Here at the SDC, we’ve covered the increasing prevalence of GPs asking for gap payments to stay afloat. The Royal Australian College of General Practitioners (RACGP) warned of this trend for months. But now, with inflation soaring and a possible recession looming, more and more Aussies are feeling the pinch.

On Reddit, one user shared that their GP is no longer bulk-billing and asked if it is happening in other practices too. Based in Sydney’s Northern Beaches, they asked: ‘Is it part of the Great Rise of the Cost of Living?’

Many said it was happening in their areas, too. A Redditor commented: ‘It recently happened where I am, in the rural outskirts of Brisbane. From walk-in to $70 per appointment, and half back. It's going to make it really tough for some people. The government should be cutting a bunch before allowing this. Sport and club funding etc., while that's important, is not medical care-important.’

GPs are increasingly forced to turn away from bulk billing after years of consecutive losses. Credit: Karolina Grabowska/Pexels​

Another said: ‘Adelaide here – can’t find a single bulk billing doctor. I get they need to cover costs, but some people simply cannot afford to see a doctor now. It's not the Australia I know. Disappointing our government has let this happen.’

A third chimed in: ‘Same here, been with GP for ten years but just after Covid lockdowns in Melb, they don't bulk bill. Telephone consult is still bulk-billed, but sometimes I need face-to-face consult which will cost me $75 less Medicare.’

Another stayed with their usual GP but acknowledged that it’s hurting their wallet: ‘My doctor is no longer bulk billing. One of my children was diagnosed with a serious health issue that is lifelong and can take them at any time. I now face paying $150 plus weekly just to see the doctor for check-up or completely moving GPs. It just makes it difficult when our current GP knows the ins and outs.’ They continued: ‘I support Australian GPs and any medical professional, the government need to get their fingers out of their butts and fix the whole medical system and Medicare.’

While Redditors were concerned about the rising costs of healthcare, many sympathised with GPs.

‘I am not smart enough to be a doctor, I have no degree and three years of industry experience in software development. I earn about the same as a bulk billing GP and I interact with 0 sick people. Either prices go up or we won't have any GPs, said one user.’

Another shared: ‘I completely agree that GPs should be charging more. It's ridiculous to expect a fully qualified specialist GP to be getting a Medicare rate of $39 per consult which usually you get 60% of that back If you are an employee of the practice. [...] My dad's an electrician and charges 120 an hour.. standard male haircuts are at $40. Why should we expect a medical specialist to charge less?’

Australia is already facing a decade-long shortage of GPs, but with how things currently are, the country is not likely to meet the recommended number soon. Fewer medical graduates are interested in becoming GPs, with only one in eight entering the specialty, which is not enough to replace veteran doctors who will retire over the coming years.

A Redditor wrote: ‘Enrolment in GP speciality is down massively over the past five years (well below the level predicted we will need), as I don’t think most doctors either want to specialise in general practice or don’t see it as lucrative as other specialities, or both. All the GPs I know have side jobs within the medical profession in addition to their work as a GP, some for financial reasons, some so they vary their work schedule as they don’t find general practice interesting. I can’t help but feel that we will have a crisis within general practice within the next decade, and the idea of a bulk billing GP will cease to exist.’

A physician also shared the sentiment among their general practise colleagues: ‘I’m a doctor but working in a hospital, and my GP colleagues are really disillusioned at the moment. They are leaving in droves – and it’s also affected the GP-run urgent cares in rural towns.’

Many fear that the healthcare system is becoming Americanised. In the US, the healthcare system often leads to high deductibles and out-of-pocket costs, which are expensive even to citizens with insurance. Millions of Americans are one medical emergency away from financial ruin – healthcare costs are the number one reason for personal bankruptcy in the country.

One user commented: ‘As someone who lived in the United States for a good portion of time, including a bit with Covid, coming back and seeing the healthcare system in Australia is very scary, it’s almost Americanised. [...] This is a huge departure from just a couple of years ago. I know of some emergency departments charging upfront payments in Sydney as well for private ones. That’s another huge issue is the emergency departments wait times are blown out of control.’

Medicare figures show that the bulk-billing rate dropped to 83.4 per cent in the last quarter of 2022, compared to 88.4 per cent late last year. However, the RACGP says that the numbers refer to the percentage of bulk-billed services, not patients who found bulk-billing GPs. RACPG President Nicole Higgins says the real level is actually far more dire, closer to 66 per cent.

Commenters encouraged fellow Aussies to make their voices heard through their representatives: ‘Straight up, write a letter to your local federal MP. Medicare rebates for GP haven't increased in a decade. They can no longer afford to bulk bill and stay open.’

