Starting November 1, patients may find it easier to access free general practitioner (GP) services as new government incentives aim to boost bulk-billing. This initiative represents a significant $7.9 billion investment in Medicare, designed to revive bulk-billing, which has declined since the pandemic began. However, participation in the program is not mandatory, and many doctors have indicated they will not enroll.

Currently, GPs receive a financial incentive for bulk-billing concession card holders and children under 16. For a standard appointment lasting between 6 to 19 minutes, the incentive is $21.85 for doctors in metropolitan areas, with higher amounts available in regional or remote locations. Under the new plan, GPs will receive this incentive for bulk-billing all patients, although it will not cover every service, meaning some patients may still face out-of-pocket fees for certain procedures.

Additionally, a new program will allow medical practices to register for further incentives. Clinics where every doctor bulk-bills all patients for eligible services will receive a 12.5 percent incentive payment on their Medicare earnings, distributed quarterly among clinics and doctors.

Patients can verify if their GP will be fully bulk-billing by checking the doctor's Healthdirect profile, which must be updated within 24 hours of signing up for the program. There are approximately 6,500 GP clinics across the country, with 1,600 currently fully bulk-billing. Another 1,000 mixed-billing practices have indicated they will transition to full bulk-billing starting tomorrow. ForHealth, the second-largest general practice provider in Australia, reports that 70 percent of its clinics will adopt bulk-billing. CEO Andrew Cohen noted that the incentives have made bulk-billing a viable business model again, stating, "We've already had patients cry at reception … just a lot of relief."

Ochre Health, another medical group, currently has 20 percent of its practices fully bulk-billing, but expects that number to rise to 50 percent. Co-founder Hamish Meldrum mentioned that the transition will be gradual, saying, "It will be a gradual thing … we won't land there on the first of November but I think we'll end up there."

Dr. Mark Fitzmaurice, who runs a medical center in Sydney, has bulk-billed every service for 24 years. He expressed concerns about rising operational costs but believes the new incentives will allow his clinic to continue bulk-billing. He urged other doctors to consider the program, emphasizing that patients suffer if clinics do not switch to bulk-billing. He stated, "I know it's complicated, so I spent hours doing the calculations … and it's the patients who really suffer if you don't swap over."

Conversely, some doctors remain skeptical about the incentives. Matthias and Lauren Ranaweera, owners of The Gympie Clinic in Queensland, argue that fully bulk-billing would result in significant financial losses for their practice. Ms. Ranaweera expressed concern about the potential impact on staff, stating, "If we lose that money it means losing a number of staff, so who would you like us to say goodbye to?"

Dr. Ranaweera criticized the government's valuation of GP services, saying, "It's not just seeing a patient and sorting out one problem — it's managing their health for the entirety of their life." He also noted that patients might expect bulk-billing as a standard, leading to confrontations with reception staff.

The Royal Australian College of GPs (RACGP) did not advocate for this policy, instead calling for higher rebates for longer appointments. President Michael Wright expressed caution, stating that many GPs are wary of becoming reliant on government funding decisions after years of underfunding. He noted, "For these GPs, this decision is fundamentally a trust issue, not just a financial one."

While the government anticipates an increase in bulk-billing rates following the new incentives, it acknowledges that widespread adoption may take up to four years. Estimates suggest that around 4,800 clinics could benefit financially from becoming fully bulk-billing, with approximately 3,600 practices expected to enroll in the first two years. Health Minister Mark Butler expressed confidence in achieving the goal of nine out of ten GP appointments being bulk-billed by 2030, stating, "I think general practices will start to see that the practice down the road or around the corner has moved to fully bulk-billing, and they take that more seriously themselves."