I just went to my regular GP and got told they will be changing the bulk billing and will not be covering any one who doesn’t own a healthcare card or a pension card so anyone attending their practice will need to pay the full amount.
There was a mention of this on a Current Affair as well. Just wanted to know what are the chances about Medicare being scrapped? What would be the possible consequences of this to the common people .
I think we will be in for a rude shock.
More and more GP clinics are charging a gap and there are zero suggestions that the government are doing anything about it. On OzBargain alone this is the 2/3rd time this has come up in the past few weeks. Daily news coverage in the media.
A great overview of why (private) GP businesses are unable to continue providing no out of pocket cost to see your GP https://www.facebook.com/ACurrentAffair9/videos/338817389817…
See my comment below for a TL;DW
https://www.ozbargain.com.au/comment/12539179/redir
I don’t think it will be scrapped, officially. Either more GPs will require the copayment or they will increase the amount the GPs are paid by Medicare. We are a couple of months into a new Government, that is dealing with a number of things on a number of fronts. The GPs themselves are setting the copayments so the Government, probably, feels this can run for a while without taking the heat politically.
I’m not saying people won’t be experiencing copayments I’m saying the Government won’t scrap it. More and more GPs will, probably, only bulk bill people with Health Care cards.
I agree the principles of subsidised health care won't be scrapped but no gap GP consults or "bulked billed/free" ones will cease to exist if Government attitudes towards our healthcare doesn't change.
It seems GPs have been begging for support as they have been absorbing costs for over 10 years hoping for change. More recent numbers saying 1 in 5 practices have started to charge a gap in the past year..
It's impossible for the GP private businesses and doctors to offer high quality care without change. The current consult subsidy of ~$39 (if kept up with inflation should be ~$85) after overheads leaves ?$10-15 for the doctor per consult, 4 consults an hour, $40-65/hour
-35% (goes to the clinic to pay for expenses),
-10% (super),
-5% (leave),
-5-10% (insurances, registration, self education expenses).
Considering the high risk/responsibility of it all and stress (years of self sacrifice and ongoing) doesn't seem very appealing…
No wonder less and less year on year medical graduates do not want to specialise in General Practice
@darkb: I think we are arguing the same points. We both think it needs to be fixed, I’m just saying the Government won’t scrap it as a matter of policy. Why should they change the policy when they can offload the decision for copayments onto the GP?
I already make copayments to my GP, and have had for many years. The guy is brilliant and I can afford the copayment.
@darkb: You're exactly right.
$85 is what the GPs charge in the regional area where I live. With a Medicare rebate of about $39, it costs me almost $50 to see a GP.
I don't begrudge the doctors charging that much but gee it'd be nice if the new government would increase the rebate a bit.
@darkb: Bulk billing doctors in my experience push patients through every 5 minutes. Only gap fee charging doctors will give you more time. 5 minutes isn't sufficient for complex matters or psych problems, but is fine just for prescription refills and simple issues like a nail infection.
@RefusdClassification: Interesting. I'm registered with two GP clinics - one that bulk-bills and one that has co-payment. I find the level of service to be pretty much the same with both but I prefer the bulk-bill clinic as the doctors, who are all Indian, seem to be a bit more thorough - and are definitely more friendly.
YMMV.
no gap GP consults or "bulked billed/free" ones will cease to exist if Government attitudes towards our healthcare doesn't change.
For those that have short memories -
This is what the Prime Minister Tony Abbot and then Health Minister Peter Dutton were intending to happen when they changed medicare. In 2014 they wanted to introduce a $7 co-payment for all GP visits. They were blocked from doing so by the senate so instead they dropped the medicare payment for a standard consult by $5 and froze the payment from inflation based increases. It didn't have an immediate effect, but has slowly been killing bulk billing.
The current consult subsidy of ~$39 (if kept up with inflation should be ~$85) after overheads leaves ?$10-15 for the doctor per consult, 4 consults an hour, $40-65/hour
This math doesn't really make sense to me…
If doctors end up with only $40-65 a hour now, and the subsidy is lifted to $85 ($46 increase) they would then end up with $224-$239 an hour … almost 5x as much. Sound right?
Political suicide didn't happen when LNP froze rebates. Wishful thinking, sorry.
