Bulk-billing rates flatline, despite billions tipped into Medicare
Health Minister Mark Butler has charge of Labor's signature election commitment: an $8 billion scheme to lift bulk-billing rates. (AAP: Lukas Coch)
In short:
Quarterly Medicare data shows bulk-billing is unimproved from a year ago at 77.6 per cent.
GP services have also fallen by about 10,000 a day, as average out-of-pocket costs tick over $50 for the first time.
What's next?
A new $7.9 billion Bulk Billing Incentive has taken effect, which is expected to begin showing in bulk-billing rates in the next quarter.
Medicare figures quietly published online have revealed bulk-billing rates have flatlined, remaining unimproved from a year ago despite billions being tipped into the scheme.
Bulk-billing rates are sitting at 77.6 per cent, the exact same as a year ago, according to data for the quarter from July to September of this year.
Meanwhile, the total number of GP services over that period compared to a year before has fallen by about 10,000 a day, and the average out-of-pocket cost for patients has ticked up by about $4 to $50.49.
Shadow Health Minister Anne Ruston said that would have flow-on consequences for the hospital system.
"Despite a huge amount of investment here we have seen very little change in any of the rates, which means we know that people are avoiding seeing the doctor because they can't afford to do so," Senator Ruston said.
"10,000 less visits every day, on the basis of the data we have seen today. That's 10,000 [services for] people that will potentially become sicker before they seek healthcare, and we already know that our hospital emergency departments are under incredible pressure."
Anne Ruston says a fall in GP services will have flow-on impacts to the hospital system. (ABC News: Matt Roberts)
Health Minister Mark Butler said he expected the rate to quickly pick up with the beginning of the government's new Bulk Billing Incentive beginning this month.
"Already over 1,000 mixed billing clinics have indicated they will switch their practice to fully bulk-billed. This is on top of the 1,600 GP practices that are currently fully bulk-billing. This means that over 2,600 practices are expected to become fully bulk-billing around the country," Mr Butler said in a statement.
"We know this investment will work, because it has already worked for the patients the incentive already applies to pensioners, concession cardholders, and families with kids."
Bulk-billing remains well below pre-COVID rates
In 2023, the federal government committed $3.5 billion to triple the incentive for doctors to see children and concession card holders without charging any out-of-pocket fee.
While that arrested the decline in bulk-billing and brought a small improvement, it appears to have again stagnated.
Rolling 12-month data shows bulk-billing rates have improved by 1.7 per cent since the tripled incentive payment began in November 2023, to 77.9 per cent in September.
But it remains well below the COVID-era high water mark of 89.2 per cent, or even the pre-COVID rate of 85.2 per cent.
At the federal election, the government promised a new measure that it said would lift bulk-billing rates back to about 90 per cent by 2030, at a cost to taxpayers of $7.9 billion.
That funding was quickly matched by the Coalition — but it and the Royal Australian College of General Practitioners (RACGP) expressed scepticism at the time about whether the measure could successfully reverse the decline in bulk-billing.
That scheme took effect at the beginning of this month.
Senator Ruston said she wanted to see Australians get affordable and timely access to GPs.
But she remained worried that Australians would continue to avoid seeing the doctor because they could not afford to do so.
"We've seen out-of-pocket costs continue to grow, we've seen the department tell us they are only going to get more expensive into the future," she said.
"This is a prime minister and a government who continues to lie to Australians about the cost of seeing their doctor. The prime minister knows that it's manifestly untrue that when you turn up to your doctor all you need is your Medicare card."
The RACGP, however, noted recent Australian Bureau of Statistics data that showed fewer patients were reporting seeing a GP due to cost, down from 8.8 per cent to 7.7 per cent.
Anthony Albanese has repeatedly claimed the "only" card Australians need to see a GP is their Medicare card. (ABC News: Adam Kennedy)
Bulk-billing boost may take years to flow through
The newly released Medicare data will be the last quarter before the $7.9 billion Bulk Billing Incentive begins to show in reporting.
Health department officials have conceded however that patients may not see the benefits of that scheme for about four years, as it would take GPs time to adjust their business models.
Officials also warned at estimates hearings in October that they expected average out-of-pocket costs for those who are not bulk-billed to rise, as "outlier" GPs who did not bulk-bill would charger higher fees.
The Department of Health's annual report, released this month, admits that the key target of more than 90 per cent of Australians accessing Medicare Benefits Schedule services, which includes bulk-billing, was not met.
"The decline in bulk-billing rates and rise in out-of-pocket costs, coupled with increasing cost-of-living pressures, has resulted in a barrier for some patients when trying to access the care they need," the annual report notes.
"From November 2023 GP bulk-billing rates began to stabilise and increase. Performance against the target is anticipated to improve as GP bulk-billing rates increase."