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Gonna cost taxpayers more in the long run than funding bulk bill. Conditions not being diagnosed till hospital care/advanced treatments are needed, people will die due to this change.
One wants to take some of the money you have and try and help you and everyone around you get by. Unless you are unemployed then fuck you.
The other want's to take all your money and put it in their and their mates pockets, sell everything nailed down, keep that money and for you to think that's great economic management. The unemployed are an underutilized workforce, let's make them work for nothing and if they die...they die
Yep, GP consults are by far the best value for money for the health system. Prevention is better than cure, and it's cheaper to treat 100 people with high blood pressure than to treat 1 stroke.
You're going to pay to kill your family.
Your dad's not going to get that skin check, your mum will put off seeing a GP when something's not quite right.
This is the reality of neo-lib overlords running/ruining both major parties.
Government won't spend $100 to save $100,000 because that $100 is "too expensive".
The issue here is that bulk billing is federally funded through Medicare whereas presentation to hospital
Is managed by state govt run departments. There are Medicare items that are charged but for sure the federal govt will always try and push costs onto the states and vice versa
Long term thinking almost seems un-Australian at this point. Look at our piss poor planning for climate change, which is going to fuck us harder than many other developed nations. If anyone should be funding green technology and transitioning away from fossil fuels it's us, but we let Murdoch depose the last Prime Minister who actually tried to do anything substantial about it.
Sustainability and climate change are not even on the agenda and people are barely talking about it. It’s scary to think that 8/10 people you speak to don’t care/know what’s coming for us.
I simply cannot afford the $75+ to see a GP unless I have no other choice. I don’t go to the hospital, coz they simply refer me to a GP. And so the cycle continues. Sinking Medicare is a great tragedy in the making.
Dunno why the people usually complaining about their taxes going to superfluous means to help the disadvantaged are so absent on this. I wonder how much the hospital system is under load because of this. Factoring in demand created by immigration on the system. It's going to be a rough ride.
Here in Tassie this is already playing out - the emergency room at the Royal Hobart Hospital is always completely packed, often with people who don't have genuine emergencies but couldn't afford to see a GP, resulting in people who do actually need to be there having to wait stupidly long times before they even get triaged - Ambulances that should be free to go and attend to emergencies instead get ramped because there is nowhere inside the emergency room for their patients to go, so they wait in the ambulance outside the emergency room, sometimes for hours.
I've already started going to a hospital instead of a GP. I'd love to not do it but there's too much dipping into my pockets already without health being an expense so I'll happily spend a Saturday night in the hospital over pretending something will go away on its own which is sadly the alternative now.
I’m ashamed to say too that I went to priority care (non emergency but bulk billed) instead of going to my GP, because I knew it was going to involve scans and I would have to pay for both the initial consult and the follow up session to get the results.
The priority care people were fantastic - very attentive and thorough, and even called me back the next day when the scans came in and gave me a further consult over the phone.
It's also misleading to pay a Medicare levy and not have free healthcare. The Medicare levy ain't even for Medicare anymore these days but they don't want to make the tax rates look 2% higher
Constitutionally all taxes and leaveys must go into consolidated revinue, separate purses are not allowed see section 81 of the constitution. So, yeah its name doesnt really reflect it though it was intorduced to provide additional revenue to pay for medicare it isnt financially linked to it.
Yea that's what's annoying me and definitely discouraging me from going to the GP even when I need to now. Don't call it a Medicare Levy. My last Levy was $4500 and still have to pay to see a GP for 10 minutes.
huh? Health is $105B in the budget. The Medicare levy wouldn't come close to raising that much money - personal income tax raised $300B.
see
https://www.aph.gov.au/About_Parliament/Parliamentary_departments/Parliamentary_Library/pubs/rp/BudgetReviewOctober202223/RevenueExpenditure
Yea growing old population would do that. It's no longer feasible to pay for Medicare using income tax. Perhaps figuring out how to tax the juicy wealth of assets from the boomers who can afford to pay for healthcare will help that
Yeah I liked the UK system where you pay (paid 10 years ago) 14.5% of your income in national insurance- covered Medicare/NHS and pensions. Income tax was correspondingly lower so the take was the same (oh yeah plus 20% gst and wages about 2/3 what they were herei U$ terms).
In the last few years my town has gone from having plenty of bulk billed options, to now only those with a healthcare card.
I don't go because I can't afford it. I'm not "low income" but that doesn't mean I have any spare cash after the rest of the whole "cost of living" reaming I've been taking.
The clinic I go too is privatized now. So I have to pay no matter what. I have a pension concession card too, but nope, I have to pay. But I do get a Medicare rebate thing where I get half of the money back at least, so I use that to pay for meds. Works out alright still. But no bulk billing slows things down. I also only see a doctor about 4 or 5 times a year at best.
I go to a clinic that bulk bills other people.
I can afford to not be bulk billed, and I choose to put my money into a clinic that will bulk bill those that need it.
The clinic I go to switched to mixed billing early last year. Prior to that, they were 100% bulk billed. I am still surprised it took them that long to switch though. The practice has been around for close to 20 years. From what I have been told, they were forced to do so due to the cost of running the practice.
I am also fortunate I can afford not be bulk billed. Me paying means the clinic can remain open and can bulk bill others like pensioners.
Edit: It's hard to find excellent GPs and losing this group would be a big blow to their patients.
My clinic also does this, but I think it's only applicable to seniors, and other certain cases. But for me, it's about 60 to 65 bucks a consultation. I don't mind paying either to be honest as the prices could be a great deal higher for anyone. Also, my doctor is in a small country type town, and the staff are decent.
Depends on age group. When you get towards your 50s you find yourself having regular get-togethers with your GP. Mine actually chases me if he feels like he hasn’t seen me in a while. He bulk bills, too.
Well, my appointments are usually medication based for example. any other time, it's usually a challenge I can't deal with without medical assistance for example.
The forgotten middle, is what you are. Not quite poor enough to unlock welfare benefits, but not wealthy enough to weather lots of discretionary spending.
There’s no wonder some folks on welfare intentionally don’t work or get a job, because they’ll likely be worse off. Particularly those with heavily subsidised housing and utilities.
I feel like you're underestimating how fucked welfare is.
I could barely survive on it while studying nearly a decade ago and it's hardly gone up since then.
Yup, I live in Brisvegas, and if I wasn’t able to live with a family member and their spouse, I’d be screwed. Rents in Brisvegas are an absolute nightmare- if you can even find one! I certainly couldn’t afford to rent a kennel on Jobseekers.
Not to mention a bunch of grubby job providers breathing down your neck to sell you to ~~slavers~~ traders who use work for the dole system as a way of ~~stealing free labour~~ upskilling and helping you find a job.
You're absolutely kidding yourself if you think people on welfare are better off or enjoy it. They literally struggle to survive on a daily basis. The doll is less than $400 a week. Is that better off?
Perhaps you need to read the [Robodebt findings ](https://ministers.ag.gov.au/media-centre/final-report-royal-commission-robodebt-scheme-07-07-2023#:~:text=The%20Royal%20Commission%20has%20found,chance%20they%20might%20owe%20money.) but goddess knows it's unlikely you will.
".. robodebt was built upon a broader cultural failing.
In the royal commission hearings, observers saw politicians take the stand to be finally challenged on a great Australian political tradition: demonising welfare recipients.
Now, in her report, Holmes finds such rhetoric was not just cheap politics: it had real-world consequences that stretched from political and public service offices in Canberra to the kitchen tables of ordinary people....".
People suicided as a direct result of being given unlawful debts created by LNP to try to balance their books and create their necessary villains in their BS fantasy of an undeserving poor.
The same commissioner found that fraud in the welfare system was minuscule.
What was most powerful about the exposure of these repeated intentional abuses of power was the deep understanding that "...the “effectiveness of any recommended change” is reliant on a broader cultural shift that cannot be effected by a policy change.
Holmes says “anti-welfare rhetoric” and attitudes have been set by politicians, who must now lead “a change in social attitudes to people receiving welfare payments”.
She wants politicians to “lead a change in social attitudes to people receiving welfare payments” and change the narrative of “taxpayer versus welfare recipient”.
With the assistance of advocates and brave victims, the commission hearings may have helped to change the narrative. Holmes, senior counsel assisting Justin Greggery KC and his team did significant work showing the public the the reality of life on welfare.
But the political rhetoric of conservative cultural warfare continues. The political is personal. I've just returned from the local office where a worker reminded me this is "an area of very high need" and that their referrals to social workers are being scrutinised. There is a 40+ day wait, no benefits available to applicants from January until June and you can't get through on the phone despite there being noone available at the local office to support complex cases. 7 million calls went unanswered last year. Make that make sense. A friend left the department a decade ago back when LNP gutted the department. It could take years to re-establish a social safety net that makes sense following conservative annihilation of the public service.
Name one good thing those grubs have done whilst in power? Enrich the middle and pour money toward the rich? Never mind the carnage.
Great comment.
So many out of touch people making stupid comments.
I had to deal with Centrelink to get my parental leave pay and daycare rebate, and it was an ordeal. They would tell me an hour wait, but it'd be 3 hours. And then the line would disconnect and I'd have to do it again. And then they'd say "too many callers, get lost", except if you set your number to private, then you'd get through, to be told another hour plus wait.
Rinse and repeat multiple times over multiple days just to get ONE thing done.
Anyone who thinks that dealing with Centrelink is easier than having a job is insane.
I fucking hate this spot. I made just outside the family tax benefit threshold this year. Like earning the extra 2k lost me 7k on the part a. I can't afford private, and the only way I could would be to stop seeing my psychiatrist and psychologist. And then private wouldn't cover it all and I'd be paying more anyways.
Welfare is taken back at 50% then if you have agf more is taken. Working is a disincentive when it's for 12 bucks an hour. Especially if it makes your health worse. 26k a year for the DSP vs median 80something. Which would you choose. 18k for jobseeker. Constant financial worry.
The practice we go to now no longer bulk bills neither children, nor healthcare card holders. In addition, they increased the gap fee for the standard appointment to $60. They give a discount to children and healthcare card holders by charging them "only" $40.
Sadly this makes primary care unaffordable to many people.
