‘The decision by the government to freeze the Medicare rebate has been opposed by virtually every public health expert,’ says Doctors Reform Society’s Con Costa. Photograph: Tracey Nearmy/AAP
More than 30% of doctors say they will have to stop bulk billing all patients due to the Medicare rebate indexation freeze, a survey by a doctors’ group has warned.
The survey of 50 GPs in Sydney by the Doctors Reform Society also found more than half of those surveyed said they would increase their fees.
The society’s vice-president, Dr Con Costa, said “because of the cuts we’ve seen under this government, many doctors are telling us that they will stop bulk billing all patients”.
“Based on our survey, I predict patients will be paying a GP copayment of up to $39 – more than five times the Abbott GP copayment of $7,” he said.
“With fewer and fewer doctors bulk billing, we’re genuinely concerned that people are going to stop seeing their local GP because the cost will be too high.”
The Turnbull government has extended the freeze on indexation of Medicare rebates until 2020, which Labor has promised to unfreeze at a cost of $2.4bn over four years.
The Australian Medical Association (AMA) has warned the indexation freeze will increase patients’ out-of-pocket costs and undermine the bulk-billing system by forcing doctors to charge them.
Costa told Guardian Australia the survey finding 30% would consider dropping bulk billing for all patients “sounds dramatic but it’s not unrealistic”.
“We’re two years into the Medicare rebate indexation freeze and we’ve got four years coming,” he said.
“You see the cuts reflected in other statistics as well like the flu vaccination rates for the elderly, which are at 30%.”
Costa suggested doctors were keeping consultations as short as possible, “giving patients what they came for”, but not giving them important additional care like a vaccination.
Costa explained the estimate of a $39 co-payment was based on the fact the AMA’s recommended GP fee for a 15-minute consultation was $76, less the $37 patients would get back from Medicare. But fees would be much higher for consultations longer than 15 minutes or out of hours, he warned.
Costa said GPs could try to preserve bulk billing by charging some clients to cross-subsidise needy groups like pensioners but that created an incentive to give a lower standard of care to bulk-billed patients.
“The prime minister says he is not privatising Medicare,” he said. “Then what is he doing?”
Costa said having to charge more patients “is not Medicare, it’s not universal bulk billing, or being able to treat the neediest – it is getting back to a user-pays system, which is the final step to privatisation”.
The health minister, Sussan Ley, has said that Labor made $6bn in cuts to Medicare and medicines when last in government, and argued it had no way to pay for its promise to restore rebate indexation.
“In contrast, the Coalition will increase investment in Medicare by a guaranteed $4bn over four years,” she said.
“Under the Coalition, Medicare will never, ever be privatised. Medicare will never, ever be sold. Medicare is a core government service.
“It will always be delivered by the government and every element of Medicare’s activities will continue to be delivered by the government.”
Ley has boasted that bulk-billing rates are at 83%. The Royal Australian College of General Practitioners (RACGP) argues bulk-billing statistics are misleading because 83% of services, not patients, are bulk billed.
“The real figure is that only 55% of doctors bulk bill at least 80% of their patients,” Costa said.
“The decision by the government to freeze the Medicare rebate has been opposed by virtually every public health expert, including the RACGP, the AMA and the Doctors Reform Society.
“For the government to continue to deny the detrimental impact on Medicare of this policy brings into question their judgement.”