In a headline-grabbing, cornerstone pre-election pitch, Labor has promised to make nine out of 10 GP visits free for patients by the end of the decade.
A move to expand the bulk-billing incentive to all Australians is the centrepiece of the plan costing $8.5 billion over four years, which Labor says will be the single largest investment in Medicare since its inception more than four decades ago.
Bulk-billing — where doctors bill Medicare directly so patients have no out-of-pocket costs — has long been seen as a stalwart of Australia’s healthcare system, removing barriers to crucial care.
Prime Minister Anthony Albanese has pledged to deliver the largest investment into Australia’s Medicare scheme since its inception. (AAP: Rob Burnett)
And promising to make it cheaper to see the doctor is an unsurprising move in a campaign that will largely be fought on cost-of-living issues, at a time when an increasing number of Australians are delaying or skipping healthcare entirely because of the cost.
The Coalition swiftly matched the commitment “dollar for dollar.”
But the $8.5bn question is: Will this change mean your GP visits are more likely to be free?
Let’s take a closer look at the announcement.
First things first, what is the bulk-billing incentive?
The bulk-billing incentive is a payment aimed at encouraging doctors to provide their services at no cost to their patients.
Crucially — doctors only receive the bulk-billing incentive payment if they agree to bulk bill, and they then receive it on top of the Medicare rebate (a government payment that typically covers a portion of the appointment cost.)
Australian general practitioners currently receive bulk-billing incentive payments in addition to the Medicare rebate if they agree to bulk bill their patients. (ABC: Michael Donnelly)
The incentive currently only applies to a small cohort of the population including children under 16 and concession card holders, and also differs depending on where you live, with GPs in remote areas receiving higher incentive payments than those in the city.
In November 2023, the incentive was tripled to about $21 in metropolitan areas, up from about $7.
But, not everyone took it up.
There was pushback from some doctors who argued the Medicare rebate was so low that even if they bulk-billed patients and received the incentive, it still wasn’t enough to cover costs.
The Medicare rebate was tripled in November 2023, but some doctors argued the increased funds still were not enough to cover their costs. (AAP: Dave Hunt)
What will this announcement do?
This announcement will expand the current bulk-billing incentive so that it can be used for all Australians (not just kids and concession card holders) from November this year.
It means a GP who bulk bills anyone will now receive a Medicare payment comprising of the rebate and an incentive payment. For a standard consult by doctors in metropolitan areas this will be about $63.50.
To sweeten the deal, any GP who bulk bills everyone they see also receives an additional quarterly payment — set at 12.5 per cent of a practice’s Medicare billing. So that payment of $63.50 we mentioned before would rise to $69.56.
As of December, about 77.5 per cent of all GP visits were bulk-billed nationally.
Labor says this plan will see that rate rise to 90 per cent by 2030, and will mean an increase of 18 million additional bulk-billed appointments a year.
“No Australian should have to check their bank balance to see if they can afford to see a doctor. That is not who we are. That is not the future we want for Australia,” Prime Minister Anthony Albanese said.
“This is a policy that lifts up our entire nation and ensures no one is held back, and no one is left behind.”
The announcement comes on the back of a spike in the number of people who delayed or skipped seeing their GP because of the cost, with Australian Bureau of Statistics figures showing a jump from 3.5 per cent in 2021-22 to 8.8 per cent in 2023-24.
So, will this policy mean you get to see your GP for free?
The short answer is: it depends.
Australian Medical Association (AMA) president Danielle McMullen said for some it will mean it’s more likely their GP bulk bills but for others, there may not be any change.
“I think in some parts of Australia this will see a shift in the rates of no out-of-pocket consultations. In other parts, it’s unlikely to make a huge difference,” she said.
“We know in some of our metropolitan centres and in some of our better-off suburbs, the average out-of-pocket cost is now above $40, and so the $20 bulk-billing incentive still doesn’t come close to meeting those costs.
“But really I do hope this will make a difference in rural and regional communities and in our areas of socio-economic disadvantage, where GP’s have been really trying as hard as they can to keep those costs down.”
Grattan Institute’s health program director Peter Breadon says, overall, the change will mean it’s more likely patients are bulk-billed.
But he notes it’s entirely up to GPs whether they bulk bill and accept the incentive, and those who don’t are free to set their own fees.
“Choosing to respond to this incentive is completely optional for GPs,” he told the ABC.
“I think there is no guarantee that people pass this on, and some clinics will be charging fees that are essentially so high that it doesn’t make financial sense for them to switch across.”
What else is in the policy?
While the policy centres around the bulk-billing incentive change, it also includes a $600 million package to expand the GP workforce.
Workforce issues have long been documented, with concerns the supply of GPs won’t keep up with growing demand.
This policy aims to expand GP training spots to 2,000 a year (an extra 400 a year) from 2028, and includes salary incentives so more trainee doctors choose to become GPs when it’s time to specialise.
Dr McMullen said those changes were “exciting” and would help address workforce shortages across the board.
What’s been the response?
The policy has been broadly welcomed but some experts still argue more needs to be done to address underlying health inequities in the system.
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The AMA and Royal Australian College of GPs have been pushing for changes to Medicare rebates, saying they’re increasingly not covering the full cost of services particularly when it comes to longer consults.
Peter Breadon says the policy change won’t address the way GPs are funded (where shorter visits are more lucrative when it comes to dollars per minute) and won’t bolster support in many areas that don’t have enough health care to go around.
“In those parts of Australia that we call GP deserts, where there’s really never been enough care for the last 10 years, you really saw low bulk-billing in those areas throughout,” he said.
“They were low even when the national rate was at historic peak, and they remain low today.
“They probably need a different solution.”
With the Coalition matching the promise, the policy will come in to effect in November this year regardless of wins government at the next election.