Freezing rebates ≠ Bulk Billed GP Consults Being Scrapped
They cut the GP rebates by $5 when they couldn't pass their $7 co-payment.
@iseeyou1312: They introduced a new lower payment tier for really short visits, for non healthcare card holders.
@tryagain: That was the change for Level B visits back in 2015. At the time they were cut from $37 to $32.
Old news
Been going on for years
Just now even more GPs sick of being underpaid by Medicare Bulk Billing
That sounds more like your doctor will no longer bulk bill regular patients and therefore charge their standard fee and the patient then receiving a rebate via Medicare (which would be less than the fee)
Oh ok makes Sense
aka "the gap"
what are the chances about Medicare being scrapped
Zero
i think what OP meant was chances of Medicare covered bulk billed gp consults being scrapped.
I am quite worried on that too, because if they scrap it, then I'd be forced to pay to be getting sick leave from my employer (to obtain sick certificate).
I can already imagine I wont be the only one thinking that way, so many part time and full time employees will be affected. This kinda policy will surely i reckon cause a lot of them to turn to CASUAL. and employers forking out more money full upfront than storing for later, or in some cases, not even honoring because employee might have to fork out JUST AS MUCH $$ to get sick certificate than to get his/her 1 day worth of sick leave $$'s.
Exactly what I wanted to ask . Thanks for pointing out .cheers I will update my post
The GP can still choose to bulk bill a visit at their discretion.
But if they can’t run a profitable business they won’t choose to as often or at all.
@morse: But they won’t entirely scrap that option. Vulnerable people may not need to be out of pocket everytime.
When i was in canberra, bulk billing GP was hard to find even for med certificate. Yet at the same clinic, you’d see people walking out with their kids and don't have to pay a cent.
@avoidfullprice: Yep it’s not ideal. Definitely not equitable. I think they should have a bulk bill incentive for GPs like they do with some medical imaging. ie if they bulk bill Medicare gives them $5 more than if they charge a gap. They’d still get less in total than if they charged a $20 gap but it might make it possible for them to bulk bill more. I do feel a lot is around competition. Here on the Gold Coast there are heaps of GPs so you can find ones that bulk bill. In other places there’s nothing.
Still cheap to get a medical certificate from the pharmacy.
Not FREE though from pharmacy
@USER DC: It’s not free if medicare fund it either - it is tax-payer funded. I don’t believe the government should be paying for a private business’ policy for people to require a medical certificate when they do not otherwise need a doctor’s appointment. Getting a certificate from pharmacist or writing a statutory declaration is a much better use of resources.
@bobkin: Well all i really care about is
i shouldn't be having to pay $$ for getting my own entitled sick leaves.
Government should make a seperate class/category of gp appointments for sick certificate issuing (literally where only thing patient cares about is getting that certificate, and all gp needs to do is that).
In that kinda case GPs shouldn't be charging their whole medical hourly rate or something for such a small thing either. Aka GPs should be getting lower pay for such a 2-3 mins job (unlike their standard 15 mins appointment)
@USER DC: When people come to me for a sick certificate, its a great opportunity to go through preventative health. A GP visit shouldn't be a in and out experience. I like to get to know my patients, do a thorough examination, go through mental health, weight/height etc…. The amount of things, sometimes life saving, I have found during these "simple" consults is staggering. I agree that sometimes people just want a certificate and nothing else but in my experience, that is quite rare and I hope businesses forego certificates, people should just do stat decs.
@USER DC: You're not paying for a cert. You are paying for the dr to take a history/examine and make an assessment/treatment plan, whether they write a certificate or not. This may take 3min or 30min if it brings up other issues. What your work requires is a different story, nothing to do with your GP. Many workplaces don't require one for 1-2 day absences.
Zero…under Labor
Zero… under anyone. There would be an extremely small portion of the population who would want Medicare to go, there is no way it's going anywhere. If only our fearless leaders could stop wasting so much money, and put some more toward it.
The Libs would get rid of it or scale it back if they had their way.
