Doctors around the country bringing an end to bulk billing

Dr Charlotte Hespe from Glebe Family Medical Practice which is looking at charging 40 per cent of fee paying patients more so they can continue to bulk bill patients on a low income.

Bulk billing is being killed off at GP practices around the country as doctors respond to the Government’s plan to freeze the Medicare rebate at $37 for six years.

A survey of over 500 doctors by the Royal Australian College of Medical Practitioners to be released today finds 14.5 million patients will face new charges to see a doctor.

Twenty nine per cent of doctors will end bulk billing for all patients as a result of the freeze.

Another 22 per cent will end bulk billing for all and introduce capped fees for low income earners, the survey shows.
In the May budget, the Turnbull Government announced it would continue the indexation freeze for all Medicare schedule fees until 2020.

Only 9 per cent of doctors said they would continue to bulk bill all patients.

  1. Dr Michael Aufgang from Meadows Medical Centre in Melbourne says the introduction of the freeze last year meant he had to introduce a fee for low income patients.

In Sydney the Glebe Family Medical Practice is considering raising its $65 fee to $70 for non bulk billed patients so it can afford to continue bulk billing low income earners.

Dr Charlotte Hespe says the practice is also considering ending bulk billing for a range of services like medication reviews and chronic care visits for wealthier patients.

“We’ve been bulk billing everybody for these services and we’re starting to introduce a charge, she said.

Glenorchy GP Dr Clare has begun to charge patients without a Health Care Card $20 a visit, after formerly bulk-billing 90 per cent of consultations.

Dr Charlotte Hespe says her practice is considering ending bulk billing for a range of services like medication reviews and chronic care visits for wealthier patients.

Primary Healthcare which runs 71 GP practices around the country says it will soon start trialling a GP fee at some new outlets. “If the freeze persists, GPs may be forced to charge co-payments, increasing the barrier to access for many patients,” Primary CEO Peter Gregg says.

A spokeswoman for Primary said “we do not agree with any policy that withdraws funding from any segment of critical frontline care”.

“This is a direct attack on the livelihoods of the hardworking GPs who provide accessible health care.”

“Our Medical Centres division is responding with several initiatives, including piloting different centre structures and private billing models,” the spokeswoman said.
Other budget cuts will see a new $20 fee which could be imposed on medical tests at around half the nation’s pathology clinics from July 1 and the cost of scans will rise.

The cost of prescriptions is also set to rise by $5 for general patients and 80 cents for pensioners from January next year.

A copy of a prescription form which many doctors were using to protest against the Medicare freeze.

Labor has pledged to end the Medicare freeze in January next year and says it won’t go ahead with the hike in prescription charges if elected.

Royal Australian College of General Practitioners president Dr Frank Jones says extending the freeze on the Medicare Benefits Schedule (MBS) until 2020 will mean the value of GP patient rebates will fall by 20 per cent in real terms by 2020.

“One estimate puts the cost of the freeze for the average GP to be in the order of $50,000 by 2019,” he says.

“The circumstances of each GP will differ but GPs may have to charge patients an add-on of $15 or more per visit by 2019 just to keep afloat,” he says.

Doctors are warning patients who cannot afford these new fees could end up in hospital emergency departments where the cost of treating them costs taxpayers an average $443 per visit.

If they don’t see a doctor at all and get sicker and end up in hospital it will cost taxpayers and average $1839 per day, the RACGP says.

Dr Aufgang says he had to introduce a fee “to try and help me balance my books, its really hard to run a high quality practice”.

The move has seen some patients leave the practice because they can’t afford to pay the fee, he says.

“I think the government knows exactly what they are doing, they are trying to move to an American model of patients paying for care and we can all see how bumblingly unequal the US system is,” he says.

Instead of seeing their GP, patients will avoid seeing a Doctor until they are very unwell, and will require more complicated care that will cost the government, and ultimately the taxpayer, substantially more than seeing their GP, he says.

Health Minister Sussan Ley said the Coalition was already increasing investment in Medicare by $4 billion over the next four years to $26 billion in 2020-21.

“Labor seems intent on running a scare campaign that somehow claims not increasing rebates for doctors by 60 cents equals a $20 cost to patients — it doesn’t add up, just like their costings,” Ms Ley said.

“GP bulk billing rates have grown to nearly 85 per cent under Coalition, compared to an average of 79 per cent under Labor, despite the pause.”

Opposition health spokeswoman Catherine King said the AMA had highlighted, General Practice is now at a tipping point as a result of the Medicare freeze.

“Practices will increasingly be forced to abandon bulk billing and charge patients even higher gap fees just to survive.
“Labor will protect bulk billing, and protect patients by scrapping Malcolm Turnbull’s GP Tax by stealth,” she said.

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