Bulk-billing rates for Medicare have remained stagnant, according to newly released data. The rates, which indicate the percentage of patients who do not pay out-of-pocket fees for general practitioner (GP) services, are currently at 77.6%. This figure is unchanged from the same period last year, despite significant government investment in the program.

The data covers the quarter from July to September 2023. During this time, the number of GP services provided has decreased by approximately 10,000 per day compared to the previous year. Additionally, the average out-of-pocket cost for patients has risen by about $4, bringing it to $50.49.

Shadow Health Minister Anne Ruston expressed concern over the implications of these figures for the healthcare system. "Despite a huge amount of investment here, we have seen very little change in any of the rates, which means we know that people are avoiding seeing the doctor because they can't afford to do so," she said. Ruston highlighted that the decline in daily visits could lead to worsening health conditions for many individuals. "That's 10,000 [services for] people that will potentially become sicker before they seek healthcare, and we already know that our hospital emergency departments are under incredible pressure."

In response, Health Minister Mark Butler stated that he anticipates an increase in bulk-billing rates due to the introduction of a new Bulk Billing Incentive this month. "Already over 1,000 mixed billing clinics have indicated they will switch their practice to fully bulk-billed," Butler noted. He added that this change would complement the 1,600 GP practices that are already fully bulk-billing, resulting in over 2,600 practices expected to adopt this model nationwide.

The federal government has committed $3.5 billion to enhance incentives for doctors to provide services without charging patients. While this funding has helped stabilize bulk-billing rates, they remain significantly lower than pre-COVID levels. The current rate of 77.9% reflects only a slight improvement of 1.7% since the tripled incentive began in November 2022. This is still far below the peak of 89.2% during the pandemic and the pre-COVID rate of 85.2%.

The government has pledged to raise bulk-billing rates to approximately 90% by 2030, at an estimated cost of $7.9 billion. However, both the Coalition and the Royal Australian College of General Practitioners (RACGP) have expressed skepticism about the feasibility of this goal.

Ruston emphasized the need for affordable access to healthcare, stating, "We've seen out-of-pocket costs continue to grow, and the department tells us they are only going to get more expensive into the future." She criticized the government for misleading the public about the costs associated with visiting a doctor.

Conversely, the RACGP pointed to recent data from the Australian Bureau of Statistics, which indicated a decrease in the percentage of patients reporting that cost was a barrier to seeing a GP, dropping from 8.8% to 7.7%.

The latest Medicare data will be the final report before the new Bulk Billing Incentive begins to show its effects. However, health department officials have warned that patients may not see immediate benefits, as it could take up to four years for GPs to adjust their business models. They also cautioned that average out-of-pocket costs for patients not covered by bulk-billing may continue to rise, as some GPs may charge higher fees.

The Department of Health's annual report acknowledged that the target of over 90% of Australians accessing Medicare Benefits Schedule services was not met. The report stated, "The decline in bulk-billing rates and rise in out-of-pocket costs, coupled with increasing cost-of-living pressures, has resulted in a barrier for some patients when trying to access the care they need." However, it expressed optimism that performance against the target would improve as bulk-billing rates stabilize and increase.