There has been a dramatic drop in bulk-billing across the nation with Canberra's rate dropping even further, a new analysis has found.
Fewer than one-quarter of general practitioner clinics in Australia bulk-bill all patients, a survey conducted by healthcare comparison site Cleanbill has shown.
But that number is even lower in Canberra with only 3.8 per cent - or three clinics - which bulk-bill all patients.
Canberrans also face higher out-of-pocket costs than most of the nation with the average doctor's visit costing $49.79. Only Tasmanians pay more.
Cleanbill conducted the same survey earlier in 2023. In that survey 34.7 per cent of clinics in Australia bulk-billed all patients but by the time the most recent survey was completed this had dropped to 23.6 per cent.
Cleanbill founder James Gillespie said he was shocked at the drop in bulk-billing clinics, especially in such a short period.
The most recent survey was conducted after November 1, when changes to Medicare rebates came into place. Under the changes doctors who bulk-bill pensioners, concession card-holders and children receive a tripled incentive.
Mr Gillespie said it was hard to determine whether these changes had yet to flow through to clinics but it was clear clinics were experiencing a challenging economic environment.
"I had thought that there may be circumstances where practices would, as a result of those changes, be able to maintain bulk-billing in other groups or keep low out-of-pocket costs in other groups," he said.
"But I think each practice is looking at their individual economic circumstances and I think what we've observed for a while is that GP clinics have been saying they're very close to the edge and they'll need to switch from bulk-billing to private billing.
"And there may in fact be a situation where the momentum was already there, where GP clinics were already moving towards it and if the policy is looking to steer the ship, it may in fact take some time for that to flow through, if in fact it flows through at all."
Royal Australian College of GPs president Nicole Higgins said the report showed more needed to be done to ensure everyone could access affordable healthcare. She said the 10-year freeze on patient Medicare rebates had contributed to the situation.
"While the government's tripling of the bulk-billing incentives has helped more GPs bulk-bill specific groups, including children, pensioners and healthcare card holders, more needs to be done to ensure care is affordable for the rest of the population," she said.
Dr Higgins also said the implementation of payroll tax to general practitioners was also resulting in higher costs.
Historically, medical practices did not pay payroll tax for doctors as they were considered contractors but this changes after a NSW Supreme Court ruled general practitioners were subject to payroll tax
"On top of all that, in many states practices are having to raise patient out-of-pocket fees to cover the costs of an extra state payroll tax on independent practitioners," Dr Higgins said.
Eligible ACT general practices are exempt from paying the tax for two years if 65 per cent of all services are bulk-billed.
This has outraged doctors and lobby groups who have said this is unattainable in the territory.
The 65 per cent bulk-billing target applies to all patient appointments whereas Cleanbill's analysis is specifically concerned with whether a clinic bulk-bills all patients.
Cleanbill's report said 87 ACT clinics provided a quote for the survey. There are a total of 98 in Canberra.
Cleanbill shows the three Canberra clinics which bulk-bill all patients are: Kambah Medical Centre, HealthFount Medical Centre and Ngunnawal General Practice.