Your state health service probably certifies and operates some clinics that will bulk bill, but if your doctor makes a mistake do you really want them to feel obligated to your state's health minister, or do you want them to feel obligated to do the right thing by you directly? It's no secret that every health department in every state is corrupt af.
incorrect, a lot of people think GPs are salaried and gap means they charge on top. they don't get any payments other than what you pay for each consult, they are mostly private businesses/contractors with no annual leave/super/sick leave/maternity leave etc. bulkbilling means they accept the rebate that government gives you for a standard consult - for a normal consult <20minutes that's $39 which also goes towards paying for rent/staff/consumables so you can see where this is going. not bulkbilling means they charge their standard fee, and you get your rebate back from Medicare directly
A standard consult rebate has gone up to $51 now.
I just checked Medicare for another rebate and saw it.
Citation needed.
You're wrong
https://www1.racgp.org.au/newsgp/professional/miserly-mbs-in…
patient rebates for a standard Level B consultation will increase to just $39.75 – a $0.65 increase compared to 2021–22.
Only 1.6%. Meanwhile Consumer Price Index (CPI) has rose by 5.1% in the same 12 months period.
As I've said a few times already, Government has been neglecting our healthcare expenditure and we need to speak up. Our Medicare subsidy for GP visits have not kept up with inflation for the past 10 years, they are currently ~$39 when they should be ~$85. Government need to be held accountable.
@darkb: I forgot it was a Sunday. I didn’t think rebates would change on the weekend.
05020 - CONSULTATION AT CONSULTING ROOMS - LEVEL 'B' (AFTER HOURS).
I think that’s item number 5020 only applies during certain hours.
Items 5000, 5020, 5040, 5060, 5200, 5203, 5207 and 5208 apply only to a professional attendance that is provided:
on a public holiday;
on a Sunday;
before 8am, or after 1 pm on a Saturday;
before 8am, or after 8pm on any day other than a Saturday, Sunday or public holiday.
http://www9.health.gov.au/mbs/fullDisplay.cfm?type=item&q=50…
The general level b at normal hours is still $39.75
Regardless of how they are paid, if the clinic you see is certified and operated by a division of Brisbane Public Hospital, then the staff there are going to feel accountable to Queensland Health ultimately, even if they are "mean to" be acting as independent GPs.
eh? GPs have nothing to do with QLD Health - why would they be divisions of Brisbane Public Hospital? Its Federally funded.
@p3nf0ld: They may be federally funded, but if you look at the websites of some clinics you'll see that the clinic itself is certified by the state health service, or is an initiative of a state hospital, or the doctors have government Queensland health email addresses (even if the clinic they work for has their own domain name for website). Totally private clinics are certified by independent medical groups, the doctors aren't employees of Queensland health, and they have email addresses that match their private domain. GPs that work for Queensland health should operate the same as any independent GP, but I think you'll find when shit hits the fan that they consider themselves public employees.
@AustriaBargain: yeah nah salaried or otherwise the drs would never protect the health service at the expense of their own medical license. they answer to ahpra/medical board, state health service has nothing to do with it. the worst that can happen is they get fired, which is not much of a loss
@May4th: Aprah doesn't even look into 70% of cases offered to them. The state health service could easily just roll the dice and deal with it later, leaving the doctor who wronged you sweating until the dice stop moving. What difference does it make to the health service if a doctor gets told off now or later? At least by pretending it doesn't exist you have the chance of not taking a hit over it. An actual independent clinic doesn't have an entire lumbering government behind it when push comes to shove. We read about health scandals all the time and investigations into overall corruption keep saying the health system is choc full of all kinds of corruption, it's totally normal to those in the system, and the problem is so big that it'll probably never change.
@May4th: I guess I'm advocating for private healthcare. One that doesn't rely on the government for anything at all, where possible. It's better to not have your own primary doctor believe they are beholden to the state just to save a few bucks.
I think the medicare rebate should be lifted to limit reliance on the state, at least when it comes to your primary care physician. We should all want better healthcare and it'll generate more demand for doctors and help stave off doctor shortages if there's suddenly billions more per year being spent on doctors. We shouldn't be worried about people wasting money, instead just worry about monitoring and catching doctors who waste money.
That is a thing in SA but less so here in QLD. People still go to ED for minor things because of this. They are building some new facilities for minor injuries etc in my area at the moment. However we still have some private GPs that bulk bill luckily.