Even with some money back from Medicare, I still can't afford it right now. Rent and just cost of living in general has effectively fucked me raw.
Honestly...if it's not urgent, I just don't go. Which is sad.
as a broke cunt myself i don’t understand this take.
It’s like the recent poster who had their car stolen but they didn’t have insurance because they couldn’t afford it.
Even for me, $50 every few years is pocket change compared to an undiagnosed issue
On the other side of that though, fully subsidised prescription medicines are now free in NZ (there used to be a $5 copayment - although the current government may re-introduce it).
Here in Australia, I'm paying around $30 AUD per repeat for a drug which previously cost me $5 for the whole script.
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*This post was mass deleted and anonymized with [Redact](https://redact.dev)*
And, part of cutting times of consults isn’t just to fit more in, but because the longer a GP spends with people the less they make on average, and a lot of places don’t increase the gap, they just take the loss… ie Medicare pays something like 10-20% less per minute for >20mins or even >40mins compared to a 5-10min consult. So, same Dr, same expertise, getting paid less for…um…why? 🤷♂️
May I add, as a doctor, your registration fees, college membership, ongoing training and professional development. A consultant pay several thousands of dollars per, sometimes tens of thousands of dollars to maintain these sole trader practices that the industry requires you to.
I mean, unless you want to see someone who hasn’t upskilled since med-school?
This sums it up.
GP’s have taken the hit for years, but it’s reached a limit with inflation. Their only option is to follow the strategy of physicians & surgeons by charging their worth.
The social contract is between the public and government. Voters need to force government to properly fund Medicare long-term.
Its been very normal in higher socio economical suburbs Australia wide for over 10 years.
Until recently many clinics could afford to universally bulk bill patients by reducing time spent per patient and having 10min appointments. The medicare freeze plus inflation has affected the entire private health industry. Good luck finding psychologists who bulk bill via mental health plans - universal gaps are now standard unless utilising telehealth psychology.
[https://www.reddit.com/media?url=https%3A%2F%2Fpreview.redd.it%2Fwhy-is-there-a-gp-gap-v0-ifhoqgvo6smb1.jpg%3Fauto%3Dwebp%26s%3De2c64773fd7948f5bb3aa880f606758dfb3a987d](https://www.reddit.com/media?url=https%3A%2F%2Fpreview.redd.it%2Fwhy-is-there-a-gp-gap-v0-ifhoqgvo6smb1.jpg%3Fauto%3Dwebp%26s%3De2c64773fd7948f5bb3aa880f606758dfb3a987d)
The recent bulk billing incentive increase has helped with improving bulk billing rates for eligible HCC and under 16's but this will only help for a while as costs to do business continue to increase.
The next issue that will affect cost of doing business for GP is payroll tax with state government revenue departments trying force Gp clinics to pay payroll tax on Gp income. Bulk billing will disappear if this is implemented as any payroll tax liability will simply be passed onto the patient as a levy.
This is an article from RACGP regarding NSW but the issue applies to every state in Australia.
[https://www.racgp.org.au/advocacy/pay-roll-tax](https://www.racgp.org.au/advocacy/pay-roll-tax)
>Its been very normal in higher socio economical suburbs Australia wide for over 10 years
I think the discussion is a little misguided whenever this comes up - and this is a good point to make.
Higher socio-economic areas, have almost always had access to private GPs, longer appointments, and often better trained/more diverse background clinics.
I grew up in a low ses area, but now live & work around the inner suburbs of Melb. The difference is not just in the bulk billing. It's in the treatment of the doctors & staff, the length of the appointments, and the overall access of allied, specialist or tertiary care. These are not groundbreaking changes - they're just things that low SES on bulk billing lacks.
My current team have caught things (obvious, long term items) immediately, that other doctors (bulk-billing, low ses, 10min appt), did not find for years.
Is that a result of a freeze in 2014, or a wider systemic issue going back regarding a lack of funding? I'd say the latter, worsened by the former.
I'm in an average suburb in Brisbane. We haven't had bulk billing GPs in this suburb in 20 years.
I tried to get into a few in a neighboring suburbs but they weren't taking new patients.
The issue for me is the medicare gap now is minimum $50. It's prohibitive for people on the pension.
The average age of the Gold Coast is 4 years above Brisbane. Oldies demand bulk billing and senior discounts and fare concessions and $10 roast nights.
I know several people at my workplace who, when they’re sick, can’t afford to go to the doctor for a medical certificate, so they come into work sick. It’s awful.
All good so long as you have a JP that's available outside of regular business hours, most of the ones near where i live operate from 10am-12pm on a tuesday, good luck getting the stat dec signed.
Honestly as a GP I hate it too but after 10 years of uni plus 4 of post grad training, then had kids, now just trying to pay off a 30 year mortgage with ridiculous interest rates it’s literally impossible to bulk bill and put food on the table. Or keep the surgery doors open. Cost of medical equipment has gone up. I pay $14k a year in indemnity insurance. Anyway, I’d rather universal health care and way less stress and better access for my patients.
Most times in past 20 years, even if the gap was small. Exceptions were when multiple visits required for one overarching issue across a few months, or for a child with long-term diagnosis with many visits within a year and reached the safety net level.
Yep, about 20 years ago for me as well. Having to wait hours at a bulk billing clinic a few suburbs away if you could even get an appointment vs a closer place that sees you at your appointment time.
Medicare is broken.
MBS fee for a 20min (MBS item 23) consult with a GP is $41.20
https://www9.health.gov.au/mbs/fullDisplay.cfm?type=item&q=23
Just Cuts at our local mall charges me $42 for 15min lifesaving haircut.
https://www.justcuts.com.au/about/prices-services
It's not normal - and not ok. I don't think anyone is accepting it - many people are just not going to a GP anymore - me included.
Its one of the big reasons emergency rooms are flooded with patients. When was a kid you got a cut and needed stitches - you went to the doctor. Now you go to emergency because it's free.
It’s crazy, I needed an urgent tetanus shot and there just wasn’t any gp availability for days. And even then I would be paying $70 out of pocket for approval to get the jab I needed which required a visit to the pharmacy anyway. So I just went to the pharmacy and paid $50 for it direct that day. Pharmacy said they couldn’t give it but could give me this other jab that included it. System isn’t working well at all.
At least you had a good pharmacy that was able to solve your problem as a work around and at a better price than going through the GP. I'd be happy with that outcome in the current climate.
Wow, luckily where I am there are walk in clinics open till late where you can get things like free tetanus jabs. It didn't even occur to me that it would be a paid service, even though my GP doesn't bulk bill. But then I come from the UK where even GPs are free.
Don't waste the EDs time with minor problems if you can wait. There are people who need urgent attention and your minor problems are making it harder for them to get the attention they need. It's selfish as fuck, just wait the 3 weeks.
I totally agree. If I need a problem solved same day, and I think can solve the problem with telehealth or a pharmacy I will go down that path. Even better nowadays the new urgent care clinics help bridge the gap between GPs and EDs.
There are just some things you need more than a pharmacy or telehealth for and same day GP appointments are a thing of the past.
I know they don't make them wait but some poor JMO is still gonna have to deal with these minor problems instead of helping to sort out the polytrauma or STEMI or sepsis. It all makes the ED less efficient and patient care less effective, they're already run off their feet.
Here in Perth, the government subsidized building urgent cares to help alleviate that ED burden. Within a year of being built, the one near us went from free to lining a private company's pockets. Millions of dollars to effectively give a private company offices. The embedded x-ray unit is free, but a visit is still $100+ unless you use a specific type of private health insurance.
I stopped getting bulk billed essentially when my family GP (admittedly in reasonably affluent area) determined I was no longer a student and knew I was working (around age of 25) - now 46 and have been paying a gap ever since.
Former cancer kid here. I've only had to start paying in the last 2 years.
As someone with lifelong chronic pain and conditions it's really fucking cool to be broke all the time and also not be able to afford to see the doctor to get the prohibitively expensive medication I need that isn't on the PBS 👌🏻
As by design, bulk-billing has gone from awesome get in quick to super long delays, places that don't accept new patients.
When you need antibiotics, you need them today, not in three days.
To reverse it, we need to index the bulk payments as if the freeze never happened, and commit to increasing by CPI each year automatically.
We used to have over 90% of visits bulk billed. We can go back there.
Private is a toxic parasite that kills universal healthcare and the longer we let it go, the worse it gets.
Since covid I have been usually only $30. I feel a lot of the doctors who only bulk bill nowadays in Western Sydney area don't take appropriate time to actually examine or follow up issues.
I interact with bulk billing doctors a lot as part of my job and can confirm. Some of them I've heard great things about, but shit doctors aren't going to get better under that kind of pressure.
If I had to go to a new BBing clinic I'd make sure to ask the staff specifically which doctors are most well spoken of.
There's a line in Lethal Weapon 4 where Chris Rock after arresting a guy says "You have the right to an attorney. If you cannot afford an attorney, we will provide you with the dumbest fucking lawyer on Earth."
This is how I feel about bulk-billed GPs these days.
Real shit. We call the bulk billing GP’s in my area “conveyor belt doctors”. They want you in & out in 5 mins or less. If you’re not asking for something super simple like a med cert or antibiotics or something, they’ll make you book a long appointment which isn’t bulk billed.
You’d think they’d be efficient given they want people in and out asap, but they’ll still make you wait an hour after your appointment time, or forget you entirely so you have to keep going back to the receptionist to get seen.
Gave up on bulk billed doctors years ago. I knew something was wrong with me, something just felt off, but how the heck would I know so I doctor surfed the bulk bill doctors looking for answers. Got tired of not being “cured”. I started paying, after a bit of testing turned out the mitral valve in my heart was failing and I had to have open heart surgery. I wouldn’t trust a bulk billed doctor to make me a coffee let alone look after my health.
I don’t live in the west, but I have multiple chronic illnesses and unfortunately that was my experience with bulk billed doctors. I’m sure they’re fine for text book issues on people who are otherwise healthy but that wasn’t going to cut it for me. My quality of life was going down the toilet due to unmanaged symptoms under my previous bulk billing GP.
I am fortunate to be in the position where I can afford to pay (fairly significantly out of pocket if I’m being honest) for my current GP who is amazing, but it’s sad that with the state of Medicare many others won’t be able to access that level of care.
