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Oh, now it makes sense.
Good morning and welcome to the Daily OS. It's Tuesday, the twenty fifth of February. I'm Harry, I'm Zara. We all need to see a doctor at some point in our lives, but it's not getting any easier or cheaper. Data consistently shows bog feeling rates are down, meaning more Australians are paying more to see a GP and per the Statistics Bureau, twenty five to thirty four year olds are the most likely cohort to delay a doctor's visit
due to cost. That's why both major parties have announced plans to make as many doctor visits free as possible. The bipartisan push has wide support, but in today's deep dive, we'll look at why some experts warn that the trip to the doctor could still carry a price tag for some time.
Harry, I don't think it's going to be news to anyone that it's extremely hard to find bulk billing. You know, we get lots and lots of messages every single day from people who are increasingly frustrated when it comes to paying for medical services. And now you know the inability to find a GP who will bulk bill them. What can you tell me about bulk billing in Australia.
Well, I think it's really interesting that you say it like that, because I've even had people say to me recently, are we turning into America when it comes to healthcare? Their system is largely for profit. But Australia for forty years has had this system called Medicare, which was designed to make healthcare universal and free for everyone. So I think it's helpful to start at why we're talking about free doctors visits, since that's basically what Medicare was meant
to be initially. It has changed over time. So when you go to a GP, think a medical clinic or a local practice, we have a system in place where doctors can bulk bill, and that's where Medicare will give the practice money directly to see a patient. A doctor can opt to charge a patient directly, which involves what's
known as an out of pocket cost. So let's just say you go to see a doctor, it costs you sixty dollars, Medicare will give you about forty two dollars eighty five back, and that leaves you with a seventeen dollars fifteen cent out.
Of pocket cost, very specific, love it.
Very quick math? Well, I mean I think a lot of people walk away from these doctor's visits actually having to do that maths really quickly in their head, thinking like, shit, how much did I just pay for a fifteen minute referral? I just needed to get a slip of paper, or I needed to get a prescription or something of that sort. And that's because back in two thousand and three we saw the introduction of what's known as the bulk billing incentive.
Rather than keeping bulk billing as universal as it was, it was designed to target specific groups who needed to go to a doctor, perhaps more than others. So if we think of pensioners, kids under sixteen, or someone who holds a concession card for various reasons. That incentive was increased tripled actually in November twenty twenty three, and that was because we were starting to see a decline of bulk billing rates right across Australia.
Okay, so there's this bulk billing incentive. It's meant to be incentivizing GP practices to bulk bill more people more often. Is that what is actually happening.
Look generally speaking, no, the official figures that we have showed fewer than half of Australians saw a fully bulk billed GP in twenty twenty three to twenty twenty four, and that was down from slightly above fifty percent the year before that. Okay, on average as well, Australians are paying about forty five dollars out of pocket to go
and see a GP. And underpinning all this, we actually know through data from the Australian Bureau of Statistics that the most likely group to avoid seeing a doctor because of the cost is twenty five to thirty four year olds.
Squarely, our democratic I would.
Say, so we've fit right neatly in there, don't we. And the Government, for its part, would argue that since bringing this triple bulk billing incentive back in November twenty twenty three, the rates of bulk billing for those targeted groups so that's under sixteens and concession card holders has actually increased, but the same isn't true for you and
I young adults. So what we saw this weekend was the government announced that it would extend that extra payment, that same payment that it's giving to under sixteens and concession card holders to everyone who visits a GP starting this November today, so our government will expand the bulk billing incentive to cover all Australis. So if a doctor bulk bills every patient, they'll be eligible for these higher payments.
And that'll also depend on locations, so you actually get more as a doctor out in the regions compared to in the cities.
So again that incentivizing.
Yeah, yeah, that's right. And I tend to understand these things through the prism of politics. As we know, Labor loves to run a campaign on health, and so they came out with this really big announcement eight point five billion dollars worth of investment into Medicare.
If they are elected at the next election. So just to be really clear, this is not something that is happening now today tomorrow. It's only happening if they're elected, right.
