Speaker 1: Already and this is this is the daily this is
Speaker 1: the Daily OS.
Speaker 2: Oh, now it makes sense.
Speaker 3: Good morning and welcome to the Daily OS. It's Tuesday,
Speaker 3: the twenty fifth of February. I'm Harry, I'm Zara. We
Speaker 3: all need to see a doctor at some point in
Speaker 3: our lives, but it's not getting any easier or cheaper.
Speaker 3: Data consistently shows bog feeling rates are down, meaning more
Speaker 3: Australians are paying more to see a GP and per
Speaker 3: the Statistics Bureau, twenty five to thirty four year olds
Speaker 3: are the most likely cohort to delay a doctor's visit
Speaker 3: due to cost. That's why both major parties have announced
Speaker 3: plans to make as many doctor visits free as possible.
Speaker 3: The bipartisan push has wide support, but in today's deep dive,
Speaker 3: we'll look at why some experts warn that the trip
Speaker 3: to the doctor could still carry a price tag for
Speaker 3: some time.
Speaker 4: Harry, I don't think it's going to be news to
Speaker 4: anyone that it's extremely hard to find bulk billing. You know,
Speaker 4: we get lots and lots of messages every single day
Speaker 4: from people who are increasingly frustrated when it comes to
Speaker 4: paying for medical services. And now you know the inability
Speaker 4: to find a GP who will bulk bill them. What
Speaker 4: can you tell me about bulk billing in Australia.
Speaker 3: Well, I think it's really interesting that you say it
Speaker 3: like that, because I've even had people say to me recently,
Speaker 3: are we turning into America when it comes to healthcare?
Speaker 3: Their system is largely for profit. But Australia for forty
Speaker 3: years has had this system called Medicare, which was designed
Speaker 3: to make healthcare universal and free for everyone. So I
Speaker 3: think it's helpful to start at why we're talking about
Speaker 3: free doctors visits, since that's basically what Medicare was meant
Speaker 3: to be initially. It has changed over time. So when
Speaker 3: you go to a GP, think a medical clinic or
Speaker 3: a local practice, we have a system in place where
Speaker 3: doctors can bulk bill, and that's where Medicare will give
Speaker 3: the practice money directly to see a patient. A doctor
Speaker 3: can opt to charge a patient directly, which involves what's
Speaker 3: known as an out of pocket cost. So let's just
Speaker 3: say you go to see a doctor, it costs you
Speaker 3: sixty dollars, Medicare will give you about forty two dollars
Speaker 3: eighty five back, and that leaves you with a seventeen
Speaker 3: dollars fifteen cent out.
Speaker 2: Of pocket cost, very specific, love it.
Speaker 3: Very quick math? Well, I mean I think a lot
Speaker 3: of people walk away from these doctor's visits actually having
Speaker 3: to do that maths really quickly in their head, thinking like, shit,
Speaker 3: how much did I just pay for a fifteen minute referral?
Speaker 3: I just needed to get a slip of paper, or
Speaker 3: I needed to get a prescription or something of that sort.
Speaker 3: And that's because back in two thousand and three we
Speaker 3: saw the introduction of what's known as the bulk billing incentive.
Speaker 3: Rather than keeping bulk billing as universal as it was,
Speaker 3: it was designed to target specific groups who needed to
Speaker 3: go to a doctor, perhaps more than others. So if
Speaker 3: we think of pensioners, kids under sixteen, or someone who
Speaker 3: holds a concession card for various reasons. That incentive was
Speaker 3: increased tripled actually in November twenty twenty three, and that
Speaker 3: was because we were starting to see a decline of
Speaker 3: bulk billing rates right across Australia.
Speaker 4: Okay, so there's this bulk billing incentive. It's meant to
Speaker 4: be incentivizing GP practices to bulk bill more people more often.
Speaker 4: Is that what is actually happening.