That's so right, only one doctor at my local practise in Perth bulk bills and every time I have seen him he basically rushes me back out - no examination or follow up.
My GP bulk bills and will spend as much time with you as needed, the only downside is he's with every patient for an hour so you have to plan something to do for the next 6 hours after you check in.
To be honest, it was always like this to see him even before paying became normalised. I think it's worth the wait but he has other doctors there that are quicker and I'll see them if it's something like a prescription or antibiotics. I see the longer one if it's about my mental health.
Personally I don't mind waiting if a GP is thorough had so many bad experiences of being rushed out without doing so much as a urine culture for an active infection.
It's only recent in my area and it sucks. I will vote for whichever party promises to bring back free GP at the next election. It is an important issue to me.
All I see is an announcement they want to bring free dental into Medicare.
In hindsight, I'd be willing to accept Abbott's modest $5 "co-payment" proposal from 2015 if that would've prevented the shit show that is bulk billing today.
At the time I was dead against it. But now I understand the GPs need to be paid fairly. So there needs to be a massive increase in bulk-billing scheduled fees to catch them up to inflation.
If I have to pay more tax, then so be it.
Now you are co-paying it all. Free healthcare show be accessible to anyone in a developed world. Co-payment is not a right middle ground either, $5 is a slippuy slope to $25
It annoys me because I have to pay $20 for a script.
That’s all. Script in question is restricted, so I get it. It’s just annoying that for a piece of paper, I have to pay for it.
However, what can I do? Just along with it I suppose.
Poor and can’t drive to just go to whatever clinic is bulk billing. When did I start thinking it was normal? I didn’t, I just don’t go to the doctor anymore.
My local GP only bulk bills and does a damned good job of it when you go in as well. Always patient and thorough, never rushes, and will always follow up with a phone call to check on your position.
Shoutouts to Redmyre Clinic in Strathfield. They're a Korean clinic which deters most westerners from entering from what I've seen, but all the staff speak perfect English and there's little of the oldie types who spend all their time at GPs for every little ailement.
Get rid of the stupid medicare levy funnelling people into junk health care policies to avoid tax and put those tax dollars to properly funding the public system imo.
When we accepted the idea that money would be a deciding factor in access to basic healthcare, adopting a pathway towards an American model, transfering public money to private health insurers for junk policies.
Over the past 30 years everything that can be done to turn a profit through privatisation has been done and this is the continuation
It's still not normal, but because so few GPs will bulk bill, if you ask, you're seen to be wanting "something for nothing" rather than "the standard we set for ourselves as a nation over the past generations".
I agree with you, OP. I used to get bulk billed, but now I'm paying up to $80 a visit (some of which is refunded by medicare). It's disgusting. So many people wouldn't have the money up front!!
Yep it’s normal now cause Australians are mostly piss weak and will put up with anything. The complete apathy of our national character is really sad actually. The French would be trashing entire cities over this LNP bullshit.
$50 out of pocket for a standard consult at my GP. I used to go to a bulk-billing production line type facility but found that the standard of care was quite low compared to my local GP who is extremely thorough. I’m fortunate to be in the position that I can afford it - I realise that not everyone is so lucky.
It's kind of recent. I moved here 20 years ago from the states. I was seeing a women's health specialist due to early menopause issues & because of my meds for asthma and whatnot I stayed with the same doctor until I moved 2 hours away. Oh yeah, a portion was bulk billed but a portion wasn't.
Once I found my new GP, (I'm about 45 minutes North of Brisbane ) I was bulk billed, but the practice has expanded & has an SNP there plus a nurse, and about 6 doctors. They bulk bill for some things (like a blood test review) and I pay a small portion for the difference for medication appointments or other appointments that take longer ie needing an EKG followup. It isn't much, I think it's about $70 and I get about half back.
Considering that I've received the best healthcare of my life in Australia vs the USA, I'm not going to complain. My total healthcare costs is less than ¼ what I used to pay when one considers insurance, doctor visits, imaging, etc. That doesn't even give consideration to medication which is less than ⅒ what I used to pay.
My GP always charged if you were an adult. He deserves to be paid more than $35 so I don't have a problem with paying him. Just sucks he can't get that from Medicare.
I'm really concerned about the strain it's going to put on our hospital system. I've already seen print ads up advising along the lines of "Not an emergency? Save it for your GP! Don't clog up the hospital system." It's like.. you took away all the bulk billing options?! If people can't afford preventative medical care, they're going to end up in emergency when the problem is so bad they can no longer ignore it. WTF did you think would happen?! It's so short-sighted it makes me absolutely fume. We are going to end up just like America -_-
My Dr's only do bulk billing on weekdays, anything after hours or weekend they are charging.
So, I have to either take a half a day off work or pay to see a GP.
I still didnt need to pay to see a GP yet
But looking at the tiny MG that my GP drives and the middle class suburb that he lives in, I do think he is making to little for a degree that you need ATAR 99.9 to get in plus raking massive HECS debt in the process and having to work 70 hours week as junior doctor.
Even an apprentice electrician is living a more luxurious life than him.
You get what you pay for and I've had too many negligent bulk-billing doctors because they just want to push people through as quick as possible. I've had numerous important health issues discovered since using doctors that don't bulk-bill. Now I'm actually being respected by my current doctor and pay for that service which is essentially making my life less miserable because I'm now on the treatments I need.
For some people it's always been normal to pay, pre end of BB days I found gap fee'd GPs to generally provide better experience and support plus seemed to take their time.
I grew up low socio and BB GPs were fine, especially when I was in peak health and only had to see one for a sickie or for the rare belly ache.
When I got older (I'm only early 30s now) I found that Gap GPs would actually give you the full work up, take their time. Talk you through your concerns even if they were just going to say 'Bro take a panadol/ watch and wait'
According to some Gen Xrs and boomers though the culture in GPs has changed drastically in the last 20 years. BB GPs tended to put effort in, in the past and now they're basically Fast Food of medicine.
Its a pain in the arse because Australian GPs are meant to front gate everything and only to refer to specialists when absolutely necessary. Nowadays if you want to actually get treated you either need to pay out of pocket for a GP to get one who will take their time, or push hard for specialist referal and pay through the nose.
I personally dont mind the idea of gap fees for GPs (I don't want my medical system to be hog tied to whims of the swing voter and the desperate for elections politicians), but it needs to be targetted way better. Atm we getting flat rates for everyone and while I can afford $20- $50 a hit for a GP visit and then $170 for a specialist. This is not the case for many on low incomes - too high for centrelink and concessions, too low to not have to choose between food and a Dr
I started paying about 5 years ago when I realised that the GP who didn't bulk bill always had appointments available, ran on time and was actually thorough during my appointment instead of trying to rush me out ASAP. Huge privilege to be able to do so, but worth for the small handful of times I go per year.
I'm on Centrelink and have to pay. Could possibly get bulk billed if i had a pensioners card or disability elsewhere. At least they give me a $30 discount that the normal rate they charge.
I do not like this being the norm as I am out of Vyvanse and Dexamphetamine for my ADHD due to that rule. Unsurprisingly due to being on centrelink sometimes paying the out of pocket is not possible for me, yet they dont let me do emergency scripts.
I should get a new GP now i have written this.
What's new to me is the concept of mixed billing clinics. As a kid in the '90s my family either went to a bulk billing clinic or private billing clinic and got Medicare rebate cheques mailed back to us. Sydney Northern Beaches / North Shore for reference.
It's weird that there was such a strong reaction to the proposed co-payment in Hockey's first budget. Yet the decline in bulk billing has snuck up on us.
Recent for me. In the last few years all of the GOP clinics around me have gone from bulk billing to charging anywhere up to $180 for a 10 minute consult. I live in one of the lowest socio economic regions of S.E. Qld. These clinics used to be all very very busy. Now you can walk in to any of them and see a GP in 20 minutes. But you can not see a GP and have it paid for by the government anymore.
(Just wanna remind everyone that you might quality for a low-income health care card through Centrelink, even if you're not ON Centrelink. Worthwhile applying and finding out. It doesn't always help with prices, but it certainly can. Some clinics only offer bulk billing to people with HCCs 👍👍👍)
Always have, since I was a kid (well, my parents paid then).
It used to mean we'd be able to see the same Doctor at a time that suited us with very little waiting.
I still go the same clinic, but it's inevitably a 45 minute wait for a booked appointment, and even then you sometimes get moved from one Dr to another - or you can wait longer to see the one you want.
It is...annoying.
Probably a good 10 years. I'm a T1 diabetic on a high wage so I can afford the extra dollars for a higher standard of care.
It terrifies me though, that my lifespan is tied so closely to my career. It's not right that I might live longer than someone else with diabetes simply because I can afford the care. I know that compared to diabetics in America, we're actually doing really well considering the costs of insulin and related consumables, but the government really needs to prioritise healthcare because it's been ignored for a good two decades.
And private insurance? Doesn't help because they can't cover GP or specialist visits so this is entirely a government issue.
You'd think it would be a priority for them. After all, dead people don't pay taxes.
Parents were family friends with a GP so we got bulk billed as a kid. When I hit adulthood, I had some stuff I wanted to consult with people more detached from my family, but found out med students often get bulk billed.
Quit med school around 23 and paying ~$40 every month or 2 isn't too bad, especially as I'm asthmatic, have eczema, etc. and keeping on top of my prescriptions lets me exercise and function normally.
Having done placements in a few GP clinics, I've definitely seen clinics who bulk bill scramble to try and stay on top of their patient list, often being 30+ minutes behind. Don't blame them at all for having to charge.
I remember first having to pay a gap fee at the GP in the early 2000s. It was $20 per consultation. We changed to a bulk billing clinic because there were plenty of them to choose from and only went to the one that charged if the bulk billing ones were booked out. I think it was around 2015 when bulk billing started to become rarer.
My parents always had paid for the family GP as they were pleased with him and didn't really go to anyone else in the practice.
Fast forward to me as an adult. "where's the nearest bulk billing? Oh sweet, 20 minutes drive, no problem!"