Another wrote: ‘Investing in primary care is the only way we will stop the increasing cost of healthcare for our country and the widening gap in those who can and can’t afford the health care they need. If you want universal healthcare to remain a thing in Australia, then call and write to your federal MP.’

If you’re interested in what doctors have to say on the matter, ABC recently interviewed Dr Sarah McLay, a GP in rural Queensland who is moving away from bulk billing after personally losing $200,000 in the last three years:

​

 

[Vet543]

While I understand that doctors need to be paid for their work, I am one of many who live pension to pension. The choices for me now are do I pay a bill or go to the doc, then there is the problem of the prescription. I know it's only $6.60 per. but when one has 10 different scripts all of which help with diabetes and other chronic illness. Needless to say doctors visit NO, Prescriptions are tablets every second day ,the list grows...

Exactly... So many pensioners battling from one pay to the next. Do we all have to return to remedies of the 1930s and 40s for a simple moment of relief from pain and such.
What did we pay taxes for? Why did we work so hard to improve life for our kids when the neighbour's kid is making so-called "Cure-All' drugs and charging hundreds for them.

 

[Rob44]

Are our doctors really interested or concerned with our health and well-being.
You work this out after you read this absolutely truthful experience.
I slipped and SLID down a one metre high embankment, hurting or cracking one of my ribs.
The pain was getting worse so I was advised to go to casualty for a check.
Upon arrival, no one was interested in my rib/ribs. The first thing was do a RAT test ..OK let's do it.
I have NO symptoms, Temp is normal and NO headaches or any type of pain expect the rib cage.
After waiting from 5.30 pm until 2.30am the next morning for a bed to become available BECAUSE they said the RAT was positive. I asked to see the result but was treated like "DON'T DOUBT US JUST DO WHAT YOU ARE TOLD. amen"
Next the casualty Doctor came in to the casualty room, in an apparent hurry, picked up the chart and read it.
THEN he turned to me and said "Do you want to be resusitated?" what? he repeated Do you want to be resusitated?" I replied, "Doctor, you have signed a hypocratic oath and under oath you are obliged to keep me alive and well. Is that NOT true? .. He ignored me saying ..Do you know what day it is? Do you know what hospital this is? What is your Mother's maiden name? What Town is this? etc etc..
Well, I answered his questions AND he said "Do you have any questions for me?"
This doctor is Asian and so I said, " Firstly, what is your name? (He hadn't introduced himself) he replied, "Gabriel" and then I asked ..Gabriel Do you know what town the Hospital is situated in?"
He immediately turned to the door and said very clearly... I don't have to put up with this shit.
Then promptly departed through the door.
Never to be seen again by me.

Four days in hospital and the Queensland Premier called Isolation for Co Vid sufferers finished.
Now the four days in the ward I was treated like a Leper .. OK I was IF I HAD COVID .. Four times everyday
the nurses would take my temperature and when asked, would show me (36.8 everytime) Blood Pressure and heart beat were anywhere from 158/53 to 168/57 regular heart beat was from 51 to 56/7 constantly.
Well, I was released and given boxes of drugs for all sorts of things because ONE enzyme SEEMED to indicate that I had had a heart attack. Wait ! No symptoms of any sort to indicate a heart attack.
Possibly, I am already dead ??

OK Then the Bulk billing is dumped at my clinic who did Blood Tests, Urine Test etc.
Now according to the Doctors I have diabetes ... my accu tester says regularly 5.4 - 7.6 and my sister has told me NOT to test for a minimum of 2hrs after eating.
My Doctor has allowed me two appointments on bulk billing and says the next will cost $65 and a refund of some kind from medicare or medibank (whoever)
My last appointment was bulk-billed and I was informed of the results from the tests now the clinic is telling me that I am to make an appointment for my result .. WHY? This time it would cost me. So I asked for phone call appointment AND ANSWER IS NO .. They have texted me 3 times this week says that they have medical information to tell me about ..WHAT INFORMATION? No Answer to that question.
Well. I HAVE NO MONEY LEFT IN MY BUDGET TO COVER DOCTOR'S FEES and I have informed the clinic of this at least 6 times when I have previous visited or phoned the clinic.
I say IF THE INFORMATION IS IMPORTANT THEN PUT IT ON MY GOV RECORDS AND I WILL FIND A DOCTOR WHO DOES BULK BILL ..
It seem that they won't do that so if I die because of a lack of medical care by not telling me what is wrong with my health then THEY SHOULD BE CHARGED WITH MANSLAUGHTER. Also, with blackmail.

