SHARED CONCERNS: Last year local Dr John Bird told The Observer he believed the city was suffering from a decline in bulk-billing.
SHARED CONCERNS: Last year local Dr John Bird told The Observer he believed the city was suffering from a decline in bulk-billing. Julia Bartrim

'Rural practices will close': AMA's worry for bulk-billing

AN AUSTRALIAN Medical Association representative is worried the rebate amount afforded to bulk-billing doctors is too low.

Currently many doctors in Gladstone are taking advantage of regional bulk-billing incentives, particularly higher rebate rates for patients below age 16 and pension and health care card holders.

AMA Queensland Council general practice representative Dr Nick Yim said doctors in regional areas like Gladstone claimed more ($9.50) for pension and health care card holders than doctors in metropolitan areas did ($6.30).

However, Dr Yim said general practitioners who bulk-billed received $37.60 from Medicare for a standard consultation and he believes this rebate amount, which was frozen from 2013 to 2017, is not enough and may affect bulk-billing availability in future years.

"(It) goes nowhere near meeting the significantly higher electricity, telecommunications and other costs required to run a clinic," Dr Yim said.

"GPs need about $75 these days to cover the costs of a standard consultation. If the Medicare rebate had kept pace with yearly consumer price index since it was introduced ... (in) 1984, doctors would be receiving more than $90 for a standard GP consultation from the government.

"Despite this, many GPs continue to offer bulk-billing services to their patients because they know that many of them need it."

Last year, the Australian Government announced a gradual lifting of the five-year Medicare freeze as part of its 2017-18 budget but Dr Yim said the increase of 55c was negligible and "nowhere near" enough to make up for wage growth in most economies, let alone growing ones like Gladstone's.

"Whilst doctors, especially in regional and remote areas often accept the patient rebate as full payment as a result of recognition of the tight financial times rural folk are currently enduring, this is unsustainable from a practice viability point of view," Dr Yim said.

"Regional and rural practices will close and this will inconvenience patients who will have to travel further, wait longer for appointments, or pay more if the GP changes to private billing.

"They will clutter emergency departments for services GPs can easily provide."

Furthermore, in Gladstone there is a clear discrepancy between the availability of bulk-billing health care providers and mental health care providers.

Dr Yim said this was because patients wanting psychology services had an extra hurdle to cross because they needed to have a diagnosed mental health disorder to be eligible for a mental health care plan through Medicare.

"The discrepancy is due to a 'cap' that the government sets for psychology and other allied health visits."

Mental health care plans let patients access six, up to 10, rebateable psychology visits a year.