As calls grow louder for an overhaul to GP Medicare bulk billing, the question is, will anything really change?
Australia prides itself on offering a range of affordable health services, funded through Medicare, which is partially funded from the Medicare surcharge or levy most Australian taxpayers contribute annually to and other government revenue.
Governments of both stripes put forward their commitment to health and Medicare each budget or election, with both Labor and the Coalition making pre-election promises about what their government would do if elected.
Labor went into the 2022 election, promising almost one billion dollars in new Medicare and primary health funding. Three-quarters of this was pledged to the “Strengthening Medicare“ fund with the specific aim of improving patient access to GPs, including after hours, decreasing pressure on hospitals and better management of complex and chronic conditions.
Then opposition leader and now Prime Minister Anthony Albanese also indicated that Labor, if elected, would create a task force chaired by the future health minister working with peak bodies such as the Australian Medical Association (AMA), Royal Australian College of GPs (RACGP) and the National Aboriginal Controlled Community Health Organisation.
This is primarily because more GPs were finding themselves with no option but to charge patients because the gap between their fee and the Medicare bulk billing rebate had more than tripled over the past decade.
In an interview with the Today Show on August 15, AMA Vice President Dr Danielle McMullen responded to concerns about the drop in bulk billing practices due to GP claims about not being able to afford to operate under the current Medicare bulk billing model and the impact this might have on patient care.
McMullen pointed to the fact that while the rebate had once covered costs for providing care, it was now covering less than half of the cost of running a consultation, pushing more GPs to move away from bulk billing and charging patients.
The knock-on effect of this is potentially twofold. Firstly, patients are holding off seeking care due to the increased cost of doing so (further exacerbated by COVID), sometimes leading to medical concerns being missed or picked up later than they should be, meaning even more care is required than might otherwise have been necessary.
And secondly, hospitals are experiencing an increase in patients presenting at Emergency wards to receive care to avoid the costs of attending a GP clinic.
There is also the potentially more serious and long-term issue that this is creating: the disruption of ongoing management of health issues by a regular GP that in the past has led to better overall patient care. McMullen, however, does feel some confidence about Labor’s pre-election commitments, followed up by post-election actions.
“We have heard encouraging signs from the new Health Minister,” she said, “…And we do have…a strengthening Medicare taskforce that’ll be working together by the end of the year to have some solutions. Now it won’t fix general practice and the challenges facing us overnight, but we are hopeful that there will be steps taken to make sure that we modernise Medicare and make it easier to see your GP and get the time with them that you need to manage your health.”
The Medicare bulk billing issue might also be correlated to some extent with the number of medical school graduates choosing to become a GP at the end of the degree: Presently, only about 15 per cent take this career path.
McMullen admitted that the AMA needed to do more to make the decision to become a GP a rewarding career choice, both professionally and financially. An overhaul of Medicare to ensure the financial viability of being a GP rather than becoming a highly paid specialist or surgeon would hopefully go some way in improving the flow from medical school into general practice.
As the task force begins to tackle the issues it has been handed to look at and find solutions for, it’s a situation of “wait and see”, but at least there appears to be some degree of goodwill between the government and the health sector and hunger for real change.
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