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City dwellers hold up bulk billing rate

Practices dumping bulk billing as Medicare rebate freeze bites - Featured Image

The bulk billing rate is continuing to climb despite the Federal Government’s four-year Medicare rebate freeze, underlining concerns about the increasing financial pressure on the nation’s GPs.

Eighty-three per cent of standard GP visits were bulk billed last financial year, up from 82.2 per cent in 2013-14, and 10 percentage points higher than a decade before.

Sydneysiders were the most likely to be bulk billed – more than 96 per cent of GP visits in western and south-west Sydney were covered entirely by the Medicare rebate, compared with around 84 per cent in Melbourne, 83 per cent in Adelaide, about 80 per cent in Brisbane, 76 per cent in Perth, and just 57 per cent in Canberra – the nation’s lowest reading.

Not only are patients in west and south-west Sydney the least likely to face a charge to see their GP, they tend to see their GP more often than other Australians. As a result, Medicare expenditure per person in these areas is well above the national average.

Updated National Health Performance Authority figures, released on 19 November, show people in south and west Sydney saw their GP, on average, 7.5 times in 2013-14, and cost Medicare between $340 and $345 per person. The national average that year was $258.

Medicare expenditure on GP visits per person was much lower in rural areas – down to as little as $200 in country WA – reflecting the relative scarcity of GPs in these regions and their low rates of bulk billing.

People in country Western Australia saw their GP, on average just 4.1 times in 2013-14, and 75.5 per cent of visits were bulk billed.

The competitive pressure caused by a high concentration of GPs in urban areas is helping holding up bulk billing rates in the big cities.

But the AMA has warned that an increasing proportion will be forced to begin charging patients as the Medicare rebate freeze bites.

The four-year freeze came into effect in mid-2014 and will hold remuneration from Medicare flat while other costs, particularly staff wages, utility charges, rent and equipment, continue to rise.

The National Health Performance Authority provides a detailed breakdown of bulk billing rates, GP and specialist visits and expenditure, and after-hours attendances, by Primary Health Network and 300 smaller areas covering the whole of the continent.

The latest report, Medicare Benefits Schedule GP and specialist attendances and expenditure in 2013-14, can be viewed at: http://www.myhealthycommunities.gov.au/

Adrian Rollins