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End of bulk billing for millions

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Millions of patients may no longer be bulk billed and will instead face up-front charges of up to $45 or even more to see their family doctor as a result of the Federal Government’s radical overhaul of medical practice funding, the AMA and other medical groups have warned.

AMA President Associate Professor Brian Owler said the Government’s move to slash the rebate for GP consultations of less than 10 minutes, to freeze indexation of the Medicare Benefits Schedule through to 2018, and to slash the rebate for non-concession card holders by $5, would make it impossible for many practices to continue to bulk bill patients.

“What we’re going to see is $3.5 billion pulled out of general practice,” A/Professor Owler said. “General practice cannot survive those sorts of changes. What it will mean is that GPs will be forced to pass these changes on to their patient in terms of costs.”

Medicare rebates have already been frozen for almost two years, and the Government’s plan will see that freeze extended for a further four years, while inflation grows at an average annual rate of 2.5 per cent.

The new arrangement essentially delivers GPs, specialists and allied health professionals a six-year pay cut and reducing the money they have to operate their practices, including paying staff wages and rent, utility costs, medical supplies and training and IT charges, the AMA President said.

“What’s going to happen is that as specialist and GP practice costs rise, they’re going to have to stop bulk billing, they’re going to have to stop using no-gap schedules, and people are going to have to pay more out of their own pocket,” he said.

But Health Minister Peter Dutton accused critics of the Government’s package of engaging in “scaremongering”.

“Inaccurate claims being made about changes to Medicare are nothing short of scaremongering,” Mr Dutton said. “The Government is taking prudent action to improve the quality of health care – encouraging a shift away from ‘six minute medicine’ – and at the same time strengthening Medicare.”

The Minister said many doctors already charged some patients for their services, and whether or not to bulk bill a patient or charge a co-payment were decisions that were “entirely at their discretion”.

But A/Professor Owler said the rebate cuts and years-long freeze to indexation left doctors with little choice but to pass their increased costs onto their patients if their practices were to remain financially viable.

He said the AMA considered the changes completely unacceptable, and doctors were prepared to go on to a war footing to fight them.

“[These changes] are an attack on small business,” he said. “The AMA opposes these cuts [and will] hold the Government to account on its commitments.”

Adrian Rollins