WEBVTT - Are GP visits about to get cheaper? 0:00:00.480 --> 0:00:03.640 Already and this is this is the daily this is 0:00:03.680 --> 0:00:04.360 the Daily OS. 0:00:05.120 --> 0:00:06.840 Oh, now it makes sense. 0:00:14.680 --> 0:00:17.360 Good morning and welcome to the Daily OS. It's Tuesday, 0:00:17.440 --> 0:00:20.640 the twenty fifth of February. I'm Harry, I'm Zara. We 0:00:20.680 --> 0:00:22.439 all need to see a doctor at some point in 0:00:22.480 --> 0:00:25.880 our lives, but it's not getting any easier or cheaper. 0:00:26.480 --> 0:00:30.280 Data consistently shows bog feeling rates are down, meaning more 0:00:30.280 --> 0:00:33.400 Australians are paying more to see a GP and per 0:00:33.440 --> 0:00:36.560 the Statistics Bureau, twenty five to thirty four year olds 0:00:36.600 --> 0:00:39.480 are the most likely cohort to delay a doctor's visit 0:00:39.760 --> 0:00:43.159 due to cost. That's why both major parties have announced 0:00:43.200 --> 0:00:46.559 plans to make as many doctor visits free as possible. 0:00:47.120 --> 0:00:50.960 The bipartisan push has wide support, but in today's deep dive, 0:00:51.040 --> 0:00:53.680 we'll look at why some experts warn that the trip 0:00:53.720 --> 0:00:56.600 to the doctor could still carry a price tag for 0:00:56.680 --> 0:00:57.200 some time. 0:01:01.320 --> 0:01:03.440 Harry, I don't think it's going to be news to 0:01:03.680 --> 0:01:07.880 anyone that it's extremely hard to find bulk billing. You know, 0:01:07.920 --> 0:01:10.640 we get lots and lots of messages every single day 0:01:10.640 --> 0:01:14.280 from people who are increasingly frustrated when it comes to 0:01:14.440 --> 0:01:17.840 paying for medical services. And now you know the inability 0:01:17.880 --> 0:01:21.000 to find a GP who will bulk bill them. What 0:01:21.080 --> 0:01:23.600 can you tell me about bulk billing in Australia. 0:01:24.040 --> 0:01:26.400 Well, I think it's really interesting that you say it 0:01:26.480 --> 0:01:29.000 like that, because I've even had people say to me recently, 0:01:29.160 --> 0:01:31.880 are we turning into America when it comes to healthcare? 0:01:32.520 --> 0:01:35.760 Their system is largely for profit. But Australia for forty 0:01:35.800 --> 0:01:38.720 years has had this system called Medicare, which was designed 0:01:38.720 --> 0:01:43.200 to make healthcare universal and free for everyone. So I 0:01:43.240 --> 0:01:45.759 think it's helpful to start at why we're talking about 0:01:45.800 --> 0:01:49.600 free doctors visits, since that's basically what Medicare was meant 0:01:49.600 --> 0:01:54.320 to be initially. It has changed over time. So when 0:01:54.320 --> 0:01:57.800 you go to a GP, think a medical clinic or 0:01:57.840 --> 0:02:00.760 a local practice, we have a system in place where 0:02:00.840 --> 0:02:04.320 doctors can bulk bill, and that's where Medicare will give 0:02:04.400 --> 0:02:08.160 the practice money directly to see a patient. A doctor 0:02:08.200 --> 0:02:11.600 can opt to charge a patient directly, which involves what's 0:02:11.680 --> 0:02:14.960 known as an out of pocket cost. So let's just 0:02:14.960 --> 0:02:17.120 say you go to see a doctor, it costs you 0:02:17.200 --> 0:02:20.560 sixty dollars, Medicare will give you about forty two dollars 0:02:20.639 --> 0:02:24.239 eighty five back, and that leaves you with a seventeen 0:02:24.280 --> 0:02:26.320 dollars fifteen cent out. 0:02:26.120 --> 0:02:28.400 Of pocket cost, very specific, love it. 0:02:28.600 --> 0:02:30.520 Very quick math? Well, I mean I think a lot 0:02:30.600 --> 0:02:34.200 of people walk away from these doctor's visits actually having 0:02:34.240 --> 0:02:36.800 to do that maths really quickly in their head, thinking like, shit, 0:02:36.880 --> 0:02:39.960 how much did I just pay for a fifteen minute referral? 0:02:40.480 --> 0:02:42.359 I just needed to get a slip of paper, or 0:02:42.440 --> 0:02:45.040 I needed to get a prescription or something of that sort. 0:02:45.520 --> 0:02:47.960 And that's because back in two thousand and three we 0:02:48.000 --> 0:02:51.320 saw the introduction of what's known as the bulk billing incentive. 