Bulk billing figures show more investment needed

The small increase in Queensland’s bulk billing rate since changes to Medicare last November highlights the urgent need for more investment in primary care and general practice.

Early data released by the Australian Government shows the bulk billing rate in Queensland increased by 2.2 per cent in late 2023, following the tripling of the incentives for children and Commonwealth concession card holders who are bulk billed.

“We welcome any investment in health, particularly primary care, and we recognise the tripling of the incentive has made some difference but more is needed to reverse the decades of underfunding for patients to have access to their GP,” AMA Queensland President Dr Maria Boulton said.

“We said when this was announced that it would be of most benefit in regional and remote areas where the incentive payment is $10 or $20 higher than in metropolitan areas.

“It may have helped some practices that were preparing to stop bulk billing to continue for longer, and it may have enabled some practices to return to bulk billing some patients.

“But as we predicted, it has made little difference, particularly in metropolitan areas, as practices continue to be faced with charging patients a fee or closing their doors.

“The most vulnerable patients appear to have benefited the most, with a 3.1 per cent increase in bulk billing rates for people aged over 65 years.

“Even a small increase in bulk billing rates, particularly for vulnerable patients, is welcome and means more of those patients are finding it cheaper to see their GP.

“These changes have not had an impact on Australians who are not eligible for the incentives.

“Every Australian should have access to free quality healthcare. Hospital care – the most expensive form of healthcare – is free but primary care, which prevents illness and complications from chronic disease and is the most cost-effective, is not.

“GPs help patients stay healthy and out of hospital. They are the first port of call for most patients who suffer from mental health issues. They may be the only health service in rural areas and provide additional essential care such as maternity services, emergency treatment and anaesthetics.

“The current Medicare patient rebates barely cover half of the cost of providing that care, leaving GPs to subsidise their patients and become economically unviable, or charge them a fee.

“Why do governments have the view that patients can get the most expensive public hospital care for free, but they have to pay for the preventative care that helps to keep them out of hospital in the first place?

“What we need is sustained and increased investment to attract more doctors into general practice, including workforce incentives and funding to help graduates train to be GPs.

“We need a workforce strategy to ensure shortages in other primary care health professions (nurses, allied health), which are worse in rural areas, are also addressed.

“Medicare rebates for all patients also need to increase so everyone can cover the cost of their health care, no matter their age or where they live. We will continue to advocate for greater investment in our health system from all levels of government.”

Background:

• The bulk billing incentive is a small incentive provided to doctors who bulk bill patients from vulnerable groups. Not all services are eligible for the bulk billing incentive. They are different to patient Medicare rebates.
• The increased incentive ranges from $20 in metropolitan areas to $40 in very remote areas.
• Nationally, the bulk billing rate increased by just 1.4 per cent in metropolitan areas and by 0.9 per cent in very remote areas.
• According to Government figures, across Queensland the bulk billing rate increased from 73.6 per cent in October 2023 to 75.8 per cent in December 2023.