Man.. I am certianly irate BUT if I say that at the clinic desk they would probably call the police and heve me charge for aggressive behaviour .. so GOODBYE CRUEL WORLD.. maybe.
Ohh! Not one doctor has taken a look at my rib... and the pain has subsided unless I really breath in heavily.. What happened to the Queensland Casket System?

 

[aquarius123]

I am also irate at this gap cost for elderly and on principle will not be going to the doc unless I have some dire illness. I will probably go to emergency at the hospital instead, it costs about the same in this regional area. For the last few years my local doctor clinic has been requiring me to do an assessment for a plan every now and then but has now told me I haven't got any critical illnesses so I don't deserve to be on a plan. On a plan I used to get four physio visits free and one podiatrist visit free but now they charge gaps as well.

 

[Rob44]

Are our doctors really interested or concerned with our health and well-being.
You work this out after you read this absolutely truthful experience.
I slipped and SLID down a one metre high embankment, hurting or cracking one of my ribs.
The pain was getting worse so I was advised to go to casualty for a check.
Upon arrival, no one was interested in my rib/ribs. The first thing was do a RAT test ..OK let's do it.
I have NO symptoms, Temp is normal and NO headaches or any type of pain expect the rib cage.
After waiting from 5.30 pm until 2.30am the next morning for a bed to become available BECAUSE they said the RAT was positive. I asked to see the result but was treated like "DON'T DOUBT US JUST DO WHAT YOU ARE TOLD. amen"
Next the casualty Doctor came in to the casualty room, in an apparent hurry, picked up the chart and read it.
THEN he turned to me and said "Do you want to be resusitated?" what? he repeated Do you want to be resusitated?" I replied, "Doctor, you have signed a hypocratic oath and under oath you are obliged to keep me alive and well. Is that NOT true? .. He ignored me saying ..Do you know what day it is? Do you know what hospital this is? What is your Mother's maiden name? What Town is this? etc etc..
Well, I answered his questions AND he said "Do you have any questions for me?"
This doctor is Asian and so I said, " Firstly, what is your name? (He hadn't introduced himself) he replied, "Gabriel" and then I asked ..Gabriel Do you know what town the Hospital is situated in?"
He immediately turned to the door and said very clearly... I don't have to put up with this shit.
Then promptly departed through the door.
Never to be seen again by me.

Four days in hospital and the Queensland Premier called Isolation for Co Vid sufferers finished.
Now the four days in the ward I was treated like a Leper .. OK I was IF I HAD COVID .. Four times everyday
the nurses would take my temperature and when asked, would show me (36.8 everytime) Blood Pressure and heart beat were anywhere from 158/53 to 168/57 regular heart beat was from 51 to 56/7 constantly.
Well, I was released and given boxes of drugs for all sorts of things because ONE enzyme SEEMED to indicate that I had had a heart attack. Wait ! No symptoms of any sort to indicate a heart attack.
Possibly, I am already dead ??

OK Then the Bulk billing is dumped at my clinic who did Blood Tests, Urine Test etc.
Now according to the Doctors I have diabetes ... my accu tester says regularly 5.4 - 7.6 and my sister has told me NOT to test for a minimum of 2hrs after eating.
My Doctor has allowed me two appointments on bulk billing and says the next will cost $65 and a refund of some kind from medicare or medibank (whoever)
My last appointment was bulk-billed and I was informed of the results from the tests now the clinic is telling me that I am to make an appointment for my result .. WHY? This time it would cost me. So I asked for phone call appointment AND ANSWER IS NO .. They have texted me 3 times this week says that they have medical information to tell me about ..WHAT INFORMATION? No Answer to that question.
Well. I HAVE NO MONEY LEFT IN MY BUDGET TO COVER DOCTOR'S FEES and I have informed the clinic of this at least 6 times when I have previous visited or phoned the clinic.
I say IF THE INFORMATION IS IMPORTANT THEN PUT IT ON MY GOV RECORDS AND I WILL FIND A DOCTOR WHO DOES BULK BILL ..
It seem that they won't do that so if I die because of a lack of medical care by not telling me what is wrong with my health then THEY SHOULD BE CHARGED WITH MANSLAUGHTER. Also, with blackmail.

Man.. I am certianly irate BUT if I say that at the clinic desk they would probably call the police and heve me charge for aggressive behaviour .. so GOODBYE CRUEL WORLD.. maybe.
Ohh! Not one doctor has taken a look at my rib... and the pain has subsided unless I really breath in heavily.. What happened to the Queensland Casket System?