Short answer, our tax system is very regressive.
If you look at other countries with universal health care, taxes are high and everyone contribute. Here in Australia the medicare related tax (medicare levy/ surcharge) are simply just too low and only applicable if you earn income (wealthier individuals aren't drawing in salaries so usually avoid paying these taxes). So this results in an underfunded medicare which governments are always trying to reduce costs.
2% feels steep to me, because I still need to pay gaps and have private health insurance to avoid waiting 2 years for elective surgery (should I need it).
In essence I have to pay twice for the same thing.
Happy to pay 15% (shared between employee and employer) from my gross salary for adequate service. Did so in the past and had no significant waiting times, no gap payments, cheaper medication, …
15%?! Shit maybe if you are on minimum wage, working 2 days a week. Doesn't compute if you're earning 6 figure a year.
@reactor-au: You've to look at other countries with universal healthcare. That's what I paid in Germany … and compared to Australia the service was way better. No gap payments, no wait in the ED, no years long wait for elective surgery …
Employee paid around 7.5%, employer had to foot the rest.
@dragonos81: I didn't know how socialized medicine worked in Germany, so thanks for the information. Here in Australia a good start would be to lift the Medicare levy to 4% and add a 4% employer contribution. Use the revenue to increase Medicare doctor rebates (GP and specialists) by 25% and improve public hospitals to private hospital standards. Cap the amount doctors can charge in out of pocket fees.
Capitalism is the disease, socialism is the cure.
@RefusdClassification: I think we should make Medicare Levy Surcharge compulsory for high income household, kill the private insurance junk policies. I pay for Private Insurance, but i felt it's a waste of money. I rather have good public health system rather than this half arse public/private system in australia.
The Medicare Levy isn't avoidable by high income individuals, it's a tax on income.
You’ve spent too long on auspol
The reason many GPs are scrapping bulk billing is that the Medicare rebates they receive were temporarily frozen by the Labor government in 2013, but the Liberal government which followed kept the freeze going until 2020.
Unfortunately, since the Medicare rebate indexation restarted, high real inflation means the gap continues growing and we are now at the point where many GPs find it is unfeasible for them to cover it.
I suggest anyone who values bulk billing by GPS write to their federal parliamentary representatives and ask them to do more to address the widening gap.
Not quite right. The ALP started the freeze, but Tony Abbott cut the rebates by $5 and then continued the freeze when his $7 co-payment couldn't go through the Senate. So GPs should get $44 for a 10-20 minute consult, but they have to pay a $5 fee to the government, which leaves them with $39.
If you're in one of the larger cities, then you should be able to easily find another practice which still does bulk billing, but you might have to do some travelling to get there.
In Sydney, for example, I find that there are lot more bulk billing practices in Western Sydney, compared to the North & South.
Usually, the bulk billing practices will be very large multi-doctor clinics & the doctors won't spend any time chit-chatting with you about random things like your weight etc. Their emphasis is to see you in the shortest possible time & to give you only the care for the specific reason that you are seeing them.
Surprised the liberals didn't do it. Labor cares a bit more about people.
The freeze was a terrible idea from Labor to begin with, even as a temporary measure, but despite the coalition’s complaints at the time, I think keeping it going was very much in line with their reluctance to sufficiently fund Medicare.
The Liberals have always wanted people to pay something extra (make a copayment), above and beyond our taxes, for medical services.
Do you actually believe that or are you being facetious
A great overview of why (private) GP businesses are unable to continue providing no out of pocket cost to see your GP https://www.facebook.com/ACurrentAffair9/videos/338817389817…
tl;dw
-Successive Governments have purposefully not increased the Medicare subsidy in line with inflation for over 10 years, currently a standard consult ~$39 if adjusted appropriately should be ~$85. Bulk billing you essentially means you are getting a 50% discount - in which industry is this appropriate/acceptable/sustainable?
-The private businesses are forced pass on these cost to their customers just like the Banks, Woolies/Coles, Petrol stations or be forced to close.
-GPs are fighting so hard to advocate for their patient's health and their rights, lots of lobbying and meetings with government with only empty promises and no signs of change.
