Out of pocket: Dr Ralph Audehm at Dianella Community Health in Broadmeadows, Melbourne. He is likely to start charging his patients at least $5. Photo: Eddie Jim
The average upfront cost of a 15-minute consultation with a GP could exceed $100 within two years under the federal government’s proposed changes to Medicare, the Doctors Reform Society says.
The society, a lobby group that supports publicly funded universal health care, says the Abbott government’s plan to reduce the Medicare rebate for doctors by $5 and freeze it until 2018 is promoting a “return to a failed privatised system of the past” with doctors free to charge what the market will bear.
Society national president and GP Con Costa said extending the current two-year-long freeze on Medicare rebates for another four years would hit GP clinics’ budgets hard, driving many doctors away from bulk-billing and into increasing their fees for patients who do not have concession cards.
GP tax changes.
One GP said the changes would be devastating for the working poor and might stop them from seeking medical help.
In 2012, the former Labor government froze the Medicare rebate for a standard “Level B” consultation of up to 20 minutes at $37.05. The Australian Medical Association recommends GPs charge $75 for such consultations, meaning patients without concessions are usually out of pocket $37.95.
But Dr Costa said, given some doctors were already charging $80, it was likely some would be charging at least $100 by 2016.
Illustration: Matt Golding.
Under the government’s new proposal, if a doctor charges $100 up front, a non-concession patient would receive a rebate of $32.05, leaving them out of pocket $67.95.
“We’re predicting a rapid rise in the cost to see a family doctor,” Dr Costa said.
“Up until now, Medicare and high rates of bulk-billing have kept a lid on doctors’ fees and charges in general practice. Once you destroy this cost control, you basically open Pandora’s box.”
The Australian Medical Association has long complained that Medicare rebates for GPs’ work have not kept up with inflation and average weekly earnings. President Brian Owler last week said the increasing gap between rebates and the cost of running clinics would prompt some doctors to shift to more private billing.
At the moment, about 82 per cent of GP visits are bulk-billed. For patients who pay privately, the average out-of-pocket cost is $30.
The AMA estimates about a quarter of patients who are bulk-billed do not have concessions.
AMA Victorian branch president Tony Bartone said this group of patients were likely to face more “commercial fees” under the government’s new system, due to begin in July.
He said upfront fees of $80-$90 were likely by the end of 2016. “I think $100 would be at the absolute outside extreme,” he said.
Broadmeadows GP Dr Ralph Audehm said the government’s proposed changes would mean his clinic, which bulk-bills everyone regardless of their ability to pay, would have to start charging fees.
He predicted a fee of at least $5 to cover the “pay cut of about 18 per cent” for the care of people without a concession and the cost of restructuring the front desk to start taking payments.
Dr Audehm said his practice, which cares for many needy patients, was already bordering on being financially unviable, leaving it little choice.
He said the fees would be devastating for some of the “working poor” – people on low incomes who do not qualify for concessions. “It will probably stop them seeking medical care when they need it.”
The Australian Bureau of Statistics’ most recent survey found 5 per cent of patients who needed to see a GP delayed it or did not go because of the cost.
Dr Costa said rising GP fees would pave the way for health insurers to argue they can cover the growing gap fees. “This is about bringing the insurers in,” he said.
A spokesperson for federal Health Minister Peter Dutton said doctors were free to determine the value of their services, but were “encouraged to consider the personal circumstances of their patients when determining fees”.
The spokesperson said bulk-billing facilities were available to every doctor and that under the proposal there would be no change for patients with a concession.