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Rate of bulk billing hits record high

"GPs are doing their bit to maintain access for their patients": Steve Hambleton.

"GPs are doing their bit to maintain access for their patients": Steve Hambleton. Photo: Alex Ellinghausen

The proportion of GP visits being bulk-billed has hit a record high, with 82.4 per cent of GP services in the first three months of the year provided at no cost to the patient.

Health Minister Tanya Plibersek contrasted the figures with those when Tony Abbott was health minister, when bulk-billing rates dipped as low as 67 per cent.

''These historic high rates of bulk billing are a result of concerted effort on the part of this government,'' she said. ''We've invested hundreds of millions of dollars into incentives to encourage doctors, pathologists, radiologists and other health professionals to bulk bill.''

But Australian General Practice Network co-chairman Nicholas Demediuk said the growth of large corporate-style medical practices, which bulk bill but spend less time with each patient, had contributed to the trend. ''It's not really great medicine,'' he said. ''We call it five-minute medicine and we don't think it's the best way.''

The Department of Human Services last month launched an investigation into possible overservicing or incorrect claiming by health practitioners working in the same practice. The inquiry will initially focus on practices where four or more doctors have provided about 80 services on 20 or more days over 12 months.

Dr Demediuk said other factors included an increase in the number of medical graduates, which was driving competition for patients, while higher rebates for some services, such as care plans, had made it easier for doctors to bulk bill.

He said while the upside of higher bulk billing was better access to care, the downside was there was no price signal to deter people from using services excessively.

Australian Medical Association president Steve Hambleton said more doctors were bulk billing because they cared about their patients, many of whom were ''doing it tough''. ''The GPs are doing their bit to maintain access for their patients,'' he said.

Royal Australian College of General Practitioners president Liz Marles said the figures were not a good measure of the affordability of healthcare, because they showed the number of services bulk billed, rather than the number of people who were accessing bulk billing.

''Affordability of healthcare in Australia is poor,'' Dr Marles said.

She cited a recent report by the Consumer Health Forum that found Australia had the fifth highest out-of-pocket healthcare costs in the world, with the average Australian paying $1075 per year in out-of-pocket expenses.

Dr Marles said a recent report showed in the past 12 months, about 8 per cent of patients who needed to see a GP had delayed or went without the visit because of cost.

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22 comments

  • Typical of the AMA president Steve Hambleton to say that doctors 'were doing it tough' hardly some see as many as 60 patients a day, sort of conveyor belt syndrome. Patients in this situation are sent off for tests that they don't really need, because the doctor cannot in any way concentrate on 60 patients a day....some even 80!

    Commenter
    Pythinia
    Date and time
    May 14, 2013, 7:54AM
    • You go to the doctor these day and they don't even do the basics anymore. When I was a kid they would look in your eyes, ears, listen to your heart, tap your chest, look down your throat, check your lymph glands, etc. Now it's an administrative role where they fill out a prescription or fill out a form for more tests. What happened to the real GP?

      Commenter
      eyeroll
      Location
      Sydney
      Date and time
      May 14, 2013, 8:23AM
    • Pythinia, Hambleton is saying that many doctors will bulk bill because their patients are 'doing it tough'. Maybe it's not the norm but there are many kind and compassionate doctors out there who will put people before payment.

      Commenter
      Charlotte
      Location
      Sydney
      Date and time
      May 14, 2013, 9:16AM
    • I've recently moved clinics. The closest one became like a turnstile, a revolving door of OS Drs. once they did their stint in a rural practice. They leave not because of the town but because of the "clinic chain" they work for (operates over 80), they are treated with contempt. My new clinic is small and privately owned, OS Drs but "real" ones, taking time and thorough. In fact you usually wait as my new Dr well exceeds the appointment time. Both clinics bulk bill.
      it's the NBN that is going to change the face of rural medicine and cost. Having to travel an 8 hr round trip for specialists proves expensive with accommodation, meals etc. The NBN will slash all the wasted time and costs in many instances.
      The AMA have been one of the most powerful and political unions in the country. I view their reasons for the uptake in bulk billing with warranted sceptisim.

      Commenter
      A country gal
      Date and time
      May 14, 2013, 12:38PM
    • Charlotte - I agree there are some doctors who take the Hippocratic Oath seriously but let's be realistic - a good portion of medical students are only doing medicine because they see it as a highly remunerated profession. How to explain the doctors who refuse to work in the bush where they are truly needed? I have seen advertisements by some bulk-billing clinics which gives one the indication they are run more like profit-generating businesses. When will bleeding heart socialists ever accept the fact that anything that does not cost the user directly is more likely to be abused and that includes doctor consultations.

      Commenter
      hbloz
      Date and time
      May 14, 2013, 2:09PM
  • The last 4 bulk billing doctors I went to were truly horrible. I don't know how they're allowed to get away with charging medicare for the "services" they provide. I now only go to bulk billing doctors when I need a medical certificate for work, any time when I'm actually sick I'll visit a real doctor who'll actually look at what's wrong with me, without diagnosing everything as a "cold".

    Commenter
    Cameron
    Date and time
    May 14, 2013, 8:21AM
    • 2 Doctors at seperate clinics actually told me I wouldbe better off paying their $60 fee rather than ask for bulk billing, as I would get better service. They both told me that 'I cost the clinic and make it unprofitable by having to spend time over the 10 mins allocated.'
      What is that medicare levy for again?

      Commenter
      Mary
      Location
      Qld
      Date and time
      May 14, 2013, 8:30AM
      • "GPs are doing their bit to maintain access for their patients":

        What arrogance! How are they doing that? By making you wait half an hour to see them for 5 minutes. And if you want to visit the your good ol' "family" doctor, they'll make sure you get slugged with a $30 gap for the privilege. And then refer you to their preferred pathology supplier who will then continue to bleed you dry financially (and medically).

        And don't get me started on specialists that make you wait 3 months to see them and then slap you with a $100 gap! And all the while the government rakes in our medicare $!! What a cartel the specialists run - when will it stop?!

        ''These historic high rates of bulk billing are a result of concerted effort on the part of this government,''

        Yeah right - the only "concerted" effort by the government is to not produce enough doctors and then fill demand by importing doctors that barely speak English.

        Don't get sick people!

        Commenter
        Broke
        Location
        The Real World
        Date and time
        May 14, 2013, 8:41AM
        • As a medical student who went to an AMA protest against provider number caps - it is clear that the doctor shortage was exacerbated by government policy meaning long waits. It is also clear that large gaps have been caused by governments making sure the Medicare rebate does not keep up with inflation or wages meaning that poor patients are paying more and more. This will be even worse after today's budget which is rumoured to be freezing rebates. Patients will suffer and the medical workforce will suffer - a lose-lose situation for healthcare in our country.

          Commenter
          short memories
          Date and time
          May 14, 2013, 3:06PM
      • They certainly don't bulk bill in this country town. Charge like wounded bulls would be an apt description.

        Commenter
        Bec
        Date and time
        May 14, 2013, 8:56AM

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