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:

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[Aussie all the Way]

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 ???

That's a really good idea BUT you try and get people to pay an a bit extra Tax even if it is for the betterment of the country they will categorically say NO, people are very greedy now days and only think of themselves. The GST should go up as well but thats a whole other subject that people will scream about. Trying to convince people that the only way to get things done is from Tax's etc is impossible, all they want is a drop in tax.

 

[Rob44]

That's a really good idea BUT you try and get people to pay an a bit extra Tax even if it is for the betterment of the country they will categorically say NO, people are very greedy now days and only think of themselves. The GST should go up as well but that's a whole other subject that people will scream about. Trying to convince people that the only way to get things done is from Tax's etc is impossible, all they want is a drop in tax.

Does anyone know what GPs are paid for an 8-hour working day? I don't; let's say $90 for a ten-minute consultation would work out at $360 per hour, allowing for paperwork and a breathing space. That is $2880 per day. Allow 50% going to practice costs. That comes down to $1440 per day or $7200 per week for 5 day week. Or $345,600 for a 48-week year. No doubt there are complications that might lessen that income, but those would be expenses and time off for courses/conferences etc travel for which would be tax deductible

 

[MotherGoose]

Does anyone know what GPs are paid for an 8-hour working day? I don't; let's say $90 for a ten-minute consultation would work out at $360 per hour, allowing for paperwork and a breathing space. That is $2880 per day. Allow 50% going to practice costs. That comes down to $1440 per day or $7200 per week for 5 day week. Or $345,600 for a 48-week year. No doubt there are complications that might lessen that income, but those would be expenses and time off for courses/conferences etc travel for which would be tax deductible

Pulling random figures out of the air doesn't prove your argument. Having run a medical practice I can assure you that, in reality, the costs of running one far exceeds the 50% that you have arbitrarily selected. Why do you think it is so rare to find solo medical practitioners these days?

 

[Rob44]

Pulling random figures out of the air doesn't prove your argument. Having run a medical practice I can assure you that, in reality, the costs of running one far exceeds the 50% that you have arbitrarily selected. Why do you think it is so rare to find solo medical practitioners these days?

Thanks for your limited information. In the light of a layman's ignorance of what GPs actually do receive as remuneration and what are practice-costs a simple layman can only pull figures out of the the air to make a simple guesstimate in the hope of simply learning something from a professional. The argument from the medical profession is that the Medicare rebate is inadequate to enable a GP to bulk bill, or even to reduce fees. Hence a GP's fees have risen to $90+. Which, given the significant amount now having to be paid in medical costs by the less well-off, and those living on the Old Aged Pension as sole income are not well off by any Australia yardstick, means that some financially vulnerable people are most certainly in the position of not being able to receive their needed medical services.

It would help us to argue with politicians as to the need to raise the Medicare levy if we actually understood what are practice costs and what the GPs' take-home pay really is. It is quite simple. No doubt various GPs will have differing costs/incomes but I am sure that that GPs' patients would be happy to assist whatever lobbying is going on in order to increase the Medicare levy.