Medical practitioners are calling on the government to reform Medicare's current funding model, claiming that the system poses a threat to bulk billing and other GP services which could subsequently make quality health care inaccessible in the country.

It was said that in many cases, GPs were forced to adjust the cost of their labour just to keep their services accessible to many Australians who are in need of medical support.

Royal Australian College of GPs president Dr Karen Price said that GPs are being forced to make sacrifices just to keep their services affordable.

“If this keeps going, we’re going to have a two-tier health system,” she said.

Medical practitioners said that the outdated Medicare funding system should be reformed to keep up with the changing times. Credit: news.com.au.​

Dr Price disclosed that the current Medicare rebate is just $39.10 for 20 minutes of a doctor’s time.

She explained that the low rebate rates have prompted many GPs to reduce their bulk billing hours out of concern for the sustainability of their businesses.

Dr Price quipped: “The Medicare rebate has not kept pace with the costs of running a practice in terms of staffing costs, equipment and so forth.”

“Up until now, many of us have been subsidising the gap ourselves, particularly for vulnerable patients.”

The Australian Medical Association (AMA) is also campaigning for the reforms, emphasising that Medicare's funding system should keep up with the current times.

It should be noted that the current model was launched in the 80s and has not been changed since.

AMA president Dr Omar Khorshid urged the government to recognise the struggles that Australian GPs experience to provide quality health care to people.

He said: “Doctors working in general practice have been forced time and time again to wear the brunt of these real cuts to Medicare.”

“The health care needs of patients have become much more complex as the population has aged, yet Medicare is stuck in the 1980s.”

Medical practitioners also claimed that patients who are seeking long-term care may not benefit much from Medicare due to its inadequate funding.

Dr Price explained: “Vulnerable patients, in particular, have often long and complex medical conditions, often multiple medical conditions.”

“The Medicare rebate is really only designed for acute, high-volume care, so detailed holistic care is not well supported by Medicare.”

This means that pensioners who are in need of long-term health support will be adversely affected if Medicare does not reform its model.

The current Medicare funding is inadequate to support Australians who are in need of long-term care, the experts said. Credit: NCA Newswire/Christian Gilles.​

Experts also revealed that while the government claims that bulk billing levels are at a record high, their analysis showed that the claim was a case of data misrepresentation.

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.

Dr Price said: “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.”

Additionally, the figures released by the government only accounted for the bulk billing "activities" rather than "per patient" records.

“So our numbers and the Productivity Commission’s numbers are somewhere around 67-70 per cent or so of people are bulk billed,” she said.

Dr Price also disclosed that the general practice industry is facing a shortage as many medical school graduates opt to go into hospital practice.

It was said that only 15 per cent of the graduates choose general practice due to financial uncertainty as opposed to hospital practice where they could get a more sustainable stream of income.

“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,” she said.

The shortage means that health care could become inaccessible in rural and remote and outer suburban areas.

What are your thoughts on this? Is it high time for the government to reform Medicare? Share your thoughts with us in the comments below.

 

[leanneh]

It is absolutely ridiculous that Medicare hasn't been reviewed since the 80s. Our population has aged considerably since then. Medicare is already failing those of us living in aged care facilities. The Medicare rebate to GPs to attend residents is so low we are expected to pay a very high Gap fee. Obviously this applies to the majority of residents who are no longer able to attend the surgery.

 

[Capsam]

There is a subtle but very real change in access to medical care after one reaches 70. I am grateful that my G P bulk bills but access to specialist care takes months of waiting. Often it ends up as a Telehealth call & a “wait & see” approach to treatment based on a “ risk or benefit”. As I said recently to a specialist, “So we will review in a year by which time this growth may have become cancerous & spread? You will then maybe tell me at the next appointment that it has spread too far to treat?” Treatment, even for complex health issues should not be determined by age. If I were rich & could afford private treatment, my operation would have happened immediately & my age would have been irrelevant in that circumstance.

 

[Coro]

I have just discovered the largest medical centre in my area will stop bulk billing at the end of this month. A standard appointment will now cost $90. I suspect there will be many others following the same path unless there can be some changes.

 

[Ricci]

My GP is a 30 min drive (on a good day) away but the practice does bulk bill for all pensioners. There are closer doctors but none of them bulk bill and I can't afford the $100 plus costs. Unfortunately none of the specialists I see bulk bill so it is nothing for me to spend 2 and 300 dollars some months on seeing them. Just one of my medications which is not on the pbs cost me $400 per month, the rest averages out to about $80 per month. Getting old is no joke but when you have to juggle finances to try to stay healthy it stinks.

 

[Liz]

It is not only GP's not bulk billing, it is such services as MRI's for knees, I had a fall recently and only found out when sent to have a MRI, there is no rebate on knee MRI's if you are over 50 from Medicare. What aren't older people supposed to have any falls. My GP practice did a ring around to find the cheapest company in the wide area and the costs ranged from $190 (without contrast) to over $600. Is it no wonder people are not getting treatment for injuries or rocking up to public hospitals and clogging an already crowded system. When sent to the Orthop I paid nearly $300 out of pocket to see him. Sometimes with older people it comes down to, do you feed yourself or do you pay the medical profession. I am extremely blessed to have a fabulous GP but she told me recently she would have to charge for visits on the weekend, luckily I try and see her during the week to be bulk billed but I am sure it is coming to a stage where this will end as well. Either that or as I a finding in an aging practice the GP's are retiring. So where do you go?