0:02:51.880 --> 0:02:55.200 Rather than keeping bulk billing as universal as it was, 0:02:55.600 --> 0:02:59.200 it was designed to target specific groups who needed to 0:02:59.240 --> 0:03:02.600 go to a doctor, perhaps more than others. So if 0:03:02.600 --> 0:03:07.000 we think of pensioners, kids under sixteen, or someone who 0:03:07.040 --> 0:03:11.640 holds a concession card for various reasons. That incentive was 0:03:11.720 --> 0:03:15.400 increased tripled actually in November twenty twenty three, and that 0:03:15.480 --> 0:03:17.799 was because we were starting to see a decline of 0:03:18.040 --> 0:03:20.359 bulk billing rates right across Australia. 0:03:20.480 --> 0:03:23.960 Okay, so there's this bulk billing incentive. It's meant to 0:03:24.000 --> 0:03:29.680 be incentivizing GP practices to bulk bill more people more often. 0:03:30.480 --> 0:03:32.200 Is that what is actually happening. 0:03:32.680 --> 0:03:36.480 Look generally speaking, no, the official figures that we have 0:03:36.720 --> 0:03:40.040 showed fewer than half of Australians saw a fully bulk 0:03:40.080 --> 0:03:43.200 billed GP in twenty twenty three to twenty twenty four, 0:03:43.760 --> 0:03:46.800 and that was down from slightly above fifty percent the 0:03:46.880 --> 0:03:49.640 year before that. Okay, on average as well, Australians are 0:03:49.640 --> 0:03:52.240 paying about forty five dollars out of pocket to go 0:03:52.280 --> 0:03:55.880 and see a GP. And underpinning all this, we actually 0:03:55.920 --> 0:03:59.440 know through data from the Australian Bureau of Statistics that 0:03:59.480 --> 0:04:03.280 the most likely group to avoid seeing a doctor because 0:04:03.320 --> 0:04:06.600 of the cost is twenty five to thirty four year olds. 0:04:06.640 --> 0:04:08.840 Squarely, our democratic I would. 0:04:08.600 --> 0:04:11.160 Say, so we've fit right neatly in there, don't we. 0:04:11.720 --> 0:04:14.760 And the Government, for its part, would argue that since 0:04:14.800 --> 0:04:18.080 bringing this triple bulk billing incentive back in November twenty 0:04:18.120 --> 0:04:21.200 twenty three, the rates of bulk billing for those targeted 0:04:21.200 --> 0:04:24.440 groups so that's under sixteens and concession card holders has 0:04:24.520 --> 0:04:28.440 actually increased, but the same isn't true for you and 0:04:28.480 --> 0:04:31.640 I young adults. So what we saw this weekend was 0:04:31.680 --> 0:04:35.400 the government announced that it would extend that extra payment, 0:04:35.440 --> 0:04:37.920 that same payment that it's giving to under sixteens and 0:04:38.040 --> 0:04:41.720 concession card holders to everyone who visits a GP starting 0:04:41.760 --> 0:04:46.320 this November today, so our government will expand the bulk 0:04:46.400 --> 0:04:53.600 billing incentive to cover all Australis. So if a doctor 0:04:53.800 --> 0:04:58.200 bulk bills every patient, they'll be eligible for these higher payments. 0:04:58.640 --> 0:05:01.880 And that'll also depend on locations, so you actually get 0:05:01.880 --> 0:05:04.359 more as a doctor out in the regions compared to 0:05:04.720 --> 0:05:05.480 in the cities. 0:05:05.800 --> 0:05:07.400 So again that incentivizing. 0:05:07.920 --> 0:05:11.160 Yeah, yeah, that's right. And I tend to understand these 0:05:11.200 --> 0:05:14.480 things through the prism of politics. As we know, Labor 0:05:14.640 --> 0:05:18.880 loves to run a campaign on health, and so they 0:05:19.200 --> 0:05:21.720 came out with this really big announcement eight point five 0:05:21.760 --> 0:05:25.000 billion dollars worth of investment into Medicare. 0:05:24.800 --> 0:05:26.920 If they are elected at the next election. So just 0:05:26.960 --> 0:05:28.800 to be really clear, this is not something that is 0:05:28.800 --> 0:05:33.479 happening now today tomorrow. It's only happening if they're elected, right. 