Speaker 3: Look generally speaking, no, the official figures that we have
Speaker 3: showed fewer than half of Australians saw a fully bulk
Speaker 3: billed GP in twenty twenty three to twenty twenty four,
Speaker 3: and that was down from slightly above fifty percent the
Speaker 3: year before that. Okay, on average as well, Australians are
Speaker 3: paying about forty five dollars out of pocket to go
Speaker 3: and see a GP. And underpinning all this, we actually
Speaker 3: know through data from the Australian Bureau of Statistics that
Speaker 3: the most likely group to avoid seeing a doctor because
Speaker 3: of the cost is twenty five to thirty four year olds.
Speaker 2: Squarely, our democratic I would.
Speaker 3: Say, so we've fit right neatly in there, don't we.
Speaker 3: And the Government, for its part, would argue that since
Speaker 3: bringing this triple bulk billing incentive back in November twenty
Speaker 3: twenty three, the rates of bulk billing for those targeted
Speaker 3: groups so that's under sixteens and concession card holders has
Speaker 3: actually increased, but the same isn't true for you and
Speaker 3: I young adults. So what we saw this weekend was
Speaker 3: the government announced that it would extend that extra payment,
Speaker 3: that same payment that it's giving to under sixteens and
Speaker 3: concession card holders to everyone who visits a GP starting
Speaker 3: this November today, so our government will expand the bulk
Speaker 3: billing incentive to cover all Australis. So if a doctor
Speaker 3: bulk bills every patient, they'll be eligible for these higher payments.
Speaker 3: And that'll also depend on locations, so you actually get
Speaker 3: more as a doctor out in the regions compared to
Speaker 3: in the cities.
Speaker 2: So again that incentivizing.
Speaker 3: Yeah, yeah, that's right. And I tend to understand these
Speaker 3: things through the prism of politics. As we know, Labor
Speaker 3: loves to run a campaign on health, and so they
Speaker 3: came out with this really big announcement eight point five
Speaker 3: billion dollars worth of investment into Medicare.
Speaker 4: If they are elected at the next election. So just
Speaker 4: to be really clear, this is not something that is
Speaker 4: happening now today tomorrow. It's only happening if they're elected, right.
Speaker 3: That's right. But a bit of a spanner in the works.
Speaker 3: The Coalition came out and matched the Labor government dollar
Speaker 3: for dollar.
Speaker 4: So I'm pleased to announce today the Coalition government is
Speaker 4: committed to nine billion dollars worth of investment into our
Speaker 4: general practice network.
Speaker 2: And it should be said that it's fairly rare, especially for.
Speaker 4: An investment of this size, to see this as almost
Speaker 4: bipartisan policy, for both sides of politics to agree that
Speaker 4: this is worthy of investment and the same investment.
Speaker 3: I think if Labor was wanting to have a bit
Speaker 3: of a tussle over the cher figures of investment, they
Speaker 3: were solely disappointed by the Coalition coming out and supporting
Speaker 3: this measure. But we can be guaranteed that should either
Speaker 3: Labor or the Coalition at this stage get over the
Speaker 3: line at this election, which is due by the seventeenth
Speaker 3: of May, then we can see this bulk building incentive
Speaker 3: roll out by November.
Speaker 4: Harry, I'm really interested because clearly the fact that both
Speaker 4: sides of politics are supporting this move, there is widespread
Speaker 4: support for it. I am, though, curious about some of
Speaker 4: the criticisms of it, because we heard from Peak health bodies,
Speaker 4: from GPS themselves. What are some of the criticisms that
Speaker 4: we're hearing about this policy? Are there any?
Speaker 1: Oh?
Speaker 3: Absolutely, And let's just remember this is an incentive for
Speaker 3: GPS to bulk build their patients. It's not an enforcement mechanism.
Speaker 3: No one's going to be going in and telling them
Speaker 3: off if they refuse to bow bill. But the central
Speaker 3: question is whether this incentive is enough to cover the
Speaker 3: cost of running a clinic.
Speaker 2: Because those costs have also gotten up.
