How Labor Ensured the Death of Universal Bulk Billing

Yes yes, the LNP froze the Medicare rebates for years, pushing GPs away from being able to bulk bill all their patients, but many still chose to bulk bill, or offered bulk billing to kids and concession card holders. Others moved to private billing entirely, with some offering a slightly lower upfront cost if you’re a cardholder, but not all.

In all the cases where the GP is choosing to bulk bill or take a lower upfront payment they are effectively having to absorb that cost into the practice and have to covered by full fee paying patients.

But the changed to have a different bulk billing incentive for those that have a concession card and those that don’t has certainly stopped some bulk billing non-eligible patients, as they would then be worth $13 less per consultation, and where is the sense of obligation to bulk bill regular patients if they are worth less on the books than those with concessions and kids?

The RACGPs recommends a level B consult fee of just over $100. So, when they bulk-bill a patient, they are accepting a lower payment than if they charged them privately. If they private bill though, the patient will only get the regular rebate back, and that $20 is lost to the empty promises.

Who does the bulk billing incentive apply to? This incentive only applies to the following vulnerable patient groups, and only if they are bulk billed: Children under 16 years Commonwealth concession card holders (Centrelink or DVA cards): Pensioner Concession Card Health Care Card Commonwealth Seniors Health Card How much is the bulk billing incentive? The bulk billing incentive applies to eligible patients as per the following locations: Metro (MMM1): $20.65 Regional centres (MMM2): $30.15 Large-medium rural towns (MMM3-4): $31.95 Small rural towns (MMM5): $34.05 Remote communities (MMM6): $35.80 Very remote communities (MMM7): $39.65

So, when Labor defend the stage three tax cuts with the bulk billing incentives and the chance they make a difference to people’s ability to access the medical care they need, I laugh and cry.

If you’re on $45k, you’re unlikely to have a health care card (you might if you have a family member with a disability) so your 43c a week isn’t exactly going to cover the $90 upfront my GP charges, or the $70 with concession. You might be able to buy some of that “summer sports gear” for a certain upcoming long weekend, but you won’t be able to cover the “$30” meds that went up to $31.60 on Jan 1.

So, while the LNP starved Medicare, by creating a three-tier system, Labor are killing the last of the will for universal bulk-billing. So every time they tout the tripled bulk billing incentive, remember that it only applies to kids under 16, concession card holders and some eligible Indigenous Australians, and so leaves out the precious middle Australia that I thought they were trying to win over? No?

Who even is the Labor target market these days?

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