0:05:33.600 --> 0:05:36.120 That's right. But a bit of a spanner in the works. 0:05:36.200 --> 0:05:40.160 The Coalition came out and matched the Labor government dollar 0:05:40.200 --> 0:05:40.640 for dollar. 0:05:41.160 --> 0:05:44.000 So I'm pleased to announce today the Coalition government is 0:05:44.080 --> 0:05:47.800 committed to nine billion dollars worth of investment into our 0:05:47.839 --> 0:05:49.480 general practice network. 0:05:49.440 --> 0:05:52.840 And it should be said that it's fairly rare, especially for. 0:05:52.800 --> 0:05:55.679 An investment of this size, to see this as almost 0:05:55.760 --> 0:05:59.920 bipartisan policy, for both sides of politics to agree that 0:06:00.120 --> 0:06:02.800 this is worthy of investment and the same investment. 0:06:03.120 --> 0:06:05.720 I think if Labor was wanting to have a bit 0:06:05.720 --> 0:06:09.800 of a tussle over the cher figures of investment, they 0:06:09.800 --> 0:06:13.520 were solely disappointed by the Coalition coming out and supporting 0:06:13.520 --> 0:06:16.560 this measure. But we can be guaranteed that should either 0:06:16.640 --> 0:06:18.880 Labor or the Coalition at this stage get over the 0:06:18.880 --> 0:06:21.400 line at this election, which is due by the seventeenth 0:06:21.440 --> 0:06:25.240 of May, then we can see this bulk building incentive 0:06:25.520 --> 0:06:26.800 roll out by November. 0:06:27.279 --> 0:06:30.200 Harry, I'm really interested because clearly the fact that both 0:06:30.240 --> 0:06:34.320 sides of politics are supporting this move, there is widespread 0:06:34.400 --> 0:06:38.000 support for it. I am, though, curious about some of 0:06:38.000 --> 0:06:41.680 the criticisms of it, because we heard from Peak health bodies, 0:06:41.720 --> 0:06:44.599 from GPS themselves. What are some of the criticisms that 0:06:44.600 --> 0:06:46.760 we're hearing about this policy? Are there any? 0:06:46.960 --> 0:06:47.159 Oh? 0:06:47.200 --> 0:06:50.520 Absolutely, And let's just remember this is an incentive for 0:06:50.720 --> 0:06:55.480 GPS to bulk build their patients. It's not an enforcement mechanism. 0:06:55.640 --> 0:06:57.840 No one's going to be going in and telling them 0:06:57.880 --> 0:07:01.880 off if they refuse to bow bill. But the central 0:07:01.920 --> 0:07:06.240 question is whether this incentive is enough to cover the 0:07:06.279 --> 0:07:07.960 cost of running a clinic. 0:07:07.640 --> 0:07:09.320 Because those costs have also gotten up. 0:07:09.360 --> 0:07:13.040 Oh, absolutely a cost of living crisis. It's absolutely not exempt, 0:07:13.440 --> 0:07:16.960 and so gps are going to be faced with this 0:07:17.040 --> 0:07:20.080 question of will I get this bulk billing incentive or 0:07:20.080 --> 0:07:22.520 would it be more viable for me to continue to 0:07:22.600 --> 0:07:26.640 charge out pocket for these patients. The government's pretty confident 0:07:26.720 --> 0:07:30.480 about the incentive, working to get up to nine out 0:07:30.480 --> 0:07:34.320 of ten doctors visits bulk built by twenty thirty. I 0:07:34.440 --> 0:07:37.800 did put this question to the peak body, the Royal 0:07:37.800 --> 0:07:41.880 Australian College of GP President, doctor Michael Wright, and here's 0:07:41.880 --> 0:07:43.960 a little of what he told me earlier. 0:07:44.680 --> 0:07:48.440 Just because that incentive has been available to everyone doesn't 0:07:48.440 --> 0:07:52.440 mean everyone's going to get po built because Medicare rebates 0:07:52.600 --> 0:07:55.440 still don't cover the cost of care and so not 0:07:55.520 --> 0:07:58.440 all practices will be able to participate in this initiative. 0:07:59.040 --> 0:08:02.040 Okay, So what he's saying and what you're saying here 0:08:02.080 --> 0:08:05.120 is some of the criticism is that the amount that 0:08:05.400 --> 0:08:08.120 is given to a GP clinic, for example, or a 0:08:08.160 --> 0:08:12.640 medical center to cover the bulk billing. Is this in 0:08:12.640 --> 0:08:16.040 the amount that said GP clinic could get through out 0:08:16.080 --> 0:08:18.760 of pocket costs and charging the patient. 