Doctors' poll sounds death knell for bulk billing

The proportion of doctors who bulk bill all patients will fall from 18% today (down from 26% a year ago) to less than 4% in 12 months time.

Similarly, the proportion of doctors who do not bulk bill will rise from 12% today (up from 6% a year ago) to 19% over the next year.

More than 60% of doctors will reduce the number of patients that are bulk billed.

The poll covered AMA members, non-members, city doctors and rural doctors.

The President of the AMA, Dr Kerryn Phelps, said today the strength of the response and the clarity of the message from GPs across the country must be heeded by the Health Minister, Dr Michael Wooldridge.

"We have been telling the Minister for months now that the majority of doctors see implementation of the RVS as the key to their future in general practice and the key to the long term future of Australia's health system - but he won't listen," Dr Phelps said.

"The decline of bulk billing is a symptom of a greater malaise in the health system. GPs have had enough and are telling the AMA that they want the Medicare Benefits Schedule (MBS) to reflect the value of their professional care."

The AMA poll shows that 17.5% of GPs are currently bulk billing all patients, whereas 26.3% of these doctors were bulk billing all patients a year ago.

If the RVS is not implemented, just 3.9% of GPs will be bulk billing all patients in 12 months time.

Of the 771 respondents to the poll, 734 - or 95.2% - said they supported adjustment of the Medicare Benefits Schedule (MBS) to fully reflect the RVS fee for service outcome.

When asked if they preferred to support implementation of the RVS by an extension of blended payments subsidy programs, just 5.8% said 'yes'.

When asked which group they supported in taking the leading role in lobbying and negotiations with the Government over GP financing, 78.3% of doctors chose the AMA, with informal votes coming second with 10.5%.

"This poll reflects the message we have been getting for some time via phone calls, e-mail and letters from concerned doctors all over the country," Dr Phelps said.

"The great majority of doctors support the AMA's call for full implementation of the RVS.

"Doctors will stop bulk billing if the RVS is not implemented, and this will lead to larger gap payments for patients.

"Doctors and their patients want Medicare to survive. The RVS will revive Medicare.

"It is time Dr Wooldridge started taking notice of the hard-working doctors in the suburbs, the country towns and the crowded and under-funded public hospitals, and stopped taking advice from the handful of advisers who are out of touch with the strong feelings of doctors and patients in the community," Dr Phelps said.

The RVS is a six-year joint AMA/Government study of the Medicare Benefits Schedule (MBS), which was backed by both Labor and the Coalition parties. The MBS has not been comprehensively reviewed for nearly 30 years.

Dr Phelps said a lot of change to clinical practice has occurred in that time.

"And a lot of change to the costs of running a medical practice has occurred in that time," Dr Phelps said.

"Unless the Government acts and acts now on the RVS, universal health care under Medicare will be a thing of the past.

"Doctors will no longer be able to afford to stay in practice.

"A 15-minute GP consultation is currently valued at around $27.00. A bulk billing doctor receives only $22.95 under Medicare.

"Our independent modelling of the RVS shows that the real value is at least $44.00.

"No wonder, then, that doctors are shifting away from bulk billing in droves.

"If the MBS is not revised, doctors will simply have to turn away from Medicare, the Government insurer," Dr Phelps said.

CONTACT: John Flannery (02) 6270 5477 / (0419) 494 761