With a tripling of the bulk-billing incentive for GPs announced in Tuesday night’s budget, some patients have already begun turning up to their doctor asking to be bulk-billed, the Consumers Health Forum (CHF) chief executive, Dr Elizabeth Deveny, has said.
It’s no surprise people have been quick to respond to the news, given it is more difficult than ever to find a bulk-billing doctor, and the cost of living is rising. But Deveny said there are key details to understand before hoping to get a bulk-billed GP appointment.
“These things will take weeks or months to be reality and what we would argue very strongly is for the government to quickly support the CHF and other key peak bodies to educate healthcare consumers on the changes,” she said.
In the meantime, this is what we know so far.
What is the change and when will it take effect?
From 1 November the amount of money that the government pays your GP if they choose to bulk bill you (meaning you don’t pay anything for the appointment) has been tripled to $20.65 instead of $6.85 for a standard consultation. GPs working in very remote areas will receive $39.65. It is important to note this is not the total GPs receive from the government for bulk-billing a patient – it is the incentive GPs get paid on top of their payment from the government for a bulk-billed consult.
The incentives will cover general face-to-face and telehealth GP consultations, including home visits for people who are homebound, and consultations in residential aged-care facilities.
Will it apply to all patients?
The increased incentives are for GP consultations with children under 16, pensioners and other commonwealth concession card holders.
However, Deveny said just because someone isn’t on a low income and a concession-card holder, it doesn’t mean they aren’t struggling to afford health care.
“For some people, paying for medical expenses may not be difficult and having to pay a co-payment when they see a doctor might be fine,” she said.
“But there’s definitely a middle group who are not in scope for this, but whose healthcare costs may still be significant. It might be a family with a double income but with multiple chronic health conditions in the family. Maybe their kids have health conditions that require them to see a number of health practitioners, but this incentive only applies to GP appointments, and not psychology or speech pathology for example.”
However, funding has also been announced for MyMedicare, where patients who choose to register with their preferred GP clinic will have access to longer telehealth consultations, and those providers will also receive government incentives to provide care from a range of health practitioners.
Will GPs who have scrapped or capped bulk-billing now re-introduce it?
As the finance minister, Katy Gallagher, said on Tuesday night, GPs still don’t have to bulk bill.
“The issue is the commonwealth can’t dictate to GPs that they need to bulk bill,” she said. “That’s a decision that general practitioners make for themselves.”
Deveny said the government projects about half of the Australian population qualifies for the bulk-billing incentives. But she said this does not mean half the population will end up benefiting from them.
“A GP could decide they are still not interested in bulk-billing,” she said.
“That’s completely up to the individual practice. So that might be up to the GP themselves, or the owners of that general practice, who are sometimes GPs or sometimes big corporates.”
Deveny said she hopes that GPs pass any financial gains from the funding boost on to their patients more generally, including those who are not concession-card holders or eligible for bulk billing.
“The medical lobby groups such as the AMA [Australian Medical Association] and the RACGP [Royal Australian College of General Practitioners] talk about how it’s impossible to bulk bill anymore and how, when they do it, they’re either taking a loss or cross-subsidising it by introducing out-of-pocket costs for some patients,” she said.
The tripling of the bulk-billing incentive is more than the medical lobby groups asked for.
“So will practices actually drop their out-of-pocket costs, given they are no longer having to dig into its patients’ pockets in order to support bulk billing?” Deveny said.
“Because our expectation is that not only will those people that are in scope benefit from the bulk-billing incentives, we’re actually looking for a benefit for those people who aren’t in scope. Because there are billions of dollars of government funding now going into general practice.”
