Pensioners Pamela and Barry Thomas have gone to the same doctor in Bendigo for the past 10 years.
No matter their ailment or concern, every session has ended with their GP bulk-billing the visit.
However, that's about to change.
The clinic is moving to a privatised model and, as a result, the couple fear they will no longer be able to afford to get the care they need.
"It's going to be impossible for people like us," Mr Thomas said.
"We just won't go.
"It's a bit of a nightmare."
Can we afford the care?
Due to several health conditions and scares, Mr and Mrs Thomas tend to see their GP every four to six weeks.
Mrs Thomas has had a kidney removed, while her husband has a defibrillator and diabetes.
Both have spent months in hospital for different health conditions over the past year.
Mr Thomas said, as pensioners, they did not have a lot of money to spare.
"We really need medical care and how we are going to do it now, I don't know," Mr Thomas said.
The couple has looked at tightening their budget to pay for GP care, but with other rising costs, there's little they think can be cut.
'Traumatic' experience
In the Western Australian town of Kendenup, 350 kilometres south-east of Perth, Donna Murphy has been trying to find a bulk-billing doctor for four years.
She has autism, a crushed vertebrae in her neck, sensory and nerve issues, as well as anxiety and depression.
Ms Murphy said she needed to see a GP every month, but as she couldn't afford it, she went once every three months.
"If I want to eat and have my supplements that I need to take ... I just can't afford it, not on JobSeeker," she said.
Ms Murphy said her last doctor's appointment in a nearby town was "traumatic".
"I need an experienced doctor," she said.
"I feel the doctors have very limited, if any, understanding of my disability."
She said access to primary health care was just as much an issue as affordability with the nearest regional centre, Albany, an hour's drive away.
"I've waited over 500 days for a public neurology appointment," she said.
"I'm lucky to get a telehealth consult once every three months."
She said she could not afford to pay if it wasn't bulk-billed.
"I just feel like I'm not worthy. I'm not good enough. And no matter what I do, I can't get better," she said.
GP model at 'crisis point'
Central Victorian general practitioner Edward Griffin said a lack of bulk-billing doctors was pushing more people to public hospital emergency wards.
"All the costs have gone up … but the Medicare rebate hasn't," Dr Griffin said.
"If you were bulk-billing 90 per cent of your patients, it becomes difficult to function as a business."
Dr Griffin said families would have to make a decision about whether they fed their family or went to a private GP.
"They will end up in the emergency department, [and] that will put more pressure on the hospital system, which is already under pressure," he said.
Royal Australian College of General Practitioners president Nicole Higgins said GPs had moved away from bulk-billing because they could not afford it.
"The cost of running a GP practice has increased 7.3 per cent this year but the Medicare rebate has been frozen for years," Dr Higgins said.
"GPs need to charge a fee that allows them to keep the doors open."
She said the current system, where general practice received just 20 per cent of primary care health funding from the federal government, was at crisis point.
"The Medicare system is 40 years old, and it doesn't support modern general practice," she said.
What can the Commonwealth do?
The federal government has committed $1 billion to primary health care.
Of that, $750 million is to establish a "Strengthening Medicare" fund, which aims to improve patient access to GPs, including after hours care and better management of complex and chronic conditions.
A "Strengthening Medicare Taskforce" has been set up to decide how the money is used, with a report due in February next year.
Bendigo MP Lisa Chesters said the system was already in crisis.
"This funding can't come quick enough to help relieve the pressure and help our GPs," Ms Chesters said.
The government said it was working on how to improve patient access to care and reduce pressure on hospitals.