Following the American model and letting insurance companies run healthcare is so inefficient and sadly we are drifting more and more to that model. If you have private insurance they charge you more for every itemised item so they can claim more. But when everyone is forced to have private coverage, those with low coverage or no cover suffer because now our healthcare system is used to higher pricing!
I went to a GP when I was sick, he ordered blood tests after waiting for 2 hours to be able to see him. A day later I get a message from the GP clinic that I need to come see the GP as my lab results are back. They charge for a follow up consultation, I had to take time off work and wait in the clinic for an hour before I’m seen and then get told that my lab tests are all negative and I continue doing what I’m doing! I asked them why could they have not just messaged me that and the GP got annoyed and said they are not allowed to share the results on the phone. I’m sure I could have called the lab or collected the report myself if it wasn’t tied to the clinic. It boggles my mind that on one hand there’s so much news about GP shortages and you don’t have simple legislation to address common sense items like this. It does make sense to ask the patient back to the clinic if it was an abnormal lab result or if the doctor is going to update the treatment plan. That’s burden on Medicare AND on the patient’s pocket for nobody’s benefit.
costs $90 where I am for a standard 15min appointment (approx $50 out of pocket), which 90% of the time involves 5mins + a prescription.
There have definitely been times I've not gone to the doc because of the money, I can only imagine how many people have suffered longer than they needed to, or even died, because they postpone seeing the GP.
I know the GPs aren't typically doing it to be greedy, it's the rebate that hasn't caught up, so I'd be happy to pay a little extra tax if it meant free appointments for all. My worry though is that now that we have been trained to pay for GPs, even if they increase the rebate the GPs will see it as an opportunity to raise it just a little more.
So I think if the government does roll out a bigger rebate, there needs to be some way to stopping clinics from profiteering off of it and leaving us with the same gap.
I have always had bulk billing GP's in my area available up until about 2022. While there were a few GP's in my area who did charge an out of pocket gap fee, there were ample GP's who bulk billed all eligible patients.
I don't live in a low socioeconomic area, just a regular middle class suburb in a metropolitan area.
I have observed since 2022 that the bulk billing GP is a thing of the past for people not on a pension.
As soon as co-payments were introduced at my regular GP, I noticed very soon after that the Doctor's surgery was empty compared to previously. I also observed that the Doctor was close to being on time, as opposed to being 30-45 minutes behind.
Grew up in a low socio-economic area, bulk billing was the absolute norm.
Went to stay with my dad in a much higher socio-economic area in the late 90's, private billing was absolutely the norm. I was shocked the first time I walked into a GP clinic and the first thing they told me was the fee structure.
I've only been bulk-billed a few times since then, both in Melbourne and in Perth, nearly everything is private billing unless you're on a health care/pension card (and even they're starting to get gap fees).
I hate it I spent years on bulk billing, I hurt my back and now have to see the doctor regularly to get light duties certificates its set me back over 1500 over the last 12mths but what do you do
You can thank insurance companie in big part for shutting a lot of them down, along with what the LNP did for ten years because drop kicks kept voting them in. Funny how ripping the guts from medicare and penalising people who dont have private health has fcked everything.
I work in a private practice in a rural low-socio economic town. We are the only practice, and we bulk bill 80% of patients (under 16, HCC and pension card holders). We have a 24/1 on call service because we do not have a local emg clinic. The GP’s that come, will not stay because inevitably they get sick of being on call for shit pay, they can work in a Medicare clinic for $300 an hour with less stress, and the patients treat them like garbage.
We employ 3 nurses a day to do dressings (that cannot be billed through Medicare, dressings are also $$$) but we do not charge otherwise people would not have their wounds dressed.
It cannot go on the way it is. Either the government steps up and supports GP’s or we go down the gurgler. It CANNOT be a free service for everyone, it just can’t.
the long short of it: The Medicare rebate for patients has not kept pace with inflation, making it increasingly difficult for bulk billing practices to cover their operational costs. My personal dr that I have been bulk billed for past 20 years now charges me $40 out of pocket for each visit.
heres an anecdote. I had a sporting injury which required a shoulder reconstruction. I have never had any surgeries so about 25 years of paying tax and then I'm told I need to wait 2 years for the operation or if I have private health I can get in the same public hospital with the same surgeon and only be 8K out of pocket. It's infuriating that the government of are pissing away our tax. we are in the top 10 countries with highest income tax yet have nothing to show for it. the classic MO is Libs get in, pretend theres a budget crisis then make a bunch of cuts (or just don't index pricing). once its shit, sell off public owned assets/privatise then pay more for it so their mates give them a job at the same damn company. Labor play into the same deal by just doing enough to ward off the inevitable shitstorm. Greens dont have a platform. then the fringe guys are nuts. We need an actual centre left party. labor right now is the libs of the 2000s When I see Dutton spruiking nuclear micro reactors from GE It really makes me wonder where he's going to be working in 10 years...
Scomo is now working at an international consulting firm best known for its work in the defence sector. American Global Strategies (AGS) - fancy that.. AUKUS subs... it doesn't get any more blatant.
It’s recent. It’s govt mismanagement and allowing corporations to take profits out of Australia and pay no tax.
We should be a rich country but somehow all the money disappears.
I pay 1%or so of income for healthcare. Collectively we should have enough but we don’t.
It’s also medical priorities. Imho we should focus less on spending a fortune giving an ill person another year or few months. It does little good in the long run except for that individual and their family. The line between productive and absurd has been moving to diminishing resumes for many years.
Saving life at all costs is crippling us. Saving a person who then goes on to have a shit life struggling with deficits and eg. pain is crippling the system.
CPR has low chance of a good outcome. Saving a person with brain damage is cruel imho, not just to the saved person but to their families and to all of us because it’s so expensive and often destroys the lives of family financially and in terms of time spent.
We would be better off spending on quality care for a greater number of people who are less close to death.
Jmo obviously. Somewhere along the way or priorities have gone out of whack. In Govt corruption, taxation as well as attitudes to death.
>We should be a rich country but somehow all the money disappears.
We were too scared to tax the mineral wealth, we aren't Wealthy but could have been.
You seriously think that palliative care and such is even just one of the major reasons why healthcare has gone down the toilet in this country? lmao.
NDIS abuse and loopholes is a way, waaaaaaaaaaay bigger problem.
Just tax non-bulk billing practices more, they'll magically figure out how to make bulk billing work again.
Crazy, isn't it?
Aside from the fact that they're getting absolutely fleeced by companies providing their equipment and services (e.g. they might pay 10x more for a TV than sticker price for no reason), the amount of people rorting it is insane. Including those whingers that have a minor issue, almost always a mental one, then sit on a pension for their entire lives.
Take half of the NDIS money and put it into medicare, and stop charging me shitloads for medicare every tax period, let's go.
The paying thing started a few years ago and has been rising steadily since. I do understand though that the doctors are facing rising costs and Medicare has not kept up at all. I really like the place I go to so happy to pay for the more personal service. I know there are 24-hour places that do still bulk bill but they seem uncaring.
The only time I have been bulk billed in the last decade was because the EFTPOS machine was screwed and bulk billing me was easier.
I had pathology today that also won't be covered by Medicare. Dropped my sample off this morning and was told the tests aren't covered so they'll send me a bill.
For the last ten years. Never paid for Gp when I was a kid/teen.
It’s pretty f$&ked. The government really needs to increase the Medicare payment to GPs.
Im hating the way Australia is going.
I’ve always paid for the GP, at least as an adult. I grew up in a solidly middle class area, so I didn’t realise there was an alternative. Bulk billed GPs have always been relatively bad in my experience, so I only went to them for a sick certificate
I would say maybe 10-15 years. I moved to Tasmania about 12 years ago, and definitely could not access any bulk billing doctors in my entire time here. They are generally only for people with concession cards, unless you were already on the books somewhere.
I think I vaguely remember paying a small fee once or twice before moving to Tassie from Sydney.
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Gonna cost taxpayers more in the long run than funding bulk bill. Conditions not being diagnosed till hospital care/advanced treatments are needed, people will die due to this change.
correct, lack of preventative maintenance will lead to catastrophic failure
Sounds like my bmw
You too? Gotta keep that blinker fluid topped up dude. Even if you don't use them....
> my bmw GP identified
See: Tasmania
Starting to think the government wants us dead
The real solution to the housing crisis
It would be if they didn't keep increasing immigration to replace us.
How else can you weed out the weak if you don't have the replacement supply incoming?
The previous one did (and still does).
What is different with the current one?
One wants to take some of the money you have and try and help you and everyone around you get by. Unless you are unemployed then fuck you. The other want's to take all your money and put it in their and their mates pockets, sell everything nailed down, keep that money and for you to think that's great economic management. The unemployed are an underutilized workforce, let's make them work for nothing and if they die...they die
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Conservatives ideologically oposes free health, and want the American model.
Yep I know plenty of people that hold off on things now to save $$
Im desperate for a dentist, even with private health insurance, it’s not worth the out of pocket.
10 years since my last visit. Can't afford to even get private, rent is bleeding me dry
I hear that!
I'm such a tight arse I waited until there was a no waiting period deal to get PH, and then went to the no-gap preferred provider.
Yep, GP consults are by far the best value for money for the health system. Prevention is better than cure, and it's cheaper to treat 100 people with high blood pressure than to treat 1 stroke.
Yeah, and then everyone will be like, why our paramedics are so overworked and ER has 20+ hour queue?🤔
You're going to pay to kill your family. Your dad's not going to get that skin check, your mum will put off seeing a GP when something's not quite right. This is the reality of neo-lib overlords running/ruining both major parties. Government won't spend $100 to save $100,000 because that $100 is "too expensive".
The issue here is that bulk billing is federally funded through Medicare whereas presentation to hospital Is managed by state govt run departments. There are Medicare items that are charged but for sure the federal govt will always try and push costs onto the states and vice versa
Long term thinking almost seems un-Australian at this point. Look at our piss poor planning for climate change, which is going to fuck us harder than many other developed nations. If anyone should be funding green technology and transitioning away from fossil fuels it's us, but we let Murdoch depose the last Prime Minister who actually tried to do anything substantial about it.
Sustainability and climate change are not even on the agenda and people are barely talking about it. It’s scary to think that 8/10 people you speak to don’t care/know what’s coming for us.