With respect; I am not a medical doctor but from certain practical experience as a lay person the blood pressures and heart rates you quote could seem of concern. That, and the potential damage a broken rib may have caused, is possibly why you were kept in hospital for four days of observation. RAT tests can show false positives/negatives for Covid-19 and even though a Covid-19 infection may seem very mild or even absent of symptoms it does not mean that there is no infection and that it cannot be transmitted; and that virus is potentially far more damaging long-term than our politicians and most of our community are prepared to accept. In casualty , or the emergency department, of many of our public hospitals ( and particularly in our rural hospitals) you will find the place being run on a shoe-string, the staff being overworked with possibly some doctors working double 12-hour shifts as needed and running on lack of sleep and food, with some doctors being young and very inexperienced in their first few months of real work as a doctor, and including some who are simply arrogant and insensitive as they are just normal human beings.

However, none of us want to pay taxes, do we? None of us want to vote for a government that will enable proper public health-care by a National Health Service because it costs money better spent by government on providing us with the NBN, footie stadiums, wider faster longer freeways and on Public Servants who are non-performers (aren't they?) and etcetera etcetera.

When it comes to public health-care, we, the voters, are the problem.

 

[rachtrex]

It is not a matter of turning into America. It is an issue arising from the poor quality of supervision given by the Federal governments ( through Medicare)to the medical industry over the past 20 years. The bulk bill consultation rate should have been adjusted for CPI increases faced by gp's over that period. EP's would not, then have the need to insist on the consultation rates now required.

while i do agree about the bulk billing should be way more, I also find that only get a 10-minute consult a script and walk out how much does it cost 10-minute consult?

 

[Penny4]

I know 2 girls who are medical students at the moment. Another girl is a qualified Dr and becoming a surgeon, however it takes years & still not guaranteed a pass.
They tell me that intelligence isn't the only qualifying entry to become medical student anymore. The days of Doctors having 'an inept bed side manner' is gone.
These girls had to have personality testing.
I know a Dermatologist who's son went to medical school to also become a Dermatologist to work in his father's practice. He got honours with his grades, but failed the personality test. He was informed that he got too nervous with patients. He is now a practicing GP.
My GP practice now charges $79 with out of pocket $39.25
Pensioners are now charged $55 out of pocket $15.25
I have been going to the same GP practice since I was born, as my parents went there & my 88 yr old mother still goes there.
No such thing as loyalty these days.
I've never seen a poor Doctor.

 

[Kaylee]

My doctor's in Hobart have moved away from bulk billing. Originally I was able to get a 3 month Authority script. They then changed it to having to come in monthly for the script but still bulk billed. Now I don't know how I am going to afford the cost of the visit monthly plus the cost of getting the script dispensed. Guess I will have to give up eating that week. Pity Private Health Insurance can't be used seeing the price we pay for it & the government pushes us to have it.

 

[Lynjw]

Are our doctors really interested or concerned with our health and well-being.
You work this out after you read this absolutely truthful experience.
I slipped and SLID down a one metre high embankment, hurting or cracking one of my ribs.
The pain was getting worse so I was advised to go to casualty for a check.
Upon arrival, no one was interested in my rib/ribs. The first thing was do a RAT test ..OK let's do it.
I have NO symptoms, Temp is normal and NO headaches or any type of pain expect the rib cage.
After waiting from 5.30 pm until 2.30am the next morning for a bed to become available BECAUSE they said the RAT was positive. I asked to see the result but was treated like "DON'T DOUBT US JUST DO WHAT YOU ARE TOLD. amen"
Next the casualty Doctor came in to the casualty room, in an apparent hurry, picked up the chart and read it.
THEN he turned to me and said "Do you want to be resusitated?" what? he repeated Do you want to be resusitated?" I replied, "Doctor, you have signed a hypocratic oath and under oath you are obliged to keep me alive and well. Is that NOT true? .. He ignored me saying ..Do you know what day it is? Do you know what hospital this is? What is your Mother's maiden name? What Town is this? etc etc..
Well, I answered his questions AND he said "Do you have any questions for me?"
This doctor is Asian and so I said, " Firstly, what is your name? (He hadn't introduced himself) he replied, "Gabriel" and then I asked ..Gabriel Do you know what town the Hospital is situated in?"
He immediately turned to the door and said very clearly... I don't have to put up with this shit.
Then promptly departed through the door.
Never to be seen again by me.