0:08:19.000 --> 0:08:21.360 That's right, and it doesn't cost the same right across 0:08:21.400 --> 0:08:24.480 Australia to run a clinic either. It definitely depends on 0:08:24.600 --> 0:08:27.320 all the overhead costs that come with that. So I 0:08:27.320 --> 0:08:30.480 think there's a very fair question of whether it's viable 0:08:30.520 --> 0:08:33.960 for the future of a GP workforce. And another thing 0:08:34.000 --> 0:08:36.959 that doctor Wright also mentioned to me earlier is that 0:08:37.160 --> 0:08:40.720 if you have this incentive rollout and more clinics decided 0:08:40.720 --> 0:08:43.240 to bulg bill, then that means more people are going 0:08:43.280 --> 0:08:44.840 to go see a doctor as well. 0:08:45.040 --> 0:08:47.000 Yeah, just naturally clan and demand. 0:08:47.800 --> 0:08:51.320 And the government's response to this is that it's offering 0:08:51.360 --> 0:08:55.920 more trainee ships, so four hundred nursing apprenticeships and two 0:08:55.960 --> 0:09:01.280 thousand junior doctor trainees by twenty eight But whether that's 0:09:01.320 --> 0:09:04.320 going to be enough to feel what we know is 0:09:04.480 --> 0:09:06.600 a really stretch workforce. 0:09:06.120 --> 0:09:08.480 Get really strained. We've spoken so many times on this 0:09:08.520 --> 0:09:12.439 podcast about the strain that the GP workforce and can't 0:09:12.440 --> 0:09:16.320 be overestimated the number of industries that are facing similar strains. 0:09:16.320 --> 0:09:18.679 But just because we're talking about GPS today, there has 0:09:18.720 --> 0:09:22.760 been so much information about GP burnout, and it's interesting 0:09:22.760 --> 0:09:25.120 in the context of this sort of discussion about whether 0:09:25.160 --> 0:09:28.760 it is, as you said, commercially viable for this model 0:09:28.800 --> 0:09:30.880 to work, and how you balance that with the need 0:09:30.920 --> 0:09:31.640 for patient care. 0:09:32.120 --> 0:09:35.360 That's right, and it's really interesting that both Labor and 0:09:35.440 --> 0:09:38.880 the Coalition are on a unity ticket for this measure, 0:09:39.480 --> 0:09:41.480 and that it is very likely that we're going to 0:09:41.480 --> 0:09:44.800 see these incentives roll out starting in November. It will 0:09:44.840 --> 0:09:47.600 be a matter of how many gps decide to take 0:09:47.920 --> 0:09:51.480 up that incentive, and will certainly be keeping a close 0:09:51.520 --> 0:09:53.640 eye on it. I'm sure many of my friends and 0:09:53.679 --> 0:09:56.319 many of your friends and family who are always looking 0:09:56.320 --> 0:09:59.400 for a bulk billing GP will notice any difference. Will 0:09:59.440 --> 0:10:01.560 you be able to fine one in your local area 0:10:01.720 --> 0:10:04.960 more ease? Yeah, that's the great question. Will it work well? 0:10:05.360 --> 0:10:06.880 Have to stay tuned for that one. 0:10:07.240 --> 0:10:09.560 Thank you so much for joining us for this episode 0:10:09.559 --> 0:10:12.360 of the Daily Oas. If you learned something from today's episode, 0:10:12.400 --> 0:10:14.440 why not send it to a friend share the love. 0:10:14.720 --> 0:10:17.560 That's how our little media company grows. We'll be back 0:10:17.559 --> 0:10:20.319 again this afternoon with some more headlines, but until then, 0:10:20.440 --> 0:10:25.240 have a great day. 0:10:25.559 --> 0:10:27.840 My name is Lily Madden and I'm a proud Arunda 0:10:28.080 --> 0:10:32.160 bunge Lung Kalkotin woman from Gadighl country. The Daily os 0:10:32.280 --> 0:10:35.040 acknowledges that this podcast is recorded on the lands of 0:10:35.080 --> 0:10:38.400 the Gadighl people and pays respect to all Aboriginal and 0:10:38.440 --> 0:10:41.480 Torres Straight Island and nations. We pay our respects to 0:10:41.559 --> 0:10:44.439 the first peoples of these countries, both past and present.