Ending Bulk Billing ?

What you pay when you visit a general practitioner doctor depends on where you live.  It seems that the GP's who practice in affluent suburbs either have very restricted bulk billing rules or do not offer that discount at all.  In suburbs known for low income residents bulk billing seems to be the standard charged across the entire patient spectrum.

Health is a big ticket item in the Federal budget and what is in contention is the Medicare fee the government pays doctors for each patient visit.  This is calculated in response to the level of wage increases in Australia and in recent times pay has been stagnant.  That rebate moved from $37.05 to just $37.60 in July.  Doctors want this rebate standard coupled with the consumer price index instead of wages and had that been in force a GP consultation would have attracted a rebate of $ 41.84 in the 2017-18 year.

Doctors complain that the health visit rebate is falling behind the cost of running their surgeries to an increasing degree.  There is the threat that many may cease offering bulk billing and if that happens the number of people with illnesses that are untreated may rise sharply.  The whole concept of Medicare was to bring medical services within reach of all patients.

Bulk billing as a concept was supposed to filter the needs of patients.  The average person who visits a GP once a year for an annual checkup, or twice a year to have scripts renewed would expect to pay a small out of pocket expense, but the aged or chronically ill who need constant attention and make frequent visits would be better handled on a bulk billing basis.   Some doctors bulk billed all child visits on the basis that it encouraged poorer parents to have their children's health attended on a regular basis.

Doctors are wanting a fee rise of about four dollars for each bulk billed visit.   The standard out of pocket expense for a patient seeing a GP who does not bulk bill is expected to reach  $ 40.69 in this next financial year and a continuation of bulk billing will be essential if we are not going to see a sharp increase in people claiming they can't afford to see a doctor.   If that is allowed to happen, presentation at hospital emergency departments will inevitably increase.

There is also the risk that we will see clinics offering all services bulk billed that will offer what are termed " thirty second consultations ".   An astonishing throughput of patients per hour for the briefest face to face time with a qualified doctor, making the medical experience consistent with the cost factor flowing back to the provider.

It is essential that the provision of medical services be rewarding for practitioners and available to patients.  Unless this health rebate question is solved we will see GP's congregate in wealthy suburbs and absent from the poorer parts of the city and country towns.  That would be detrimental to the excellent health system that exists in this nation.