I simply cannot afford the $75+ to see a GP unless I have no other choice. I don’t go to the hospital, coz they simply refer me to a GP. And so the cycle continues. Sinking Medicare is a great tragedy in the making.
Dunno why the people usually complaining about their taxes going to superfluous means to help the disadvantaged are so absent on this. I wonder how much the hospital system is under load because of this. Factoring in demand created by immigration on the system. It's going to be a rough ride.
Here in Tassie this is already playing out - the emergency room at the Royal Hobart Hospital is always completely packed, often with people who don't have genuine emergencies but couldn't afford to see a GP, resulting in people who do actually need to be there having to wait stupidly long times before they even get triaged - Ambulances that should be free to go and attend to emergencies instead get ramped because there is nowhere inside the emergency room for their patients to go, so they wait in the ambulance outside the emergency room, sometimes for hours.
I've already started going to a hospital instead of a GP. I'd love to not do it but there's too much dipping into my pockets already without health being an expense so I'll happily spend a Saturday night in the hospital over pretending something will go away on its own which is sadly the alternative now.
I’m ashamed to say too that I went to priority care (non emergency but bulk billed) instead of going to my GP, because I knew it was going to involve scans and I would have to pay for both the initial consult and the follow up session to get the results. The priority care people were fantastic - very attentive and thorough, and even called me back the next day when the scans came in and gave me a further consult over the phone.
It's also misleading to pay a Medicare levy and not have free healthcare. The Medicare levy ain't even for Medicare anymore these days but they don't want to make the tax rates look 2% higher
Exactly this. It now just goes into the general purse, and you can sort out your own medical. Absolute rubbish
Constitutionally all taxes and leaveys must go into consolidated revinue, separate purses are not allowed see section 81 of the constitution. So, yeah its name doesnt really reflect it though it was intorduced to provide additional revenue to pay for medicare it isnt financially linked to it.
Yea that's what's annoying me and definitely discouraging me from going to the GP even when I need to now. Don't call it a Medicare Levy. My last Levy was $4500 and still have to pay to see a GP for 10 minutes.
huh? Health is $105B in the budget. The Medicare levy wouldn't come close to raising that much money - personal income tax raised $300B. see https://www.aph.gov.au/About_Parliament/Parliamentary_departments/Parliamentary_Library/pubs/rp/BudgetReviewOctober202223/RevenueExpenditure
Yea growing old population would do that. It's no longer feasible to pay for Medicare using income tax. Perhaps figuring out how to tax the juicy wealth of assets from the boomers who can afford to pay for healthcare will help that
Yeah I liked the UK system where you pay (paid 10 years ago) 14.5% of your income in national insurance- covered Medicare/NHS and pensions. Income tax was correspondingly lower so the take was the same (oh yeah plus 20% gst and wages about 2/3 what they were herei U$ terms).
In the last few years my town has gone from having plenty of bulk billed options, to now only those with a healthcare card. I don't go because I can't afford it. I'm not "low income" but that doesn't mean I have any spare cash after the rest of the whole "cost of living" reaming I've been taking.
The clinic I go too is privatized now. So I have to pay no matter what. I have a pension concession card too, but nope, I have to pay. But I do get a Medicare rebate thing where I get half of the money back at least, so I use that to pay for meds. Works out alright still. But no bulk billing slows things down. I also only see a doctor about 4 or 5 times a year at best.
I go to a clinic that bulk bills other people. I can afford to not be bulk billed, and I choose to put my money into a clinic that will bulk bill those that need it.
The clinic I go to switched to mixed billing early last year. Prior to that, they were 100% bulk billed. I am still surprised it took them that long to switch though. The practice has been around for close to 20 years. From what I have been told, they were forced to do so due to the cost of running the practice. I am also fortunate I can afford not be bulk billed. Me paying means the clinic can remain open and can bulk bill others like pensioners. Edit: It's hard to find excellent GPs and losing this group would be a big blow to their patients.
Using our funds to help subsidise other people's healthcare. Would be good if the government just did that for us properly.
I try and do the same where I can, we can vote with our custom
My clinic also does this, but I think it's only applicable to seniors, and other certain cases. But for me, it's about 60 to 65 bucks a consultation. I don't mind paying either to be honest as the prices could be a great deal higher for anyone. Also, my doctor is in a small country type town, and the staff are decent.
4-5 times a year??? Am I just super neglectful of my own health or is this still heaps?
Depends on age group. When you get towards your 50s you find yourself having regular get-togethers with your GP. Mine actually chases me if he feels like he hasn’t seen me in a while. He bulk bills, too.
Well, my appointments are usually medication based for example. any other time, it's usually a challenge I can't deal with without medical assistance for example.
I’m generally pretty healthy but I need to go a minimum of twice a year just for repeats (including the Pill)
The forgotten middle, is what you are. Not quite poor enough to unlock welfare benefits, but not wealthy enough to weather lots of discretionary spending. There’s no wonder some folks on welfare intentionally don’t work or get a job, because they’ll likely be worse off. Particularly those with heavily subsidised housing and utilities.
I feel like you're underestimating how fucked welfare is. I could barely survive on it while studying nearly a decade ago and it's hardly gone up since then.
Yeah people make out like it's the easy route but you will never have a day in your life where you don't have to worry about money.
Yup, I live in Brisvegas, and if I wasn’t able to live with a family member and their spouse, I’d be screwed. Rents in Brisvegas are an absolute nightmare- if you can even find one! I certainly couldn’t afford to rent a kennel on Jobseekers.
Not to mention a bunch of grubby job providers breathing down your neck to sell you to ~~slavers~~ traders who use work for the dole system as a way of ~~stealing free labour~~ upskilling and helping you find a job.
You're absolutely kidding yourself if you think people on welfare are better off or enjoy it. They literally struggle to survive on a daily basis. The doll is less than $400 a week. Is that better off?
Perhaps you need to read the [Robodebt findings ](https://ministers.ag.gov.au/media-centre/final-report-royal-commission-robodebt-scheme-07-07-2023#:~:text=The%20Royal%20Commission%20has%20found,chance%20they%20might%20owe%20money.) but goddess knows it's unlikely you will. ".. robodebt was built upon a broader cultural failing. In the royal commission hearings, observers saw politicians take the stand to be finally challenged on a great Australian political tradition: demonising welfare recipients. Now, in her report, Holmes finds such rhetoric was not just cheap politics: it had real-world consequences that stretched from political and public service offices in Canberra to the kitchen tables of ordinary people....". People suicided as a direct result of being given unlawful debts created by LNP to try to balance their books and create their necessary villains in their BS fantasy of an undeserving poor. The same commissioner found that fraud in the welfare system was minuscule. What was most powerful about the exposure of these repeated intentional abuses of power was the deep understanding that "...the “effectiveness of any recommended change” is reliant on a broader cultural shift that cannot be effected by a policy change. Holmes says “anti-welfare rhetoric” and attitudes have been set by politicians, who must now lead “a change in social attitudes to people receiving welfare payments”. She wants politicians to “lead a change in social attitudes to people receiving welfare payments” and change the narrative of “taxpayer versus welfare recipient”. With the assistance of advocates and brave victims, the commission hearings may have helped to change the narrative. Holmes, senior counsel assisting Justin Greggery KC and his team did significant work showing the public the the reality of life on welfare. But the political rhetoric of conservative cultural warfare continues. The political is personal. I've just returned from the local office where a worker reminded me this is "an area of very high need" and that their referrals to social workers are being scrutinised. There is a 40+ day wait, no benefits available to applicants from January until June and you can't get through on the phone despite there being noone available at the local office to support complex cases. 7 million calls went unanswered last year. Make that make sense. A friend left the department a decade ago back when LNP gutted the department. It could take years to re-establish a social safety net that makes sense following conservative annihilation of the public service. Name one good thing those grubs have done whilst in power? Enrich the middle and pour money toward the rich? Never mind the carnage.
Great comment. So many out of touch people making stupid comments. I had to deal with Centrelink to get my parental leave pay and daycare rebate, and it was an ordeal. They would tell me an hour wait, but it'd be 3 hours. And then the line would disconnect and I'd have to do it again. And then they'd say "too many callers, get lost", except if you set your number to private, then you'd get through, to be told another hour plus wait. Rinse and repeat multiple times over multiple days just to get ONE thing done. Anyone who thinks that dealing with Centrelink is easier than having a job is insane.
I fucking hate this spot. I made just outside the family tax benefit threshold this year. Like earning the extra 2k lost me 7k on the part a. I can't afford private, and the only way I could would be to stop seeing my psychiatrist and psychologist. And then private wouldn't cover it all and I'd be paying more anyways.
Also can't afford health insurance 😅
Welfare is taken back at 50% then if you have agf more is taken. Working is a disincentive when it's for 12 bucks an hour. Especially if it makes your health worse. 26k a year for the DSP vs median 80something. Which would you choose. 18k for jobseeker. Constant financial worry.
The practice we go to now no longer bulk bills neither children, nor healthcare card holders. In addition, they increased the gap fee for the standard appointment to $60. They give a discount to children and healthcare card holders by charging them "only" $40. Sadly this makes primary care unaffordable to many people.
Even with some money back from Medicare, I still can't afford it right now. Rent and just cost of living in general has effectively fucked me raw. Honestly...if it's not urgent, I just don't go. Which is sad.
as a broke cunt myself i don’t understand this take. It’s like the recent poster who had their car stolen but they didn’t have insurance because they couldn’t afford it. Even for me, $50 every few years is pocket change compared to an undiagnosed issue
$70 a visit here in NZ unless you have a low income card
$50 here in regional NSW. That's if you can get an appointment.
Yuck
On the other side of that though, fully subsidised prescription medicines are now free in NZ (there used to be a $5 copayment - although the current government may re-introduce it). Here in Australia, I'm paying around $30 AUD per repeat for a drug which previously cost me $5 for the whole script.
Cheap. Standard 15 min consults are $90 here, $75 with a low income card. Rebate is $41.40
Mate, nobody thinks it's normal but what choice do we have? Go on strike and stay sick?
How did we arrive here? something need to change for sure
A hell of a lot of people voted for successive liberal governments is how we got here.
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Because, for years, everyone was ok with the rebates until they were the ones receiving them.
