Older Canberrans with multiple and complex medical conditions will be the losers if the Medicare rebate cap is not removed the head of the ACT's peak doctors' body has said.
Subscribe now for unlimited access.
$0/
(min cost $0)
or signup to continue reading
Professor Steven Robson, the president of the ACT Australian Medical Association, said the four-year-old income freeze was already hurting "family doctor" style practices battling rising wages and overheads.
"It [the retention of the cap] would definitely impact on the health of Canberrans; there is no doubt about it," he said.
Adrian Watts, the managing director of Canberra's National Health Co-op which operates seven bulk-billing clinics which have added 25 general practitioners to Canberra's medical mix since 2010, agreed the cap needed to go.
Its retention, which effectively limits what doctors are paid, could result in GPs leaving bulk billing practices for ones that required a co-payment to get a pay increase.
"I would hate to have a scenario where, when we already have a 100 doctor shortfall in the ACT, doctors were attracted to leave the bulk-billing scenario," he said.
Mr Watts said the NHC, which is owned by the 32,000 Canberrans who have paid $30 to join and then pay an annual $100 membership fee, didn't pay dividends to external shareholders or practice partners.
Any additional revenue from the abolition of the cap would be used to expand its range of medical services and take the practice model nationwide.
Professor Robson said only one of the two practice models currently in play in Canberra was viable under the existing rebate schedule.
That was the corporate bulk-billing model. The other was the traditional family doctor model where the GP had a conversation with the patient about their health generally, not just the issue that brought them into the surgery he said.
"[A failure to lift the cap] is going to mean a further erosion of the traditional family type doctor model," he said. "That is a model that is very suitable for people with complex needs [such as] cardiovascular, hypertension, insulin issues and diabetes [in the one patient].
"For those patients to be managed on a quick 'in-the-door, out-the-door' bulk-bill model is just not appropriate."
Professor Robson said the ACT's low rate of bulk billing was the result of a long-term shortage of medical practitioners. The addition of new GPs, as part of the growth of corporate, bulk-billing practices across the territory, had not made a great deal of difference.
"The population of the territory has grown as well," he said.
Mr Watts said this was wrong; that the National Health Co-op had been established to address Canberra's unacceptably low rate of bulk billing [37 per cent compared to a national average in the low 80 per cent range in 2003] and had succeeded.
"We have proved you can deliver good, family general practice in the ACT using bulk billing," he said.
In 2014/2015, Canberra's bulk-billing rate was 57 per cent compared to a national rate of 83 per cent. In 2013/2014 South Canberra, at 45.1 per cent, had the lowest level of bulk billing in Australia. Belconnen, at 65.6 per cent, had the highest level of bulk billing in the ACT.
"The NHC has had a direct influence on the bulk-billing rates in the ACT, hand on my heart," Mr Watts said. "We've added 25 full-time equivalent GPs into the ACT over this time. That 65.6 per cent bulk-billing rate in Belconnen is the direct result of the NHC's five clinics [there].
"We are now the largest bulk-billing provider of healthcare in the ACT. We don't make people come and wait in a line. There's no turnstyle here. We do exactly what the AMA are saying we don't do and that is [provide] good, family-based, medicine. We have appointments. People can book for 15 minutes, 30 minutes or longer as appropriate."
