Doctors say bulk billing and other GP services are under threat if Medicare’s funding model is not reformed.
Royal Australian College of GPs president Dr Karen Price said in many cases GPs are being forced to make sacrifices to keep their services affordable and accessible.
“If this keeps going, we’re going to have a two-tier health system,” Dr Price said.
According to Dr Price, the Medicare rebate is just $39.10 for 20 minutes of a doctor’s time.
She said because of this many practice, owners were reducing their bulk billing hours out of concern for the sustainability of their businesses.
“The Medicare rebate has not kept pace with the costs of running a practice in terms of staffing costs, equipment and so forth,” Dr Price said.
“Up until now, many of us have been subsidising the gap ourselves, particularly for vulnerable patients.”
The Australian Medical Association is also calling for an overhaul of Medicare to keep up with changes since the systemxjmtzyw was launched in the 1980s.
AMA president Dr Omar Khorshid said the Government needed to recognise the pressure Australia’s GPs were under.
“Doctors working in general practice have been forced time and time again to wear the brunt of these real cuts to Medicare,” Dr Khorshid said.
“The health care needs of patients have become much more complex as the population has aged, yet Medicare is stuck in the 1980s.”
Dr Price explained Medicare was not being geared to longer term care for those with persistent issues.
“Vulnerable patients in particular have often long and complex medical conditions, often multiple medical conditions,” she said.
“The Medicare rebate is really only designed for acute, high-volume care, so detailed holistic care is not well supported by Medicare.”
Government claims of record high bulk billing levels have been refuted by some as a misrepresentation of the data.
GP bulk billing rates were at around 88.4 per cent in last year’s December 2021 quarter – 0.3 per cent higher than the December 2020 quarter and 6.4 per cent higher than the same period in 2012.
“Bulk billing rates have gone up, but some of that is a bit tricky. Obviously with Covid and mandated bulk billing for vaccinations and for some of the earlier parts of telehealth, that distorted some of those figures,” Dr Price said.
She also said government figures represent bulk billing “activity” rather than per patient.
“So our numbers and the Productivity Commission’s numbers are somewhere around 67-70 per cent or so of people are bulk billed,” Dr Price said.
According to Dr Price, a recent independent assessment showed a further $1 billion investment in general practice – compared with $74 billion spent on hospitals – would have a significant benefit and return on investment going forward.
General practice is also facing another crisis in a shortage of qualified doctors, with just 15 per cent of graduates choosing the path.
Most are opting to go into hospital practice, which Dr Price said has benefited from the largest share of attention and funding.
“At the moment it seems when there is an announcement on health, it’s always in a hospital. It doesn’t seem to be popular to say that most health care occurs in the community,” Dr Price said.
Less GPs means shortages in rural and remote and outer suburban areas, which a 2019 study by Deloitte showed could become widespread by as soon as 2030.