Four days in hospital and the Queensland Premier called Isolation for Co Vid sufferers finished.
Now the four days in the ward I was treated like a Leper .. OK I was IF I HAD COVID .. Four times everyday
the nurses would take my temperature and when asked, would show me (36.8 everytime) Blood Pressure and heart beat were anywhere from 158/53 to 168/57 regular heart beat was from 51 to 56/7 constantly.
Well, I was released and given boxes of drugs for all sorts of things because ONE enzyme SEEMED to indicate that I had had a heart attack. Wait ! No symptoms of any sort to indicate a heart attack.
Possibly, I am already dead ??

OK Then the Bulk billing is dumped at my clinic who did Blood Tests, Urine Test etc.
Now according to the Doctors I have diabetes ... my accu tester says regularly 5.4 - 7.6 and my sister has told me NOT to test for a minimum of 2hrs after eating.
My Doctor has allowed me two appointments on bulk billing and says the next will cost $65 and a refund of some kind from medicare or medibank (whoever)
My last appointment was bulk-billed and I was informed of the results from the tests now the clinic is telling me that I am to make an appointment for my result .. WHY? This time it would cost me. So I asked for phone call appointment AND ANSWER IS NO .. They have texted me 3 times this week says that they have medical information to tell me about ..WHAT INFORMATION? No Answer to that question.
Well. I HAVE NO MONEY LEFT IN MY BUDGET TO COVER DOCTOR'S FEES and I have informed the clinic of this at least 6 times when I have previous visited or phoned the clinic.
I say IF THE INFORMATION IS IMPORTANT THEN PUT IT ON MY GOV RECORDS AND I WILL FIND A DOCTOR WHO DOES BULK BILL ..
It seem that they won't do that so if I die because of a lack of medical care by not telling me what is wrong with my health then THEY SHOULD BE CHARGED WITH MANSLAUGHTER. Also, with blackmail.

Man.. I am certianly irate BUT if I say that at the clinic desk they would probably call the police and heve me charge for aggressive behaviour .. so GOODBYE CRUEL WORLD.. maybe.
Ohh! Not one doctor has taken a look at my rib... and the pain has subsided unless I really breath in heavily.. What happened to the Queensland Casket System?

Appalling service. You should report it to the AMA.

 

[MHM]

while i do agree about the bulk billing should be way more, I also find that only get a 10-minute consult a script and walk out how much does it cost 10-minute consult?

A standard consult is $72 for 10 minutes. The Medicare rebate is $39. Allow for 3 consults per hour plus 15 minutes for the paperwork on the three consults, so Medicare pays $117 per hour and the practice receives $216. Most professional people obtain more than $216 per hour to cover their gross salary, practice overheads and a profit margin for the practice. Clearly $117 per hour is grossly understated and would result in general practices going broke very quickly. Specialist costs recoverable from Medicare are impacted even more.

 

[MHM]

$39 every 10 minutes doesn't sound that bad to me, that's how long a consult is, multiply that by 6, $234 an hour. I wouldn't mind that, I know they are very well educated people. It seems to me that Doctors have forgotten why they got into the Profession in the first place, was it to do good and help people. I also think if you have Private Health Insurance you should just claim it through them and not have to pay any out of pocket, you pay enough for PHI at least you should get that back. Heaven forbid you should get a benefit from you PHI.

I don't agree with you computation of the hourly consultation income obtained by general practitioners, but even if you are right in that calculation, you have to factor into account for the costs of office overheads and profit margin of the practice. $234 would leave very little to pay very well educated and skilled professionals a decent salary.
Most PHI doesn't cover general practitioner's fees.

 

[MHM]

People often make comments about how much a medical consultation cost them for a few minutes. But it's not as if that fee is going straight into the doctor's pocket. Doctors or owners of medical clinics have to pay taxes, rent, phone bills, staff wages, medical supplies, and other overheads. When I started working for a local GP in 1987, the Medicare rebate for a standard 10-minute consultation was $17.85. It is now $39.75. So, in 36 years, the Medicare rebate has gone up a mere $21.90. Even a fool can see that this does not reflect a realistic correlation between the rebates, the costs of doing business, and economic indicators such as the inflation rate, cost of living, average weekly earnings etc. A Medicare freeze was introduced in 2013 which has resulted in no increase in the rebate for many medical services, which have remained static for years. For some medical services, it persists to this day. And for some cases, the Medicare rebate has gone down, not up. The reality is that medical clinics cannot afford to continue to bulk-bill under these circumstances as all their costs continue to rise but Medicare rebates stagnate.

I am sorry to say it, but I agree completely with your response. The (Federal) government controls Medicare. It is up to the government to make funds available to a suitable level.

