We are just trying to look after our patients and keep our small business alive
As General Practice owners and Contract doctors in a private general practice in Toowoomba, we would like to collectively clarify some of the issues around Medicare and billing.
You have probably noticed the commentary in the media about the move away from bulk billing in general practice. Perhaps you have been surprised by an increased out-of-pocket cost to see your GP.
General Practices are small private businesses, just like your local independent retailer, freelance artist or tradie, and are not funded by the government (very different to the State based public hospital system). General Practices are funded by a percentage of the fees paid by patients.
The fee you pay to see an independent doctor working within a private General Practice business is how the doctor earns their money. A portion of this fee is paid to the business, and this pays for all the administrative services and costs involved with running the premises.
Medicare does not pay GPs – Medicare pays you back some “insurance” money after you pay your doctor or health care costs. The government determines your Medicare rebate and how much help they want you to receive to pay your health bills.
From 2013-2018, the government froze your Medicare rebate to see a GP, and since then, the annual increase has been well below the consumer price index (CPI). Another way to look at the cost differences is this: Since 2010 the cost to run a General Practice business has increased 39% whereas the Medicare rebate has only increased by 12.28%. For all other non-medical costs, CPI is now at a high of 7.3%.
This year the government paid you a slight 1.6 percent increase in your Medicare rebate, (for example, for a Standard consultation the Medicare rebate has gone from $39.10 to $39.75). Over these years, GPs have been absorbing the difference and slowly watching the profession erode under strain.
Your Medicare rebate for a standard consult between 6 and 19 minutes currently stands at $39.75. This amount must cover room rental, administrative and nursing services, medical consumables, compulsory medicolegal insurance, income tax, mandatory professional development and all other overheads, with a small amount left for the doctor to live off and the business to survive.
The vast majority of GPs get no leave entitlements whatsoever. No annual, sick, maternity, compassionate or long service leave. If they are sick at home – no income. Having a baby – no income. Caring for a loved one – no income. When a patient doesn’t show up for their appointment – no income, yet many costs continue.
Please understand that the Medicare rebate is your payment from the government to help you pay for your healthcare. When you’re bulk billed, you provide consent to redirect your rebate to your GP as payment for their service. The GP simply misses out on the difference between the government’s payment to you and the actual cost of your healthcare, which is more than double your rebate amount. Every time your GP bulk bills your consult, they take more than a 50 per cent pay cut to what the Australian Medical Association (AMA) recommends they should charge (AMA currently recommends $86.00 for a standard consultation; our fees are $83.00 for a standard consultation). The GP absorbs this and has been doing so for years. But unfortunately, it’s slowly destroying their profession and ability to continue to work as a GP.
GPs need to charge a gap fee. Bulk billing is no longer sustainable for general practices in Australia. Gap fees are now essential for practices to survive. GPs are at breaking point, and it can’t go on.
There is then a further burden of the decrease in medical graduates taking up the career of GP, particularly in regional Australia.
In the 1980s, about 40 per cent of graduates chose general practice; this is now down to 9 per cent. The Royal Australian College of General Practitioners (RACGP) has reported that there are 10 new non-GP specialists to every one new GP.
Our GPs and practice teams see patients every day who are unhappy about the cost of their GP visit. We understand this frustration.
The best thing you can do to safeguard affordable healthcare is to direct that heat towards the government to increase your Medicare rebate. We urge you to contact your local member and lobby for improved health care benefits.
GPs are not Medicare-funded employees. We’re small business owners just trying to keep patients healthy and our businesses alive.
The owners of GPs on Curzon – Dr Diana Sampson, Dr Rachael Gray, Dr Jess Madsen.
Acknowledgement to: The owners of Busby Medical Practice, Russell Street Medical Centre, Loxley House Family Practice and George Street Medical Practice