-We must demand more from our government-that they appropriately fund Medicare with the tax dollars we pay them. The more noise we make the better. I encourage you all to write to your member of parliament and the health minister [email protected] if you want to continue to enjoy the healthcare we all deserve
Hmm. You might want to look at what Government has been in place for most of that 10 years. Just sayin’.
Why does it matter? Bottom line is our tax dollars are not being used to fund cost effective GP led healthcare like it should be. The gap fees wouldn't exist if they didn't neglect this.
I'll quote myself above again in case you missed it
We must demand more from our government-that they appropriately fund Medicare with the tax dollars we pay them. The more noise we make the better. I encourage you all to write to your member of parliament and the health minister [email protected] if you want to continue to enjoy the healthcare we all deserve
It irks me when people quote a timeframe, where one group has been in power, then say “both sides”. If you read my other posts you will see I think it should be fixed. But then I’m a latte sipping leftie who is old enough to remember before we had Universal Health Cover. I’m happy to quote myself but I think you can find them.
It irks me when people quote a timeframe, where one group has been in power, then say “both sides”.
C'mon mate I've seen you on OzB a bit. You aren't new here, surely? lol
Maybe SloMo could have increased the Medicare reach when he secretly signed himself into the Health portfolio.
@ThithLord: OK, so maybe the comment was a tad naïve.
I've begun to realise nothing surprises me when it comes to politics. Particularly the LNP. Maybe they got infected by Trumpism. I look at the reports coming out about Sexual harassment and bullying and think "You are kidding me?" Forgive me or this will descend into a string of four letter words. I have to resort to astonishment.
Chances? 100% at your GP :(
This country is in for a rude awakening. We are on the fast track to the US style of healthcare and unless the government steps in and makes some big changes, our "universal healthcare" will be a thing of the past.
In the past, most GP clinics were small to medium sized clinics and owned and operated by a combination of the GP's that worked there. Along came large corporate healthcare centres, opening up clinics with up to 20 doctors, these were universal bulk billing practices, working on thin margins but had enough GP's employed to make them viable. This is also were the 5 minute medicine was propagated. Instead of seeing 1 patient every 15 minutes for 80 bucks (charging a gap), you try and see 2-3 patients and just take the medicare rebate (recently increased to $39). Well, along comes a 8 year medicare rebate freeze, inflation hits, general cost of living goes up and a shortage of international GP's (thanks to COVID), and all of a sudden alot of these practices are faced with either closing their doors or going under. Some large corporate owned GP clinics/companies have already failed. This has hit rural clinics harder especially because they already had trouble recruiting doctors.
The longer this goes on, the more doctors will change to mixed or private billing, and once doctors change they are not going to change back.If a doctor starts charging all his non healthcare card holders $80ish dollars for a consult, do you think raising the medicare rebate $5-10 or even $15 will make the doctor want to change back? Why would they want to lose money?
In Australia the GP speciality has not had enough applications for 6-7 years now (actually probably longer), so we dont have enough doctors in the pipeline. For Australian trained doctors its just not a attractive speciality anymore, which means we will likely need to rely on more international trained docs as well.
In Australia the GP speciality has not had enough applications for 6-7 years now (actually probably longer), so we dont have enough doctors in the pipeline. For Australian trained doctors its just not a attractive speciality anymore, which means we will likely need to rely on more international trained docs as well.
What choice do newly trained doctors have? All other specialities reject significant numbers of applicants. Eventually doctors choose to become GPs to get out of the even worse conditions working in a public hospital
Most Australians would kill for a business where each employee could generate $39 in gross revenue every 15min. Thats a whopping $1248 per employee per 8 hour day.
Yet GPs are non viable at these rates.
Where does the money go, what does it say about other comparable small businesses that have similar sized tenancies. How are they viable.
100% transparency on the books would be a good start so people can see exactly where the money is going. How much is going toward indemnity insurance and medical supplies, specialist machines etc.
GPs by majority are NOT employees but take commission on their billings. A percentage goes to the GP and the rest goes to the clinic that they are essentially hiring rooms and staff and disposables from. Your receptionists and nurses are paid hourly wages/salary and they don’t generate billings by themselves directly, and the rest of the money goes to overheads and sometimes a profit for the business owners who took a business risk starting a clinic in the first place.