That's right. But a bit of a spanner in the works. The Coalition came out and matched the Labor government dollar for dollar.
So I'm pleased to announce today the Coalition government is committed to nine billion dollars worth of investment into our general practice network.
And it should be said that it's fairly rare, especially for.
An investment of this size, to see this as almost bipartisan policy, for both sides of politics to agree that this is worthy of investment and the same investment.
I think if Labor was wanting to have a bit of a tussle over the cher figures of investment, they were solely disappointed by the Coalition coming out and supporting this measure. But we can be guaranteed that should either Labor or the Coalition at this stage get over the line at this election, which is due by the seventeenth of May, then we can see this bulk building incentive roll out by November.
Harry, I'm really interested because clearly the fact that both sides of politics are supporting this move, there is widespread support for it. I am, though, curious about some of the criticisms of it, because we heard from Peak health bodies, from GPS themselves. What are some of the criticisms that we're hearing about this policy? Are there any?
Oh?
Absolutely, And let's just remember this is an incentive for GPS to bulk build their patients. It's not an enforcement mechanism. No one's going to be going in and telling them off if they refuse to bow bill. But the central question is whether this incentive is enough to cover the cost of running a clinic.
Because those costs have also gotten up.
Oh, absolutely a cost of living crisis. It's absolutely not exempt, and so gps are going to be faced with this question of will I get this bulk billing incentive or would it be more viable for me to continue to charge out pocket for these patients. The government's pretty confident about the incentive, working to get up to nine out
of ten doctors visits bulk built by twenty thirty. I did put this question to the peak body, the Royal Australian College of GP President, doctor Michael Wright, and here's a little of what he told me earlier.
Just because that incentive has been available to everyone doesn't mean everyone's going to get po built because Medicare rebates still don't cover the cost of care and so not all practices will be able to participate in this initiative.
Okay, So what he's saying and what you're saying here is some of the criticism is that the amount that is given to a GP clinic, for example, or a medical center to cover the bulk billing. Is this in the amount that said GP clinic could get through out of pocket costs and charging the patient.
That's right, and it doesn't cost the same right across Australia to run a clinic either. It definitely depends on all the overhead costs that come with that. So I think there's a very fair question of whether it's viable for the future of a GP workforce. And another thing that doctor Wright also mentioned to me earlier is that if you have this incentive rollout and more clinics decided to bulg bill, then that means more people are going to go see a doctor as well.
Yeah, just naturally clan and demand.
And the government's response to this is that it's offering more trainee ships, so four hundred nursing apprenticeships and two thousand junior doctor trainees by twenty eight But whether that's going to be enough to feel what we know is a really stretch workforce.
Get really strained. We've spoken so many times on this podcast about the strain that the GP workforce and can't be overestimated the number of industries that are facing similar strains. But just because we're talking about GPS today, there has been so much information about GP burnout, and it's interesting in the context of this sort of discussion about whether it is, as you said, commercially viable for this model to work, and how you balance that with the need for patient care.
That's right, and it's really interesting that both Labor and the Coalition are on a unity ticket for this measure, and that it is very likely that we're going to see these incentives roll out starting in November. It will be a matter of how many gps decide to take up that incentive, and will certainly be keeping a close eye on it. I'm sure many of my friends and many of your friends and family who are always looking
for a bulk billing GP will notice any difference. Will you be able to fine one in your local area more ease? Yeah, that's the great question. Will it work well?
Have to stay tuned for that one.
Thank you so much for joining us for this episode of the Daily Oas. If you learned something from today's episode, why not send it to a friend share the love. That's how our little media company grows. We'll be back again this afternoon with some more headlines, but until then, have a great day.
My name is Lily Madden and I'm a proud Arunda bunge Lung Kalkotin woman from Gadighl country. The Daily os acknowledges that this podcast is recorded on the lands of the Gadighl people and pays respect to all Aboriginal and Torres Straight Island and nations. We pay our respects to the first peoples of these countries, both past and present.