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Rebate freeze will cost avg GP almost $110,000

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The Medicare rebate freeze will leave a full-time GP $109,000 worse off by the time it is lifted in 2020, and practices will need to charge patients at least an extra $11.40 per visit just to maintain their income, a study on the impact of the policy shows.

Researchers at Sydney University’s Family Medicine Research Centre – which is due to close down on 30 June – have reported that the rebate freeze, which has been in place since 2014 and is due to remain until June 2020, will cost practices hundreds of thousands of dollars in lost income – underlining concerns it will force many to abandon bulk billing and begin charging patients if they are to remain financially viable.

The researchers, Christopher Harrison, Clare Bayram and Helena Britt, estimated that GPs would lose 9.4 per cent of their income if they did not pass the costs of the freeze on to their general patients.

They said that for an average full-time GP, who bills 5680 consultations a year, this would amount to a loss of $40,000 in 2019-20 alone, and total loss of $109,000 over the six years the freeze is due to be in place.

This was likely to result in extra charges for patients, the researchers said.

“The 9.4 per cent reduction in income may force GPs who bulk bill to cover their loss by charging general patients a co-payment,” they said.

They estimated that GPs would need to charge a minimum of $11.40 just to hold their income at 2014-15 levels, but admitted it was likely to be substantially higher because it did not take into account the administrative costs of setting up a billing system, increased bad debts, the impact of previous fee freezes and the income lost when a GP bulk bills a general patient facing financial hardship.

“It’s therefore likely that GPs who opt to charge a co-payment will charge more than our estimates,” they said, and cited the results of an Australian Doctor poll showing a majority would charge $25 or more for a standard consultation.

The findings of the study echo concerns raised by AMA President Dr Michael Gannon that the rebate freeze was pushing many practices to “breaking point”.

“We know that…some are being forced to introduce patient charges for the first time, others are having to increase their fees,” Dr Gannon said. “Either way, patients lose out and health suffers.”

The AMA President said the freeze was “bad policy” because it would cause many patients to consider delaying seeing their doctor, exacerbating their health problems and making it more likely they would eventually need expensive hospital treatment.

The Family Medicine Research Centre academics warned freeze was likely to hit disadvantaged and chronically ill patients the hardest.

“The freeze is likely to have a greater impact on practices that serve socioeconomically disadvantaged people, as the practices would have to absorb the reduction in gross income, which may not be viable,” they said.

Adding to the pressure on patients and doctors, the researchers estimated that the Government’s proposed increases in co-payments for Pharmaceutical Benefit Scheme medicines would hit elderly patients particularly hard.

The increases, which have so far been blocked in the Senate, would push the PBS co-payment for general patients to $43.30, and for concessional patients to $7.

The researchers estimated that aged pensioners would, on average, be left $29.65 a year worse off as a result of the changes.

Adrian Rollins