 

[Ozzy_ian]

we are on aged pension & my wife was referred to a specialist i Wollongong & he charged $250 over the normal costs per visit & he would just look at the computer & say it is Ok come again next month & if this is not a rip off I dont know what is so i just told her no to go again\

 

[MHM]

we are on aged pension & my wife was referred to a specialist i Wollongong & he charged $250 over the normal costs per visit & he would just look at the computer & say it is Ok come again next month & if this is not a rip off I dont know what is so i just told her no to go again\

Ricci, your situation is not unusual. Many doctors, both general practitioners and specialists have only one eye on their patient and the other on their profits. I don't blame you for suggesting that your wife not attend that specialist's practice again, but her health is paramount. I suggest that you go with her to her next consultation with her general practitioner, tell him/her what has happenned and ask him/her to help you by referring your wide to a specialist in the same field who does bulk bill to Medicare. Usually the gp will know who does and who doesn't.

 

[Rob44]

A standard consult is $72 for 10 minutes. The Medicare rebate is $39. Allow for 3 consults per hour plus 15 minutes for the paperwork on the three consults, so Medicare pays $117 per hour and the practice receives $216. Most professional people obtain more than $216 per hour to cover their gross salary, practice overheads and a profit margin for the practice. Clearly $117 per hour is grossly understated and would result in general practices going broke very quickly. Specialist costs recoverable from Medicare are impacted even more.

"Most professional people obtain more than $216 per hour to cover their gross salary,"

Since when do most professional people obtain more than $216 per hour to cover their gross salary and overheads?

 

[Ricci]

Ricci, your situation is not unusual. Many doctors, both general practitioners and specialists have only one eye on their patient and the other on their profits. I don't blame you for suggesting that your wife not attend that specialist's practice again, but her health is paramount. I suggest that you go with her to her next consultation with her general practitioner, tell him/her what has happenned and ask him/her to help you by referring your wide to a specialist in the same field who does bulk bill to Medicare. Usually the gp will know who does and who doesn't.

Um, I agree with your comments but I was not the poster you were replying to!

 

[MHM]

"Most professional people obtain more than $216 per hour to cover their gross salary,"

Since when do most professional people obtain more than $216 per hour to cover their gross salary and overheads?

For quite a long time. It is not unusual for lawyers to charge out at $500+ per hour, medical specialists $450+; financial advisors $ 400+; surveyors $300+; accountants $300+: consulting engineers $350+ and similar. Don't forget that these charges have to cover the professional person's gross salary, the professional practice's overheads and the practice's profit margin.

 

[Rob44]

How odd; seems that I should have charged a lot more than I did when providing a specialist consultancy.

 

[MHM]

How odd; seems that I should have charged a lot more than I did when providing a specialist consultancy.

Ricci, commercial wisdom, like any other always seems to be more enlightened in retrospect. I too, knowing what I do now, would have preferred to have charged much mor than I did. My pension funds would have been significantly healthier.

 

[Ducky2]

Here at the SDC, we’ve covered the increasing prevalence of GPs asking for gap payments to stay afloat. The Royal Australian College of General Practitioners (RACGP) warned of this trend for months. But now, with inflation soaring and a possible recession looming, more and more Aussies are feeling the pinch.

On Reddit, one user shared that their GP is no longer bulk-billing and asked if it is happening in other practices too. Based in Sydney’s Northern Beaches, they asked: ‘Is it part of the Great Rise of the Cost of Living?’

Many said it was happening in their areas, too. A Redditor commented: ‘It recently happened where I am, in the rural outskirts of Brisbane. From walk-in to $70 per appointment, and half back. It's going to make it really tough for some people. The government should be cutting a bunch before allowing this. Sport and club funding etc., while that's important, is not medical care-important.’

View attachment 10944
GPs are increasingly forced to turn away from bulk billing after years of consecutive losses. Credit: Karolina Grabowska/Pexels​

Another said: ‘Adelaide here – can’t find a single bulk billing doctor. I get they need to cover costs, but some people simply cannot afford to see a doctor now. It's not the Australia I know. Disappointing our government has let this happen.’

A third chimed in: ‘Same here, been with GP for ten years but just after Covid lockdowns in Melb, they don't bulk bill. Telephone consult is still bulk-billed, but sometimes I need face-to-face consult which will cost me $75 less Medicare.’

Another stayed with their usual GP but acknowledged that it’s hurting their wallet: ‘My doctor is no longer bulk billing. One of my children was diagnosed with a serious health issue that is lifelong and can take them at any time. I now face paying $150 plus weekly just to see the doctor for check-up or completely moving GPs. It just makes it difficult when our current GP knows the ins and outs.’ They continued: ‘I support Australian GPs and any medical professional, the government need to get their fingers out of their butts and fix the whole medical system and Medicare.’

