TRANSCRIPT
Woman 1: "Now it costs money to see the GP, so I might not see them as often as before, because now it's not bulk billing anymore so. Woman 2: Compared to it being free before it is quite a lot $40 out of pocket you know, sometimes it's only just to see you know, to do a minor check-up, but, you know, it doesn't, with added expenses. It can be a lot."
For many Australians, finding a bulk billing GP is becoming a hassle.
Bulk billing sees doctors bill Medicare instead of the patient, so there is no out-of-pocket cost for a visit to the doctor.
But it involves GPs having to accept a rebate they've long argued is too low to make bulk billing viable.
A new report by online healthcare directory Cleanbill reveals that fewer than one in four GP clinics now bulk bill every patient.
James Gillespie, founder of Cleanbill says the decline has greatly affected GP accessibility.
“The biggest finding that we've seen is in the historical comparison itself. So, we've seen an over 11 percentage point drop in bulk billing rates amongst GP clinics between the start and the end of 2023. That's driven by 514 clinics across the country. Switching from bulk billing every single patient who walks in the door to private billing their adult patients who come in. And that's a massive change that is completely unsustainable if it continues over the long term.”
The report which contacted over 6,800 clinics across Australia found that the national bulk billing rate for doctors accepting new patients now sits at 24.2 per cent.
The average out-of-pocket gap people have to pay for a visit to the doctor is almost $42 and the average out-of-pocket costs for a GP visit are highest in New South Wales, ACT and Tasmania.
New South Wales has the best bulk billing rate of over 37.2 percent; Victoria sits at 24.8 percent; Northern Territory at 19.5 percent; Queensland at 17.6 percent; South Australia at 11.3 percent; Western Australia at 10.3 percent; and the Australian Capital Territory at 3.4 percent.
And Tasmania is the worst hit state – with less than 1% of clinics bulk billing adult patients.
Mr Gillespie says the costs of running a practice in rural areas mean that the fees tend to be higher, and bulk billing rates lower.
Opposition health spokesperson Anne Ruston says reduced access to bulk billed appointments has already put additional pressure on emergency departments at hospitals.
Ms Ruston says urgent action is required to reverse the alarming trends.
"Obviously the biggest issue right now facing Australian primary care is a lack of a national integrated care workforce strategy. So far, we've seen a number of initiatives from the government, all of which rely on an improvement in the workforce. And at no time have we seen any urgency from the government about addressing workforce challenges and at a time when we know that 1.2 million Australians have chosen not to go to their GP because of the cost. This is a very concerning trend, because of course we want people to see their general practitioner because that's how they maintain good health, and we don't want to see them turning up at our overburdened hospitals at the moment. "
The federal government tripled the incentive paid to doctors who bulk bill children under 16 years of age and Commonwealth concession card holders as of November, in a bid to improve access to GPs for these groups.
Health Minister Mark Butler says the $3.5 billion incentive package would apply to three in every five GP consultations.
Even though the Cleanbill report covers a time that coincides with the Albanese government's time in office, Mr Butler says the previous administration is to blame for reduced access to bulk billing doctors.
He says "a decade of cuts and neglect" meant it had never been harder to see a bulk billing GP.
And Dr Nicole Higgins, President of the Royal Australian College of GPs says it has not been easy on GPs to survive on the current Medicare rebates.
She says the report's findings show that more needs to be done to ensure that everyone has access to affordable treatment.
"The problem is the rebate simply doesn't cover the cost of care, like the cost of electricity and wages and insurance, etc, has been increasing in general practice as well, plus the threat of payroll tax, and that's being passed on to patients. And the gap has been widening. So, people have now got out of pocket costs. But general practice only accounts for six-and-a half percent of federal government health funding. We need to flip the system around. We need to make sure that we invest in general practice not expensive hospitals, which means that if we keep people well and healthy, is a much more efficient way of doing things and it's much better for our community."
