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Medicare lags further behind as doctors forced to increase fees

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The fee for a standard GP consultation has been edged $2 higher to $73 in the latest advice issued to doctors by the AMA.

In its annual guidance to members, the AMA has recommended a modest average increase in consultation fees to reflect the rising cost of providing health services, including higher wages, utility charges, rent, insurance premiums and education and training costs.

The rise is set to be felt immediately by some patients, following the previous Federal Government’s decision to freeze Medicare Benefits Schedule patient rebates – which are usually indexed in November – through til mid-2014. The measure is expected to save the Commonwealth $664 million.

The delay means the Medicare rebate will remain stuck at $36.30 until July next year, and will account for less than half of the recommended fee for a standard Level B GP consultation.

AMA President Dr Steve Hambleton said the rebate freeze was unacceptable, and further inflated the severe discrepancy between what medical services cost to provide, and the rebate the Government was prepared to pay for them.

“The MBS simply has not kept pace with the complexity or cost of providing high quality medical services,” Dr Hambleton said.

In setting the fee increase, the AMA took into account both the movement in wages, which are one of the biggest expenses in providing health services, and increases in other costs such as electricity, equipment, property charges and professional insurance.

The average 2.93 per cent recommended fee increase is less than the 3.19 per cent rise in the Wage Price Index in the 12 months to March, and a little more than the 2.4 per cent lift in the Consumer Price Index in 2012-13.

Dr Hambleton said doctors had kept their fee increases to a minimum, but warned patients faced an increased gap between doctor charges and Government support because of the decision to freeze MBS rebates.

Government figures suggest that patients have so far been largely insulated from any increase in GP charges – in the first three months of the year the bulk billing rate hit a record high of 82.4 per cent.

Similarly, in the three months to June just 11 per cent of privately insured patients were required to make a gap payment for in-hospital medical services.

Reflecting this, Australian Institute of Health and Welfare figures show total average patient out of pocket expenses increased by just $2 in 2011-12 to $131.

But Dr Hambleton said the ability of doctors to absorb higher costs and continue to bulk bill patients was under severe strain, warning in the Herald Sun that the “last time the rebate fell below 50 per cent of the fee we saw a big drop-off in bulk billing”.

In the last edition of Australian Medicine, AMA Chair of General Practice Dr Brian Morton, savaged governments for playing on the good will of GPs to wear increased practise costs rather than passing them on to patients.

“Unfortunately, we GPs are our own worst enemy, as we willingly absorb the true cost of providing quality medical care,” Dr Morton said. “The profession is seen as a soft target by the Government. The assumption is always that GPs will absorb the costs and continue to bulk bill. This is usually backed by a proud boast about the high rate of bulk billing.”

Dr Morton urged GPs to set their fees based on their practice costs and workload.

Dr Hambleton said the AMA applauded those private health insurers who had ignored the Federal Government’s Medicare rebate freeze and had “stuck with the tradition of indexing their schedule of benefits on 1 November. These insurers have acted in good faith to minimise the cost impact on their members”.

Adrian Rollins