While Redditors were concerned about the rising costs of healthcare, many sympathised with GPs.

‘I am not smart enough to be a doctor, I have no degree and three years of industry experience in software development. I earn about the same as a bulk billing GP and I interact with 0 sick people. Either prices go up or we won't have any GPs, said one user.’

Another shared: ‘I completely agree that GPs should be charging more. It's ridiculous to expect a fully qualified specialist GP to be getting a Medicare rate of $39 per consult which usually you get 60% of that back If you are an employee of the practice. [...] My dad's an electrician and charges 120 an hour.. standard male haircuts are at $40. Why should we expect a medical specialist to charge less?’

Australia is already facing a decade-long shortage of GPs, but with how things currently are, the country is not likely to meet the recommended number soon. Fewer medical graduates are interested in becoming GPs, with only one in eight entering the specialty, which is not enough to replace veteran doctors who will retire over the coming years.

A Redditor wrote: ‘Enrolment in GP speciality is down massively over the past five years (well below the level predicted we will need), as I don’t think most doctors either want to specialise in general practice or don’t see it as lucrative as other specialities, or both. All the GPs I know have side jobs within the medical profession in addition to their work as a GP, some for financial reasons, some so they vary their work schedule as they don’t find general practice interesting. I can’t help but feel that we will have a crisis within general practice within the next decade, and the idea of a bulk billing GP will cease to exist.’

A physician also shared the sentiment among their general practise colleagues: ‘I’m a doctor but working in a hospital, and my GP colleagues are really disillusioned at the moment. They are leaving in droves – and it’s also affected the GP-run urgent cares in rural towns.’

Many fear that the healthcare system is becoming Americanised. In the US, the healthcare system often leads to high deductibles and out-of-pocket costs, which are expensive even to citizens with insurance. Millions of Americans are one medical emergency away from financial ruin – healthcare costs are the number one reason for personal bankruptcy in the country.

One user commented: ‘As someone who lived in the United States for a good portion of time, including a bit with Covid, coming back and seeing the healthcare system in Australia is very scary, it’s almost Americanised. [...] This is a huge departure from just a couple of years ago. I know of some emergency departments charging upfront payments in Sydney as well for private ones. That’s another huge issue is the emergency departments wait times are blown out of control.’

Medicare figures show that the bulk-billing rate dropped to 83.4 per cent in the last quarter of 2022, compared to 88.4 per cent late last year. However, the RACGP says that the numbers refer to the percentage of bulk-billed services, not patients who found bulk-billing GPs. RACPG President Nicole Higgins says the real level is actually far more dire, closer to 66 per cent.

Commenters encouraged fellow Aussies to make their voices heard through their representatives: ‘Straight up, write a letter to your local federal MP. Medicare rebates for GP haven't increased in a decade. They can no longer afford to bulk bill and stay open.’

Another wrote: ‘Investing in primary care is the only way we will stop the increasing cost of healthcare for our country and the widening gap in those who can and can’t afford the health care they need. If you want universal healthcare to remain a thing in Australia, then call and write to your federal MP.’

If you’re interested in what doctors have to say on the matter, ABC recently interviewed Dr Sarah McLay, a GP in rural Queensland who is moving away from bulk billing after personally losing $200,000 in the last three years:

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Here at the SDC, we’ve covered the increasing prevalence of GPs asking for gap payments to stay afloat. The Royal Australian College of General Practitioners (RACGP) warned of this trend for months. But now, with inflation soaring and a possible recession looming, more and more Aussies are feeling the pinch.

On Reddit, one user shared that their GP is no longer bulk-billing and asked if it is happening in other practices too. Based in Sydney’s Northern Beaches, they asked: ‘Is it part of the Great Rise of the Cost of Living?’

Many said it was happening in their areas, too. A Redditor commented: ‘It recently happened where I am, in the rural outskirts of Brisbane. From walk-in to $70 per appointment, and half back. It's going to make it really tough for some people. The government should be cutting a bunch before allowing this. Sport and club funding etc., while that's important, is not medical care-important.’

View attachment 10944
GPs are increasingly forced to turn away from bulk billing after years of consecutive losses. Credit: Karolina Grabowska/Pexels​

Another said: ‘Adelaide here – can’t find a single bulk billing doctor. I get they need to cover costs, but some people simply cannot afford to see a doctor now. It's not the Australia I know. Disappointing our government has let this happen.’

