for those of more than 20 minutes.

Oh, the irony of Labor – ostensibly the political party dedicated to reducing inequality – tipping hundreds of millions of dollars into doctors’ incomes!

Let’s very conservatively assume 80 per cent of the announced $8.5bn ends up as a massive increase in doctors’ net income. That implies an extra $170,000 of income on average for the nation’s 40,000 odd GPs. No wonder the president of the Royal Australian College of General Practitioners described the plan as “well overdue” and “amazing”.

Artificially creating a zero price for any goods or service leads to massive overuse, as it has done in the case of doctors’ visits, where the average annual number per person has crept above six over the past decade.

Rather than mindlessly tipping extra borrowed money into Medicare to push that average up even higher, government should be investigating how artificial intelligence could help drastically reduce the number of GP visits, saving taxpayers a fortune over time and improving population health to boot.

It’s already breathtakingly good. In January, on holiday in London, I found myself unusually ill, and worried I might have had pneumonia. I shuffled off to the only GP clinic within walking distance, Somerford Grove off Stoke Newington Rd, where I was relieved to find no patients in the waiting room.

Alas, despite looking like death warmed up, the assistant said I couldn’t see one of their doctors because I wasn’t registered with the NHS and lived outside the catchment area.

So it ended up being me and ChatGPT after that, which reassured me I probably didn’t have pneumonia – coughing up blood could easily be a result of burst capillaries from days of severe coughing.

Prime Minister Anthony Albanese and partner Jodie Haydon arrive to make a major speech about Medicare. Picture: Scott Gelston/NewsWire

I probably had a bacterial infection, it deduced, and it was right (I eventually paid £100 – $201 – a few days later to see a real GP).

Chat’s ability to analyse symptoms, its knowledge of the latest academic research, was remarkable, more than any single individual doctor could possibly possess.

It won’t be long before health-specific AIs are developed that are far better. We all know that many doctors’ visits are unnecessary, perhaps a large minority of them.

Couldn’t patients be encouraged to use AI-powered triage systems first to weed such visits out? No more going to the doctors for colds, or other ailments that will obviously heal on their own. Doctors would be freed up to deal with patients who require human-to-human interaction.

AI could slash the cost of analysing medical test results, while wearable AI-powered devices could flag when tests might be needed. The future is unsettling and unpredictable, but what’s certain is that last century’s extremely expensive model of taxpayers subsidising physical GP visits is already becoming obsolete.

Doctors’ unions and government bureaucrats will seek to slow the process down, but they won’t ultimately be able to stop it, just as technology wrought beneficial chaos in other industries before it.

As more and more Australians discover the potential of AI in their day-to-day lives, they should realise any plans to shovel more borrowed money at doctors – for a tiny increase in bulk-billing rates, which politicians can brandish about every three years – should be thoroughly condemned.