You’re not imagining it – it’s getting more expensive to see a doctor in Australia.
Charlotte Davis has visited the same doctor in Cannon Hill for over a decade.
This year, however, is the first time she has had to pay out-of-pocket costs for a standard consultation.
“I have a few chronic health conditions, so I end up seeing my doctor quite regularly, and my consultations have always been bulk billed,” Mrs Davis says.
“When I went to an appointment in January this year, my doctor apologised and said she’s going to have to start charging a gap fee because the Medicare payments simply aren’t enough to cover the cost of running her practice.
“It was a bit of a shock and is another expense I have to try and fit in… But I understood where she [the doctor] was coming from.”
Between January and April this year, the online health directory service, Cleanbill, gathered pricing and availability information from every GP clinic in Australia.
Only 35.1% of GP clinics offer full bulk billing for patients around the country.
Patients who are bulk billed do not pay any out-of-pocket costs for a consultation with a doctor. Instead, GPs directly bill the government through Medicare.
Cleanbill found the average out-of-pocket cost to see a GP is $41.69, with variability across all states and territories.
An analysis of the clinics listed as “bulk billing only” on the government health services finder Healthdirect database was conducted in March 2023.
Healthdirect requires all clinics to be responsible for updating their billing information and is not an exhaustive list of every service provider in Australia.
However, the data collected gives a general overview of the average amount of clinics offering bulk-billing services and the regions where bulk-billing is significantly low.
Click on the interactive map below to see the average percentage of bulk billing clinics around Australia.
Data was scraped from the Healthdirect website in March 2023
In the southern region of Tasmania, no bulk-billing clinics are listed. This data is consistent with findings from Cleanbill that on average only 6.9% of clinics in Tasmania offer bulk billed services.
The ACT has the lowest proportion of bulk billing with only 5.5% of GP practices listed as offering no patient out-of-pocket costs.
New South Wales is the state with the highest rate of bulk billing clinics with 49% of clinics offering the service, followed by the Northern Territory at 41%.
GPs have been raising the alarm for years
Senior Lecturer in General Practice at The University of Queensland, Dr David King, says the scarce availability of GPs who will bulk bill has long been a crisis in plain sight.
“GPs have been sounding the alarm for years,” Dr King says.
“The Medicare repayment rate that the government will pay a doctor for providing a consultation, has failed to cover the day-to-day costs of running a general practice for many years now.
“From the COVID pandemic and the growing more complex health conditions we’re seeing in the community now, it’s more important than ever to have a primary healthcare service that is easily accessible.
“There are thousands of Australians every year who delay or do not receive the appropriate healthcare services they need due to concerns about what it will cost.
“This is unacceptable and ultimately leads to increased stress on our public hospitals as patients end up there when they are unable to access appropriate primary healthcare in the community.”
“We want to be able to provide free and accessible services to the community, but we have to be able to pay our staff and keep the lights on too.”
The Medicare benefits schedule has long been criticised for failing to keep up with inflation in the healthcare sector over the years.
Royal Australian College of GPs president, Dr Nicole Higgins, says the current situation is compounded by the 10-year freeze on patient Medicare rebates introduced by the Coalition in 2014.
“GPs are paying more to cover the cost of their practices, staff, medical products and utilities, yet the amount paid by the government remains static,” Dr Higgins said.
“We want to be able to provide free and accessible services to the community, but we have to be able to pay our staff and keep the lights on too.”
What’s being done?
In February, the federal government released the Strengthening Medicare taskforce report.
The report recommended to deliver better care for people with chronic illnesses, GPs must work in a multidisciplinary, team-based care model with other healthcare professionals to provide coordinated and continuous patient care.
Adjunct associate professor from The University of Sydney’s Menzies Centre for Health Policy and Economics Dr Lesley Russell says the data illustrates just how the current Medicare system has strayed from the Whitlam government’s original vision for a universal healthcare system.
“Medicare is by design a system purpose-built to provide crucial medical care to all Australians,” she said.
“With the current state of the availability of bulk billing… It calls into question just how universal our healthcare system is if the cost of accessing it is increasing.
“There’s also the cohort of people who simply aren’t accessing care because they can’t afford it who we don’t have data on. There’s no baseline to know how many members of the community are foregoing care because of rising costs.”
“We’re long overdue for significant reform. Australians deserve better and improved quality of care."
General Practitioners and health care professionals are hoping there will be some relief in this year's federal budget.
The Australian Medical Association Queensland President, Maria Boulton, says healthcare costs in Australia are rising higher than the cost-of-living pressures and wage increases.
“The Labor party has come to the table and promised funding for better support for primary healthcare providers.
“We’re long overdue for significant reform. Australians deserve better and improved quality of care.
“A strengthened Medicare system is integral to providing universal and equitable health services for all Australians.”