Speaker 3: Oh, absolutely a cost of living crisis. It's absolutely not exempt,
Speaker 3: and so gps are going to be faced with this
Speaker 3: question of will I get this bulk billing incentive or
Speaker 3: would it be more viable for me to continue to
Speaker 3: charge out pocket for these patients. The government's pretty confident
Speaker 3: about the incentive, working to get up to nine out
Speaker 3: of ten doctors visits bulk built by twenty thirty. I
Speaker 3: did put this question to the peak body, the Royal
Speaker 3: Australian College of GP President, doctor Michael Wright, and here's
Speaker 3: a little of what he told me earlier.
Speaker 1: Just because that incentive has been available to everyone doesn't
Speaker 1: mean everyone's going to get po built because Medicare rebates
Speaker 1: still don't cover the cost of care and so not
Speaker 1: all practices will be able to participate in this initiative.
Speaker 4: Okay, So what he's saying and what you're saying here
Speaker 4: is some of the criticism is that the amount that
Speaker 4: is given to a GP clinic, for example, or a
Speaker 4: medical center to cover the bulk billing. Is this in
Speaker 4: the amount that said GP clinic could get through out
Speaker 4: of pocket costs and charging the patient.
Speaker 3: That's right, and it doesn't cost the same right across
Speaker 3: Australia to run a clinic either. It definitely depends on
Speaker 3: all the overhead costs that come with that. So I
Speaker 3: think there's a very fair question of whether it's viable
Speaker 3: for the future of a GP workforce. And another thing
Speaker 3: that doctor Wright also mentioned to me earlier is that
Speaker 3: if you have this incentive rollout and more clinics decided
Speaker 3: to bulg bill, then that means more people are going
Speaker 3: to go see a doctor as well.
Speaker 2: Yeah, just naturally clan and demand.
Speaker 3: And the government's response to this is that it's offering
Speaker 3: more trainee ships, so four hundred nursing apprenticeships and two
Speaker 3: thousand junior doctor trainees by twenty eight But whether that's
Speaker 3: going to be enough to feel what we know is
Speaker 3: a really stretch workforce.
Speaker 4: Get really strained. We've spoken so many times on this
Speaker 4: podcast about the strain that the GP workforce and can't
Speaker 4: be overestimated the number of industries that are facing similar strains.
Speaker 4: But just because we're talking about GPS today, there has
Speaker 4: been so much information about GP burnout, and it's interesting
Speaker 4: in the context of this sort of discussion about whether
Speaker 4: it is, as you said, commercially viable for this model
Speaker 4: to work, and how you balance that with the need
Speaker 4: for patient care.
Speaker 3: That's right, and it's really interesting that both Labor and
Speaker 3: the Coalition are on a unity ticket for this measure,
Speaker 3: and that it is very likely that we're going to
Speaker 3: see these incentives roll out starting in November. It will
Speaker 3: be a matter of how many gps decide to take
Speaker 3: up that incentive, and will certainly be keeping a close
Speaker 3: eye on it. I'm sure many of my friends and
Speaker 3: many of your friends and family who are always looking
Speaker 3: for a bulk billing GP will notice any difference. Will
Speaker 3: you be able to fine one in your local area
Speaker 3: more ease? Yeah, that's the great question. Will it work well?
Speaker 2: Have to stay tuned for that one.
Speaker 4: Thank you so much for joining us for this episode
Speaker 4: of the Daily Oas. If you learned something from today's episode,
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Speaker 4: again this afternoon with some more headlines, but until then,
Speaker 4: have a great day.
Speaker 3: My name is Lily Madden and I'm a proud Arunda
Speaker 3: bunge Lung Kalkotin woman from Gadighl country. The Daily os
Speaker 3: acknowledges that this podcast is recorded on the lands of
Speaker 3: the Gadighl people and pays respect to all Aboriginal and
Speaker 3: Torres Straight Island and nations. We pay our respects to
Speaker 3: the first peoples of these countries, both past and present.