Gap fees are the highest they have been since Medicare was created
New data shows a drop in the bulk billing rate for GPs in a reversal of a 15-year stable trend, as doctors fear ordinary healthcare is increasingly out of reach of battlers.
Patients are paying the highest gap fees for medical services since Medicare’s inception amid intensifying cost-of-living and mortgage pressures, with new data showing a drop in the bulk billing rate for GPs in a reversal of a 15-year stable trend.
Figures released by the Australian Institute of Health and Welfare show that the proportion of the cost covered by the Medicare Benefits Schedule has been steadily declining in recent months, reversing a 15-year trend of stability.
Doctors now fear that ordinary healthcare is increasingly out of reach of battlers, who are treating doctors’ visits as a discretionary expense.
The proportion of the cost of GP visits funded through the MBS has been in steady decline since February 2022, when it sat at 89.95 per cent. Each month following this time, there has been a drop in the proportion of the cost covered by Medicare.
In the latest figures for October 2023, the cost covered is now at 84.58 per cent, with the next update to occur in January 2024.
According to federal Health Minister Mark Butler, however, the true bulk billing figure is only around 64 per cent – the proportion of patients that have every doctor’s visit bulk-billed – with Covid measures falsely inflating the figures.
For specialist appointments, the MBS rebate returning to patients has also been in decline. In January 1998, the proportion dropped below 80 per cent to 79.73 per cent for the first time since the MBS was created in 1984, and never recovered to 80 per cent or above. The proportion of the cost covered by Medicare for specialists dropped in January 2011 below 70 per cent and never recovered, steadily declining to the most recent data in October 2023 to 57.96 per cent.
The data puts Australia as one of the highest countries in the world for specialist gap fees, with regional people particularly disadvantaged.
The figures come weeks after Mr Butler announced the tripling of the bulk billing incentive, which came into effect as from 1st November, and under which doctors will receive greater incentives to bulk bill pensioners and children.
The current data is for October, so the latest AIHW figures do not reflect that policy.
The federal government will be hoping to see an uplift in bulk billing when the next data is released for November and December in January 2024.
The Royal Australian College of General Practitioners said GPs were effectively subsidising patient care out of their own pockets in clinics all over the country and the situation was still not sustainable.
“Successive governments have devalued the patients Medicare rebate. The patients rebate has not kept up with the cost of providing care,” said RACGP president Nicole Higgins.
“GPs have been subsidising care for the last 10 years and can no longer afford to because they also face cost-of-living pressures to keep their doors open.
“The government spends only 6.5 per cent of the total healthcare budget on general practice.
“Politicians don’t cut ribbons for prevention and general practice. Keeping people out of hospitals doesn’t win votes, but neither does ramping and overflowing emergency departments.
“GPs keep people living longer and healthier and out of hospitals.
“We need the government to flip its funding by putting more into general practice and primary care.”
Executive director of the Primary Care Business Council Jeremy Stone said prior to the tripling of the bulk billing incentive, their data also demonstrated a steady decline in the proportion of the cost of covered by Medicare for services provided, such as GP and specialist visits.
“We certainly welcome the tripling of the bulk billing incentive – it will make a huge difference to lives of healthcare card holders,” Mr Stone said.
“We won’t have the numbers for November 1 onwards until probably late December to tell us how the tripling of the incentive has impacted the decline in bulk billing rates,” he said.
“We think it will at the very least stabilise it, but we are waiting for that data.”
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