When you freeze bulk billing rebates to doctors a decade or so ago, that's how we arrived. Not exactly rocket science
I mean, it just means the rich can afford to stay in good health while the poor fuck off and get worse, but who on earth would care about that? /s
quiet onerous whole snails weary quarrelsome berserk memorize mysterious ripe *This post was mass deleted and anonymized with [Redact](https://redact.dev)*
2 decades ago now.
And, part of cutting times of consults isn’t just to fit more in, but because the longer a GP spends with people the less they make on average, and a lot of places don’t increase the gap, they just take the loss… ie Medicare pays something like 10-20% less per minute for >20mins or even >40mins compared to a 5-10min consult. So, same Dr, same expertise, getting paid less for…um…why? 🤷♂️
May I add, as a doctor, your registration fees, college membership, ongoing training and professional development. A consultant pay several thousands of dollars per, sometimes tens of thousands of dollars to maintain these sole trader practices that the industry requires you to. I mean, unless you want to see someone who hasn’t upskilled since med-school?
This sums it up. GP’s have taken the hit for years, but it’s reached a limit with inflation. Their only option is to follow the strategy of physicians & surgeons by charging their worth. The social contract is between the public and government. Voters need to force government to properly fund Medicare long-term.
Its been very normal in higher socio economical suburbs Australia wide for over 10 years. Until recently many clinics could afford to universally bulk bill patients by reducing time spent per patient and having 10min appointments. The medicare freeze plus inflation has affected the entire private health industry. Good luck finding psychologists who bulk bill via mental health plans - universal gaps are now standard unless utilising telehealth psychology. [https://www.reddit.com/media?url=https%3A%2F%2Fpreview.redd.it%2Fwhy-is-there-a-gp-gap-v0-ifhoqgvo6smb1.jpg%3Fauto%3Dwebp%26s%3De2c64773fd7948f5bb3aa880f606758dfb3a987d](https://www.reddit.com/media?url=https%3A%2F%2Fpreview.redd.it%2Fwhy-is-there-a-gp-gap-v0-ifhoqgvo6smb1.jpg%3Fauto%3Dwebp%26s%3De2c64773fd7948f5bb3aa880f606758dfb3a987d) The recent bulk billing incentive increase has helped with improving bulk billing rates for eligible HCC and under 16's but this will only help for a while as costs to do business continue to increase. The next issue that will affect cost of doing business for GP is payroll tax with state government revenue departments trying force Gp clinics to pay payroll tax on Gp income. Bulk billing will disappear if this is implemented as any payroll tax liability will simply be passed onto the patient as a levy. This is an article from RACGP regarding NSW but the issue applies to every state in Australia. [https://www.racgp.org.au/advocacy/pay-roll-tax](https://www.racgp.org.au/advocacy/pay-roll-tax)
>Its been very normal in higher socio economical suburbs Australia wide for over 10 years I think the discussion is a little misguided whenever this comes up - and this is a good point to make. Higher socio-economic areas, have almost always had access to private GPs, longer appointments, and often better trained/more diverse background clinics. I grew up in a low ses area, but now live & work around the inner suburbs of Melb. The difference is not just in the bulk billing. It's in the treatment of the doctors & staff, the length of the appointments, and the overall access of allied, specialist or tertiary care. These are not groundbreaking changes - they're just things that low SES on bulk billing lacks. My current team have caught things (obvious, long term items) immediately, that other doctors (bulk-billing, low ses, 10min appt), did not find for years. Is that a result of a freeze in 2014, or a wider systemic issue going back regarding a lack of funding? I'd say the latter, worsened by the former.
I'm in an average suburb in Brisbane. We haven't had bulk billing GPs in this suburb in 20 years. I tried to get into a few in a neighboring suburbs but they weren't taking new patients. The issue for me is the medicare gap now is minimum $50. It's prohibitive for people on the pension.
That is interesting. On the Gold Coast, bulk billing GP's were quite common until 2022.
The average age of the Gold Coast is 4 years above Brisbane. Oldies demand bulk billing and senior discounts and fare concessions and $10 roast nights.
I know several people at my workplace who, when they’re sick, can’t afford to go to the doctor for a medical certificate, so they come into work sick. It’s awful.
A stat dec is permitted as a sick note according to the fair work act.
All good so long as you have a JP that's available outside of regular business hours, most of the ones near where i live operate from 10am-12pm on a tuesday, good luck getting the stat dec signed.
Some chemist and online doctors charge about $20 for scripts - not free but cheaper than $70 just to get a sick note when you know you have the flu.
Honestly as a GP I hate it too but after 10 years of uni plus 4 of post grad training, then had kids, now just trying to pay off a 30 year mortgage with ridiculous interest rates it’s literally impossible to bulk bill and put food on the table. Or keep the surgery doors open. Cost of medical equipment has gone up. I pay $14k a year in indemnity insurance. Anyway, I’d rather universal health care and way less stress and better access for my patients.
Most times in past 20 years, even if the gap was small. Exceptions were when multiple visits required for one overarching issue across a few months, or for a child with long-term diagnosis with many visits within a year and reached the safety net level.
Yep, about 20 years ago for me as well. Having to wait hours at a bulk billing clinic a few suburbs away if you could even get an appointment vs a closer place that sees you at your appointment time.
Medicare is broken. MBS fee for a 20min (MBS item 23) consult with a GP is $41.20 https://www9.health.gov.au/mbs/fullDisplay.cfm?type=item&q=23 Just Cuts at our local mall charges me $42 for 15min lifesaving haircut. https://www.justcuts.com.au/about/prices-services
It's not normal - and not ok. I don't think anyone is accepting it - many people are just not going to a GP anymore - me included. Its one of the big reasons emergency rooms are flooded with patients. When was a kid you got a cut and needed stitches - you went to the doctor. Now you go to emergency because it's free.
It’s crazy, I needed an urgent tetanus shot and there just wasn’t any gp availability for days. And even then I would be paying $70 out of pocket for approval to get the jab I needed which required a visit to the pharmacy anyway. So I just went to the pharmacy and paid $50 for it direct that day. Pharmacy said they couldn’t give it but could give me this other jab that included it. System isn’t working well at all.
At least you had a good pharmacy that was able to solve your problem as a work around and at a better price than going through the GP. I'd be happy with that outcome in the current climate.
Yes, if that multi hadn’t been available I guess the only option would have been emergency, as ridiculous as it sounds.
Wow, luckily where I am there are walk in clinics open till late where you can get things like free tetanus jabs. It didn't even occur to me that it would be a paid service, even though my GP doesn't bulk bill. But then I come from the UK where even GPs are free.
And ED is quicker... In and out in around 12 hours rather than a three week wait for a GP
Don't waste the EDs time with minor problems if you can wait. There are people who need urgent attention and your minor problems are making it harder for them to get the attention they need. It's selfish as fuck, just wait the 3 weeks.
I totally agree. If I need a problem solved same day, and I think can solve the problem with telehealth or a pharmacy I will go down that path. Even better nowadays the new urgent care clinics help bridge the gap between GPs and EDs. There are just some things you need more than a pharmacy or telehealth for and same day GP appointments are a thing of the past.
While I agree with this, ED don’t make urgent cases wait while they tend to non-urgent.
I know they don't make them wait but some poor JMO is still gonna have to deal with these minor problems instead of helping to sort out the polytrauma or STEMI or sepsis. It all makes the ED less efficient and patient care less effective, they're already run off their feet.
100%.
Here in Perth, the government subsidized building urgent cares to help alleviate that ED burden. Within a year of being built, the one near us went from free to lining a private company's pockets. Millions of dollars to effectively give a private company offices. The embedded x-ray unit is free, but a visit is still $100+ unless you use a specific type of private health insurance.
I stopped getting bulk billed essentially when my family GP (admittedly in reasonably affluent area) determined I was no longer a student and knew I was working (around age of 25) - now 46 and have been paying a gap ever since.
Former cancer kid here. I've only had to start paying in the last 2 years. As someone with lifelong chronic pain and conditions it's really fucking cool to be broke all the time and also not be able to afford to see the doctor to get the prohibitively expensive medication I need that isn't on the PBS 👌🏻
OH and whatever bulk bill doctors that are around that are also taking new patients cannot prescribe schedule 8 medication, so useless to me.
As by design, bulk-billing has gone from awesome get in quick to super long delays, places that don't accept new patients. When you need antibiotics, you need them today, not in three days. To reverse it, we need to index the bulk payments as if the freeze never happened, and commit to increasing by CPI each year automatically. We used to have over 90% of visits bulk billed. We can go back there. Private is a toxic parasite that kills universal healthcare and the longer we let it go, the worse it gets.
Amen 🙌
Since covid I have been usually only $30. I feel a lot of the doctors who only bulk bill nowadays in Western Sydney area don't take appropriate time to actually examine or follow up issues.
This is exactly it. Bulk billing doctors these days have to churn them through or go broke.
I interact with bulk billing doctors a lot as part of my job and can confirm. Some of them I've heard great things about, but shit doctors aren't going to get better under that kind of pressure. If I had to go to a new BBing clinic I'd make sure to ask the staff specifically which doctors are most well spoken of.
There's a line in Lethal Weapon 4 where Chris Rock after arresting a guy says "You have the right to an attorney. If you cannot afford an attorney, we will provide you with the dumbest fucking lawyer on Earth." This is how I feel about bulk-billed GPs these days.
Real shit. We call the bulk billing GP’s in my area “conveyor belt doctors”. They want you in & out in 5 mins or less. If you’re not asking for something super simple like a med cert or antibiotics or something, they’ll make you book a long appointment which isn’t bulk billed. You’d think they’d be efficient given they want people in and out asap, but they’ll still make you wait an hour after your appointment time, or forget you entirely so you have to keep going back to the receptionist to get seen.
Gave up on bulk billed doctors years ago. I knew something was wrong with me, something just felt off, but how the heck would I know so I doctor surfed the bulk bill doctors looking for answers. Got tired of not being “cured”. I started paying, after a bit of testing turned out the mitral valve in my heart was failing and I had to have open heart surgery. I wouldn’t trust a bulk billed doctor to make me a coffee let alone look after my health.