Maybe the clinic is taking too high a percentage, maybe insurance is too high, maybe the leases on the medical equipment is too high, maybe the disposable medical supplies are too high.
Fact is, no one really knows anything until we see 100% transparency on the books.
@t_c: GP clinics aren't public businesses though, expecting transperancy is a highly unusual expectation.
@downbythecreek: I agree highly unusual, but just as a GP wouldn't prescribe medication without first examining their patient, how can government prescribe more funding without examining the financials of clinics.
@t_c: The market rate for a GP appointment is all that matters, their overhead/profit is irrelevant, this is a supply/demand issue. I am in SE QLD, my GP is $90 for a consult and it takes weeks to get an appointment.
If the government wants to make a GP consult for the end consumer cheaper, they can either increase supply, reduce demand, or apply some other sort of price modifier.
Sure, they could legislate that clinics have to bulk bill or charge certain prices, but these are private businesses that do the heavy lifting of our nation's primary healthcare, closures enmasse would occur and this would absolutely crush the public system.
You think $39 per 15min ($160 per hour) is how much you would pay a Lawyer or Accountant? Do they need to show you their books too to justify how much they charge?
If, "Some large corporate owned GP clinics/companies have already failed"
Then there is clearly a problem.
But in the absence of data, how can there be any solution?
This is something that impacts everyone and the future for so many. I've never written to a member, does it matter what I say really or is it more just about writing in the first place?
Most important is to write at all. It does help if you can explain how this is impacting you and your family.
As someone with a disability, and a related chronic illness, who doesn’t qualify for NDIS support but still requires regular clinical attention, I wrote about how the rising costs have forced me to make very difficult choices about when and where I get medical care. I explained that those choices resulted in me presenting to my local hospital’s emergency department on two occasions in the last three years.
Thanks for taking action!
We don't have money for healthcare. But we do have money for Olympics.
and submarines
and fireworks and flagpoles
And barrels of pork
?5B of submarines that we aren't even getting
and 3.5B of tanks
and 2B bailout of private companies whilst their executives receive bonuses
etc
But…but ..but….LNP are the fiscally responsible ones right :/
Every party, MP , state government is responsible.
Firstly, State government doesn't contribute or decide on Medicare, it's a federal issue.
Secondly, saying "every party is to blame" downplays the weighting of blame with respect to almost a decade of "fiscally responsible" single party in power decision making.
Neither party is roses and sunshine, but you're kidding yourself if you think we should apply equal blame weighting across all political parties for whatever fiscal messes we are in now.
@SBOB: At the Federal level the LNP has been in power, roughly, twenty of the last twenty-five years.
People, also, need to look at the history of Medicare and why it isn’t called MediBank and why we have MediBank Private as a fund.
In my case most of this is lived history.
https://www.abc.net.au/news/2021-06-07/australian-war-memori…
This made my blood boil. Veterans are killing themselves, and we couldn’t find money to support them, but this white elephant was being proposed. Funnily enough the guy pushing it was Dr Brendon Nelson who used to be President of the AMA.
And a referendum in a couple of years to give Aborigines a Constitutional "voice" that will cost hundreds of millions of dollars, and produce exactly the same result as what could be created by passing a law this week and be working in months. A body that parliament, ie the government, defines how it works, which means it will be elected, and parliament can ignore whatever it recommends. Oh, and of course we can't have the referendum when the polling booths are all set up because we're all going to them to vote in an election. No, it has to be held separately to we aren't "confused" by politics going on at the same time.
Victoria set up a similar body about three years ago. The First Peoples Assembly. They spent $13 million organising to sign up as many of the 30,000 Aborigines as they could to vote in its elections. They succeeded in signing up just over 2,000 of them . About 7%. That's $6,000 in taxpayers money per person they got to register to vote in the Victorian equivalent of the "voice".
It's truly disgraceful how governments squander money. Everything ends up costing 5 times more than it should, like $500,000 for an off leash area on parkland a council already owns.
There is enough to go around if government wastefulness if curtailed. It would be better if governments just gave everyone cash payments instead of wasteful spending money for them on various government programs. Let people decide how to use their money, instead of government bureaucrats and corrupt politicians.
Won’t happen. It would be political suicide to do it.