A third chimed in: ‘Same here, been with GP for ten years but just after Covid lockdowns in Melb, they don't bulk bill. Telephone consult is still bulk-billed, but sometimes I need face-to-face consult which will cost me $75 less Medicare.’

Another stayed with their usual GP but acknowledged that it’s hurting their wallet: ‘My doctor is no longer bulk billing. One of my children was diagnosed with a serious health issue that is lifelong and can take them at any time. I now face paying $150 plus weekly just to see the doctor for check-up or completely moving GPs. It just makes it difficult when our current GP knows the ins and outs.’ They continued: ‘I support Australian GPs and any medical professional, the government need to get their fingers out of their butts and fix the whole medical system and Medicare.’

While Redditors were concerned about the rising costs of healthcare, many sympathised with GPs.

‘I am not smart enough to be a doctor, I have no degree and three years of industry experience in software development. I earn about the same as a bulk billing GP and I interact with 0 sick people. Either prices go up or we won't have any GPs, said one user.’

Another shared: ‘I completely agree that GPs should be charging more. It's ridiculous to expect a fully qualified specialist GP to be getting a Medicare rate of $39 per consult which usually you get 60% of that back If you are an employee of the practice. [...] My dad's an electrician and charges 120 an hour.. standard male haircuts are at $40. Why should we expect a medical specialist to charge less?’

Australia is already facing a decade-long shortage of GPs, but with how things currently are, the country is not likely to meet the recommended number soon. Fewer medical graduates are interested in becoming GPs, with only one in eight entering the specialty, which is not enough to replace veteran doctors who will retire over the coming years.

A Redditor wrote: ‘Enrolment in GP speciality is down massively over the past five years (well below the level predicted we will need), as I don’t think most doctors either want to specialise in general practice or don’t see it as lucrative as other specialities, or both. All the GPs I know have side jobs within the medical profession in addition to their work as a GP, some for financial reasons, some so they vary their work schedule as they don’t find general practice interesting. I can’t help but feel that we will have a crisis within general practice within the next decade, and the idea of a bulk billing GP will cease to exist.’

A physician also shared the sentiment among their general practise colleagues: ‘I’m a doctor but working in a hospital, and my GP colleagues are really disillusioned at the moment. They are leaving in droves – and it’s also affected the GP-run urgent cares in rural towns.’

Many fear that the healthcare system is becoming Americanised. In the US, the healthcare system often leads to high deductibles and out-of-pocket costs, which are expensive even to citizens with insurance. Millions of Americans are one medical emergency away from financial ruin – healthcare costs are the number one reason for personal bankruptcy in the country.

One user commented: ‘As someone who lived in the United States for a good portion of time, including a bit with Covid, coming back and seeing the healthcare system in Australia is very scary, it’s almost Americanised. [...] This is a huge departure from just a couple of years ago. I know of some emergency departments charging upfront payments in Sydney as well for private ones. That’s another huge issue is the emergency departments wait times are blown out of control.’

Medicare figures show that the bulk-billing rate dropped to 83.4 per cent in the last quarter of 2022, compared to 88.4 per cent late last year. However, the RACGP says that the numbers refer to the percentage of bulk-billed services, not patients who found bulk-billing GPs. RACPG President Nicole Higgins says the real level is actually far more dire, closer to 66 per cent.

Commenters encouraged fellow Aussies to make their voices heard through their representatives: ‘Straight up, write a letter to your local federal MP. Medicare rebates for GP haven't increased in a decade. They can no longer afford to bulk bill and stay open.’

Another wrote: ‘Investing in primary care is the only way we will stop the increasing cost of healthcare for our country and the widening gap in those who can and can’t afford the health care they need. If you want universal healthcare to remain a thing in Australia, then call and write to your federal MP.’

If you’re interested in what doctors have to say on the matter, ABC recently interviewed Dr Sarah McLay, a GP in rural Queensland who is moving away from bulk billing after personally losing $200,000 in the last three years:

​

I’m believe every person on pension and payments of any kind should also pay $1 per week towards Medicare the tax rate should go to 2 percent to save the Medicare system because the cost to everyone will be far worse if this doesn’t happen and emergency departments will all start charging they will have no choice. People will also stop their medications as they cannot afford a Drs visit. I believe there should be a referendum asking the people to vote for proactive solutions to this issue. Incidentally private health only covers in hospital treatment not the local GP or Specialist visits outside of the hospital so people how do we get this going ???

 

[Rob44]

We could ask Cuba to send some of their doctors here on a Medical Aid Project as they do for other 3rd -world countries.