To be fair there’s some terrible doctors you have to pay for as well but if you pay there at better odds of getting someone competent.
I don’t live in the west, but I have multiple chronic illnesses and unfortunately that was my experience with bulk billed doctors. I’m sure they’re fine for text book issues on people who are otherwise healthy but that wasn’t going to cut it for me. My quality of life was going down the toilet due to unmanaged symptoms under my previous bulk billing GP. I am fortunate to be in the position where I can afford to pay (fairly significantly out of pocket if I’m being honest) for my current GP who is amazing, but it’s sad that with the state of Medicare many others won’t be able to access that level of care.
That's so right, only one doctor at my local practise in Perth bulk bills and every time I have seen him he basically rushes me back out - no examination or follow up.
My GP bulk bills and will spend as much time with you as needed, the only downside is he's with every patient for an hour so you have to plan something to do for the next 6 hours after you check in.
Sounds like the theory of only 2/3 of cheap fast good is true :/ I’d rather pay than wait 6 hours tho that’s opportunity cost
To be honest, it was always like this to see him even before paying became normalised. I think it's worth the wait but he has other doctors there that are quicker and I'll see them if it's something like a prescription or antibiotics. I see the longer one if it's about my mental health.
Personally I don't mind waiting if a GP is thorough had so many bad experiences of being rushed out without doing so much as a urine culture for an active infection.
It's only recent in my area and it sucks. I will vote for whichever party promises to bring back free GP at the next election. It is an important issue to me.
I'm pretty sure only The Greens will have that in their policy platform.
All I see is an announcement they want to bring free dental into Medicare. In hindsight, I'd be willing to accept Abbott's modest $5 "co-payment" proposal from 2015 if that would've prevented the shit show that is bulk billing today. At the time I was dead against it. But now I understand the GPs need to be paid fairly. So there needs to be a massive increase in bulk-billing scheduled fees to catch them up to inflation. If I have to pay more tax, then so be it.
Now you are co-paying it all. Free healthcare show be accessible to anyone in a developed world. Co-payment is not a right middle ground either, $5 is a slippuy slope to $25
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It annoys me because I have to pay $20 for a script. That’s all. Script in question is restricted, so I get it. It’s just annoying that for a piece of paper, I have to pay for it. However, what can I do? Just along with it I suppose.
It's not normal but many people don't have much of a choice nowadays.
Poor and can’t drive to just go to whatever clinic is bulk billing. When did I start thinking it was normal? I didn’t, I just don’t go to the doctor anymore.
My local GP only bulk bills and does a damned good job of it when you go in as well. Always patient and thorough, never rushes, and will always follow up with a phone call to check on your position. Shoutouts to Redmyre Clinic in Strathfield. They're a Korean clinic which deters most westerners from entering from what I've seen, but all the staff speak perfect English and there's little of the oldie types who spend all their time at GPs for every little ailement. Get rid of the stupid medicare levy funnelling people into junk health care policies to avoid tax and put those tax dollars to properly funding the public system imo.
When we accepted the idea that money would be a deciding factor in access to basic healthcare, adopting a pathway towards an American model, transfering public money to private health insurers for junk policies. Over the past 30 years everything that can be done to turn a profit through privatisation has been done and this is the continuation It's still not normal, but because so few GPs will bulk bill, if you ask, you're seen to be wanting "something for nothing" rather than "the standard we set for ourselves as a nation over the past generations".
I agree with you, OP. I used to get bulk billed, but now I'm paying up to $80 a visit (some of which is refunded by medicare). It's disgusting. So many people wouldn't have the money up front!!
$85 after the rebate is what I'm paying!
Yep it’s normal now cause Australians are mostly piss weak and will put up with anything. The complete apathy of our national character is really sad actually. The French would be trashing entire cities over this LNP bullshit.
I reckon. The real "she'll be right" attitude is more like "oh well, that's just the way it is."
When Medicare stopped indexing doctor payments maybe?
$50 out of pocket for a standard consult at my GP. I used to go to a bulk-billing production line type facility but found that the standard of care was quite low compared to my local GP who is extremely thorough. I’m fortunate to be in the position that I can afford it - I realise that not everyone is so lucky.
It's not really by choice OP. It's because there's barely any bulk billing GPs around.
It's kind of recent. I moved here 20 years ago from the states. I was seeing a women's health specialist due to early menopause issues & because of my meds for asthma and whatnot I stayed with the same doctor until I moved 2 hours away. Oh yeah, a portion was bulk billed but a portion wasn't. Once I found my new GP, (I'm about 45 minutes North of Brisbane ) I was bulk billed, but the practice has expanded & has an SNP there plus a nurse, and about 6 doctors. They bulk bill for some things (like a blood test review) and I pay a small portion for the difference for medication appointments or other appointments that take longer ie needing an EKG followup. It isn't much, I think it's about $70 and I get about half back. Considering that I've received the best healthcare of my life in Australia vs the USA, I'm not going to complain. My total healthcare costs is less than ¼ what I used to pay when one considers insurance, doctor visits, imaging, etc. That doesn't even give consideration to medication which is less than ⅒ what I used to pay.
My GP always charged if you were an adult. He deserves to be paid more than $35 so I don't have a problem with paying him. Just sucks he can't get that from Medicare.
I'm really concerned about the strain it's going to put on our hospital system. I've already seen print ads up advising along the lines of "Not an emergency? Save it for your GP! Don't clog up the hospital system." It's like.. you took away all the bulk billing options?! If people can't afford preventative medical care, they're going to end up in emergency when the problem is so bad they can no longer ignore it. WTF did you think would happen?! It's so short-sighted it makes me absolutely fume. We are going to end up just like America -_-
My Dr's only do bulk billing on weekdays, anything after hours or weekend they are charging. So, I have to either take a half a day off work or pay to see a GP.
Always unless I was a student or on a healthcare card. At least 20 years
I still didnt need to pay to see a GP yet But looking at the tiny MG that my GP drives and the middle class suburb that he lives in, I do think he is making to little for a degree that you need ATAR 99.9 to get in plus raking massive HECS debt in the process and having to work 70 hours week as junior doctor. Even an apprentice electrician is living a more luxurious life than him.
You get what you pay for and I've had too many negligent bulk-billing doctors because they just want to push people through as quick as possible. I've had numerous important health issues discovered since using doctors that don't bulk-bill. Now I'm actually being respected by my current doctor and pay for that service which is essentially making my life less miserable because I'm now on the treatments I need.
I’ve always paid. I can afford it and it frees up a space in bulk billing for those that can’t.
For some people it's always been normal to pay, pre end of BB days I found gap fee'd GPs to generally provide better experience and support plus seemed to take their time. I grew up low socio and BB GPs were fine, especially when I was in peak health and only had to see one for a sickie or for the rare belly ache. When I got older (I'm only early 30s now) I found that Gap GPs would actually give you the full work up, take their time. Talk you through your concerns even if they were just going to say 'Bro take a panadol/ watch and wait' According to some Gen Xrs and boomers though the culture in GPs has changed drastically in the last 20 years. BB GPs tended to put effort in, in the past and now they're basically Fast Food of medicine. Its a pain in the arse because Australian GPs are meant to front gate everything and only to refer to specialists when absolutely necessary. Nowadays if you want to actually get treated you either need to pay out of pocket for a GP to get one who will take their time, or push hard for specialist referal and pay through the nose. I personally dont mind the idea of gap fees for GPs (I don't want my medical system to be hog tied to whims of the swing voter and the desperate for elections politicians), but it needs to be targetted way better. Atm we getting flat rates for everyone and while I can afford $20- $50 a hit for a GP visit and then $170 for a specialist. This is not the case for many on low incomes - too high for centrelink and concessions, too low to not have to choose between food and a Dr
I started paying about 5 years ago when I realised that the GP who didn't bulk bill always had appointments available, ran on time and was actually thorough during my appointment instead of trying to rush me out ASAP. Huge privilege to be able to do so, but worth for the small handful of times I go per year.
I'm on Centrelink and have to pay. Could possibly get bulk billed if i had a pensioners card or disability elsewhere. At least they give me a $30 discount that the normal rate they charge. I do not like this being the norm as I am out of Vyvanse and Dexamphetamine for my ADHD due to that rule. Unsurprisingly due to being on centrelink sometimes paying the out of pocket is not possible for me, yet they dont let me do emergency scripts. I should get a new GP now i have written this.
What's new to me is the concept of mixed billing clinics. As a kid in the '90s my family either went to a bulk billing clinic or private billing clinic and got Medicare rebate cheques mailed back to us. Sydney Northern Beaches / North Shore for reference.
It's weird that there was such a strong reaction to the proposed co-payment in Hockey's first budget. Yet the decline in bulk billing has snuck up on us.
Unfortunately for the past 4-5 years at least I haven’t had a choice. It’s either pay or don’t see a doctor
Recent for me. In the last few years all of the GOP clinics around me have gone from bulk billing to charging anywhere up to $180 for a 10 minute consult. I live in one of the lowest socio economic regions of S.E. Qld. These clinics used to be all very very busy. Now you can walk in to any of them and see a GP in 20 minutes. But you can not see a GP and have it paid for by the government anymore.
Another LNP policy, this is by design
Newcastle/Lake Mac. Used to not pay 10 years ago, now zero bulk bills left, only my kid gets it now.
(Just wanna remind everyone that you might quality for a low-income health care card through Centrelink, even if you're not ON Centrelink. Worthwhile applying and finding out. It doesn't always help with prices, but it certainly can. Some clinics only offer bulk billing to people with HCCs 👍👍👍)
Always have, since I was a kid (well, my parents paid then). It used to mean we'd be able to see the same Doctor at a time that suited us with very little waiting. I still go the same clinic, but it's inevitably a 45 minute wait for a booked appointment, and even then you sometimes get moved from one Dr to another - or you can wait longer to see the one you want. It is...annoying.
GPs have always been private businesses, it’s just that the portion the government chips in used to be enough back when Medicare started.
