“Doctor, doctor, give me the news.” So sang Robert Palmer all those years ago (in 1979 to be exact.) Those of us old enough will remember the next line: “I got a bad case of loving you.”
Had the late Palmer been alive today and living in Australia, he might have been inclined to alter that line. Faced with continuing increases to GP fees he might have sung: “I’ve got a bill I can’t afford from you.”
Such is the plight of many Australians today, as GP fees increase, and more doctors abandon bulk-billing. As the challenge of finding a GP who bulk-bills becomes harder, more Australians are learning how steeply fees have risen.
Why are GPs moving away from bulk-billing?
There’s not much science required to answer this question. The simple fact is that government rebates given to doctors who bulk-bill have not increased in line with inflation. But the business costs of those doctors have, making bulk-billing a less attractive – and in some cases, unaffordable – option.
Why has the rebate not kept pace with inflation? Doctors and the Australian Medical Association (AMA) would like an answer from the federal government to that themselves. And in news that will surprise nobody, the incumbent government is laying the blame at the feet of its predecessors.
“Peter Dutton froze the Medicare rebate when he was the health minister almost 10 years ago,” said Mark Butler. Mr Butler, now himself health minister, highlighted the effects of “a freeze that remained in place for six long years”. It led, he said, “to a very substantial decline in bulk-billing in general practice”.
Of course, governments of both persuasions have a history of blaming their oppositely aligned predecessors. In this case, though, Mr Butler’s assertion is hard to refute.
Doctor, doctor give me the good news on GP fees
There is, in fact, good news at hand. From 1 November, the government bulk-billing incentive will triple – for some Australians. A suite of changes to the Medicare Benefits Schedule includes an increase in the number of eligible bulk-billing items. All of these will be eligible for payments triple the amount of existing standard bulk-billing incentive payments.
This will result in doctors in city areas being paid $62.05 when bulk-billing. Their rural counterparts will receive $81.10 for the same services. However, this significant increase will apply only to children under 16 and patients with a Commonwealth concession card.
For patients falling outside those two categories, the changes aren’t so generous. The Medicare rebate will rise, and for the second time in five months. But the rise will be the princely sum of 20 cents to $41.40. That’s hardly likely to bring relief in GP fees.
Still, the larger increases will have a positive effect, says AMA spokesperson Dr Danielle McMullen. Dr McMullen said her practice in Townsville, Queensland, had stopped bulk-billing patients as rising costs outstripped the Medicare rebate.
But as a result of this increase, she plans to reintroduce the practice from November. “The plan is to go back to bulk-billing those vulnerable patients, which hopefully makes a real difference to the community,” she said.
What about non-bulk-billers?
For doctors who do not bulk-bill, GP fees have certainly increased. The AMA’s recommended fee has risen twice this year already. It rose from $89 to $90, and in July jumped to $98. From 1 November it is recommending clinics charge $102 for a standard consultation.Those increases aren’t unreasonable. The increase in the recommended AMA fees since November last year comes in at 5.58 per cent, which is below the official inflation rate of 6 per cent.
And with the government’s new incentives for concession card holders and children, there’s a reasonable chance of reversing the drop in the bulk-billing rate which, in the year to July, dropped from 88.3 per cent to 80.2 per cent.
Has your GP moved away from bulk-billing? Has this affected the frequency of your GP visits? Let us know via the comments section below.