The ACT's federal Labor politicians have refused to weigh in on restoring rural bulk billing incentives to the capital, as new data reveals Canberrans are paying more to see a doctor.
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Four years ago Canberra and Queanbeyan were cut off from federal government rural incentives which gave extra payments to clinics that bulk-billed pensioners, children and other concession patients.
Now, pressure is building to address Canberra's low bulk billing rates - the worst in the country - as people struggle through cost of living pains.
Despite calls from ACT Health Minister Rachel Stephen-Smith to restore rural incentives, federal Labor representatives would not say whether they supported such a move.
Instead, a joint statement from spokespeople for Minister Katy Gallagher, Assistant Minister Andrew Leigh, Alicia Payne and David Smith referred The Canberra Times to a federal government review, due to be finalised in mid-2024.
The review will consider how to distribute doctors more equitably around the country, including the classification system, under which Canberra is treated as a metropolitan area.
"The Albanese government is committed to making it easier for Canberrans to see a doctor," the statement from ACT Labor representatives read.
"Last year, we made the largest investment in bulk-billing in the 40-year history of Medicare.
"In the ACT, that's meant an estimated additional 2842 trips to the GP being bulk billed."
New data shows the cost of bulk billing rates
The Albanese government tripled bulk billing incentive payments for doctors from November 1 2023, a move which increased Canberra's rate of bulk billed GP visits by 1.9 percentage points from October to December 2023.
But the number of clinics who bulk bill all patients in the territory is incredibly low, with analysis from Cleanbill, an online healthcare comparison directory, showing there is only one general bulk billing practice open to new patients in each of Canberra's three electorates.
Canberrans also pay some of the highest out-of-pocket costs to see the doctor but the analysis shows people in the city's north are paying less to see a doctor.
The average out-of-pocket costs for doctors in Bean and Canberra is about $53. It's only $42 in Fenner.
Cleanbill founder James Gillespie said the higher costs were "over-and-above" the Medicare rebate changes introduced last year.
The ACT Health Minister said she wanted the territory to return to its prior classification.
Ms Stephen-Smith said she had repeatedly raised this with the former Morrison government and with federal Health Minister Mark Butler.
"Since the former Coalition government reduced bulk-billing incentives for ACT general practices, I have consistently raised concerns about this, formally and informally," she said.
"I have written multiple times to the federal government and raised the issue through bilateral meetings and in public comments.
"When the Albanese government was elected, it was one of the first things I raised with [Mr Butler]."
But Ms Stephen-Smith's federal Labor counterparts have reserved their thoughts on the matter until the government's review of Medicare is revealed.
"The findings of the review are expected to be handed to government in the middle of this year, and Minister for Health Mark Butler will have more to say later this year," their joint statement read.
David Pocock urges 'a look at' the system
Under the current system, the Modified Monash Model - known as the MMM system - the territory is classified as a metropolitan area, meaning doctors receive a smaller incentive payment to bulk bill than their regional counterparts.
ACT independent senator David Pocock has urged that "a look at our MMM classification has to be on the table".
Senator Pocock clashed with Senator Gallagher at estimates earlier in February, when he suggested Canberra's bulk billing rate would get more attention if it were a marginal electorate. Senator Gallagher rejected this idea.
"Despite being a capital city, we have many of the same challenges as a regional area," Senator Pocock said.
"We don't have enough GPs and it's comparatively more expensive to run a practice, particularly to hire admin staff.
"I think a look at our MMM classification has to be on the table, and it has to go further than it previously did, which really only targeted the outskirts of Canberra at a classification that didn't provide much additional benefit."