For Tasmanian mother Bec Haight, it will be cheaper for her and her family to fly to Melbourne than to be seen by a doctor in her home city.
The Hobart mother of two has struggled to find an affordable doctor after her previous doctor, who bulk-billed, retired earlier this year.
"I'm a single parent on a disability pension and I've got a sick kid. It's hard," she said.
"I don't have $330 for my family to go see the doctor, I don't have that kind of money laying around."
After attempting to find another doctor who bulk-billed in Hobart, she said it was now cheaper for her to fly her family to the mainland to see a bulk-billing doctor, where she would also be eligible for telehealth in the future.
The cheapest flights to Melbourne return for herself and her children — aged one and five — would come to less than $330.
"Honestly, going to Melbourne seems like the sensible choice. It's ludicrous but I don't see any other option," she said.
Both Ms Haight and her one-year-old son have complex medical conditions, meaning they require regular appointments.
"You should be able to receive basic medical care, and if not, then there are some pretty big failures in the system," she said.
An increasing number of GP clinics across the country have moved away from a bulk-billing payment system in favour of privately charging patients.
Tim Jackson from the Royal Australian College of General Practitioners said the bulk-billing model was no longer sustainable for many practices.
"The federal government have never really increased the Medicare rebate by how much it costs to actually provide the service.
"It just becomes unsustainable for GPs to continue to bulk-bill everyone," he said.
"If GPs do accept the bulk-billing rate for everyone, then it is a difficult business model to go forward."
Tasmanian GP John Saul from the Australian Medical Association said calls to increase the rebate had been ignored.
"Our patients are the ones who are suffering. They're the ones who now can no longer afford to pay the extra to see a doctor.
"We just can't keep the doors open if we bulk-bill.
"Virtually no one in Australia is going to be able to bulk-bill, the way we are headed."
'Crunch time' for Medicare rebate
Tasmania has one of Australia's worst bulk-billing rates, meaning many patients face out-of-pocket costs when going to the doctor.
Dr Jackson said many GPs were taking a mixed-billing approach, where some patients are bulk-billed, such as concession card holders and children, whereas others are charged a fee.
In lower socio-economic areas and towns outside major cities, he said there was greater pressure for bulk-billing, and that is forcing some practices to consider whether it is viable to operate.
"We [Tasmanians] tend to be older, and lower socio-economic, we have more chronic diseases and we have poor health literacy, so for all of those reasons, we really need people to get access to good general practice primary health care."
Dr Jackson said it was "crunch time" for the Medicare rebate to be increased significantly, something that independent health policy analyst Martyn Goddard said could be some time off.
"It is going to take many years and a lot of political will and a lot of money to get back to where we were 20 or 30 years ago," he said.
"We've got an older, sicker and poorer population in Tasmania, we need more health care, but we've got access to less."