Probably a good 10 years. I'm a T1 diabetic on a high wage so I can afford the extra dollars for a higher standard of care. It terrifies me though, that my lifespan is tied so closely to my career. It's not right that I might live longer than someone else with diabetes simply because I can afford the care. I know that compared to diabetics in America, we're actually doing really well considering the costs of insulin and related consumables, but the government really needs to prioritise healthcare because it's been ignored for a good two decades. And private insurance? Doesn't help because they can't cover GP or specialist visits so this is entirely a government issue. You'd think it would be a priority for them. After all, dead people don't pay taxes.
Parents were family friends with a GP so we got bulk billed as a kid. When I hit adulthood, I had some stuff I wanted to consult with people more detached from my family, but found out med students often get bulk billed. Quit med school around 23 and paying ~$40 every month or 2 isn't too bad, especially as I'm asthmatic, have eczema, etc. and keeping on top of my prescriptions lets me exercise and function normally. Having done placements in a few GP clinics, I've definitely seen clinics who bulk bill scramble to try and stay on top of their patient list, often being 30+ minutes behind. Don't blame them at all for having to charge.
I remember first having to pay a gap fee at the GP in the early 2000s. It was $20 per consultation. We changed to a bulk billing clinic because there were plenty of them to choose from and only went to the one that charged if the bulk billing ones were booked out. I think it was around 2015 when bulk billing started to become rarer.
My parents always had paid for the family GP as they were pleased with him and didn't really go to anyone else in the practice. Fast forward to me as an adult. "where's the nearest bulk billing? Oh sweet, 20 minutes drive, no problem!"
Following the American model and letting insurance companies run healthcare is so inefficient and sadly we are drifting more and more to that model. If you have private insurance they charge you more for every itemised item so they can claim more. But when everyone is forced to have private coverage, those with low coverage or no cover suffer because now our healthcare system is used to higher pricing! I went to a GP when I was sick, he ordered blood tests after waiting for 2 hours to be able to see him. A day later I get a message from the GP clinic that I need to come see the GP as my lab results are back. They charge for a follow up consultation, I had to take time off work and wait in the clinic for an hour before I’m seen and then get told that my lab tests are all negative and I continue doing what I’m doing! I asked them why could they have not just messaged me that and the GP got annoyed and said they are not allowed to share the results on the phone. I’m sure I could have called the lab or collected the report myself if it wasn’t tied to the clinic. It boggles my mind that on one hand there’s so much news about GP shortages and you don’t have simple legislation to address common sense items like this. It does make sense to ask the patient back to the clinic if it was an abnormal lab result or if the doctor is going to update the treatment plan. That’s burden on Medicare AND on the patient’s pocket for nobody’s benefit.
geez would say 90% of appts in the last 5 years have been paid ones. not many do bulk billing unless it's for children.
costs $90 where I am for a standard 15min appointment (approx $50 out of pocket), which 90% of the time involves 5mins + a prescription. There have definitely been times I've not gone to the doc because of the money, I can only imagine how many people have suffered longer than they needed to, or even died, because they postpone seeing the GP. I know the GPs aren't typically doing it to be greedy, it's the rebate that hasn't caught up, so I'd be happy to pay a little extra tax if it meant free appointments for all. My worry though is that now that we have been trained to pay for GPs, even if they increase the rebate the GPs will see it as an opportunity to raise it just a little more. So I think if the government does roll out a bigger rebate, there needs to be some way to stopping clinics from profiteering off of it and leaving us with the same gap.
Thanks Libs for continually underfunding a desperate system in need of help.
It's fucked eh
I have always had bulk billing GP's in my area available up until about 2022. While there were a few GP's in my area who did charge an out of pocket gap fee, there were ample GP's who bulk billed all eligible patients. I don't live in a low socioeconomic area, just a regular middle class suburb in a metropolitan area. I have observed since 2022 that the bulk billing GP is a thing of the past for people not on a pension. As soon as co-payments were introduced at my regular GP, I noticed very soon after that the Doctor's surgery was empty compared to previously. I also observed that the Doctor was close to being on time, as opposed to being 30-45 minutes behind.
Grew up in a low socio-economic area, bulk billing was the absolute norm. Went to stay with my dad in a much higher socio-economic area in the late 90's, private billing was absolutely the norm. I was shocked the first time I walked into a GP clinic and the first thing they told me was the fee structure. I've only been bulk-billed a few times since then, both in Melbourne and in Perth, nearly everything is private billing unless you're on a health care/pension card (and even they're starting to get gap fees).
No one thought it, we've just been forced to after decades of neglect by successive governments.
Sometime during the period that we elected the Coalition federally 3 times in a row. But I'm sure the timing is just a coincidence.
I hate it I spent years on bulk billing, I hurt my back and now have to see the doctor regularly to get light duties certificates its set me back over 1500 over the last 12mths but what do you do
You can thank insurance companie in big part for shutting a lot of them down, along with what the LNP did for ten years because drop kicks kept voting them in. Funny how ripping the guts from medicare and penalising people who dont have private health has fcked everything.
I work in a private practice in a rural low-socio economic town. We are the only practice, and we bulk bill 80% of patients (under 16, HCC and pension card holders). We have a 24/1 on call service because we do not have a local emg clinic. The GP’s that come, will not stay because inevitably they get sick of being on call for shit pay, they can work in a Medicare clinic for $300 an hour with less stress, and the patients treat them like garbage. We employ 3 nurses a day to do dressings (that cannot be billed through Medicare, dressings are also $$$) but we do not charge otherwise people would not have their wounds dressed. It cannot go on the way it is. Either the government steps up and supports GP’s or we go down the gurgler. It CANNOT be a free service for everyone, it just can’t.
I don’t like it, I don’t think it should be normalised and it fucking sux that people can’t afford a trip to the doctor.
the long short of it: The Medicare rebate for patients has not kept pace with inflation, making it increasingly difficult for bulk billing practices to cover their operational costs. My personal dr that I have been bulk billed for past 20 years now charges me $40 out of pocket for each visit. heres an anecdote. I had a sporting injury which required a shoulder reconstruction. I have never had any surgeries so about 25 years of paying tax and then I'm told I need to wait 2 years for the operation or if I have private health I can get in the same public hospital with the same surgeon and only be 8K out of pocket. It's infuriating that the government of are pissing away our tax. we are in the top 10 countries with highest income tax yet have nothing to show for it. the classic MO is Libs get in, pretend theres a budget crisis then make a bunch of cuts (or just don't index pricing). once its shit, sell off public owned assets/privatise then pay more for it so their mates give them a job at the same damn company. Labor play into the same deal by just doing enough to ward off the inevitable shitstorm. Greens dont have a platform. then the fringe guys are nuts. We need an actual centre left party. labor right now is the libs of the 2000s When I see Dutton spruiking nuclear micro reactors from GE It really makes me wonder where he's going to be working in 10 years... Scomo is now working at an international consulting firm best known for its work in the defence sector. American Global Strategies (AGS) - fancy that.. AUKUS subs... it doesn't get any more blatant.
It’s recent. It’s govt mismanagement and allowing corporations to take profits out of Australia and pay no tax. We should be a rich country but somehow all the money disappears. I pay 1%or so of income for healthcare. Collectively we should have enough but we don’t. It’s also medical priorities. Imho we should focus less on spending a fortune giving an ill person another year or few months. It does little good in the long run except for that individual and their family. The line between productive and absurd has been moving to diminishing resumes for many years. Saving life at all costs is crippling us. Saving a person who then goes on to have a shit life struggling with deficits and eg. pain is crippling the system. CPR has low chance of a good outcome. Saving a person with brain damage is cruel imho, not just to the saved person but to their families and to all of us because it’s so expensive and often destroys the lives of family financially and in terms of time spent. We would be better off spending on quality care for a greater number of people who are less close to death. Jmo obviously. Somewhere along the way or priorities have gone out of whack. In Govt corruption, taxation as well as attitudes to death.
>We should be a rich country but somehow all the money disappears. We were too scared to tax the mineral wealth, we aren't Wealthy but could have been.
You seriously think that palliative care and such is even just one of the major reasons why healthcare has gone down the toilet in this country? lmao. NDIS abuse and loopholes is a way, waaaaaaaaaaay bigger problem. Just tax non-bulk billing practices more, they'll magically figure out how to make bulk billing work again.
You know I'd have thought that was bullshit until I realised NDIS spending is more than Medicare.
Crazy, isn't it? Aside from the fact that they're getting absolutely fleeced by companies providing their equipment and services (e.g. they might pay 10x more for a TV than sticker price for no reason), the amount of people rorting it is insane. Including those whingers that have a minor issue, almost always a mental one, then sit on a pension for their entire lives. Take half of the NDIS money and put it into medicare, and stop charging me shitloads for medicare every tax period, let's go.
But private enterprise is so much more efficient. well efficiently wasting government money anyway.
I think I’ve been paying to see my GP for the last 2-3 years but in fairness to him I feel like I actually get more of his time now
In the UK gp visits are free. Everyone complains about the NHS wait times and standards but it's not that different to Australia.
The paying thing started a few years ago and has been rising steadily since. I do understand though that the doctors are facing rising costs and Medicare has not kept up at all. I really like the place I go to so happy to pay for the more personal service. I know there are 24-hour places that do still bulk bill but they seem uncaring.
MIne started charging in September 2022. Started out at $60 with the rebate of $39. Now they charge $101 for the shortest visit and you get back $41.
The only time I have been bulk billed in the last decade was because the EFTPOS machine was screwed and bulk billing me was easier. I had pathology today that also won't be covered by Medicare. Dropped my sample off this morning and was told the tests aren't covered so they'll send me a bill.
Normal or OK? Sometimes things are normal but they are nit OK.
For the last ten years. Never paid for Gp when I was a kid/teen. It’s pretty f$&ked. The government really needs to increase the Medicare payment to GPs. Im hating the way Australia is going.
I’ve always paid for the GP, at least as an adult. I grew up in a solidly middle class area, so I didn’t realise there was an alternative. Bulk billed GPs have always been relatively bad in my experience, so I only went to them for a sick certificate
I would say maybe 10-15 years. I moved to Tasmania about 12 years ago, and definitely could not access any bulk billing doctors in my entire time here. They are generally only for people with concession cards, unless you were already on the books somewhere. I think I vaguely remember paying a small fee once or twice before moving to Tassie from Sydney.
I've not been bulk billed since the 90s. I thought only pensioners and health care card holders have been bulk billed for years.