New stats on bulk-billing rates have churned up discourse on how the new reforms will perform long-term.
With the much-anticipated November 1 bulk billing reforms already beginning to reshape primary care, Health Minister Mark Butler is now hinting at wider moves to reign in non-GP specialist fees.
The Department of Health, Disability and Ageing has revealed nearly 3000 clinics have now signed up for the Bulk Billing Practice Incentive Program (BBPIP).
This brought the bulk-billing rate for November up to 81% with the focus now shifting to the future for how the federal government will be able to meet its ambitious targets for the incentives.
“The statistics highlighted at Senate Estimates this week are in line with the estimates made by the Government ahead of 1 November,” an RACGP spokesperson told The Medical Republic.
“We know the new incentives will increase support for many GPs and their patients, particularly for practices universally bulk-billing and those in regional and rural Australia where the incentives are greatest.
“But as the Department of Health’s own modelling shows they won’t work for all practices.”
Health Minister Mark Butler has been on the media rounds for the initiative, highlighting where it will benefit patients as the BBPIP progresses.
Per Mr Butler, up to four million additional bulk-billed visits to GPs were completed in November.
Now, Mr Butler is setting his sights on non-GP specialist fees.
“What we’re finding in some areas is specialist fees are completely out of control,” Mark Butler told 2RM.
“I’ve been up front with doctors’ groups – from my point of view, every option is on the table, we cannot continue in the direction we’re going right now.
“It’s not only a huge hit to household budgets, but we know that more and more Australians are choosing not to access the care that they need to because of cost.”
One of Labor’s pre-election promises this year was to make the Medical Costs Finder website mandatory for all non-GP specialists.
Today, he said the department was considering other options to “potentially control fees”.
He even briefly mentioned the infamous 1940s ‘civil conscription’ clause in the constitution.
Section 51 xxiiiA of the Commonwealth of Australia Constitution Act states that the government does have the power to make laws on medical and dental services “but not so as to authorise any form of civil conscription”.
“We’re looking at that because traditionally what we’ve done, there are some restrictions in the Constitution on what we can do, what we can force doctors to do,” Butler toldABC Radio Melbourne.
“I’m looking at these options very carefully because traditionally, doctors have been allowed to charge a modest fee on top of the Medicare rebate, but it’s gone well beyond that in some areas.”
The AMA has argued that a neglected Medicare has contributed to this inconsistent pricing for specialist fees and that addressing this will in turn assist with patient affordability.
“Medicare, which greatly underpins private pricing, has been neglected for decades,” AMA president Dr Danielle McMullen told TMR.
“The Medicare Benefits Schedule has been poorly indexed and was even frozen for several years from 2013.
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“We recognise that healthcare is not immune to the affordability challenges affecting so many aspects of our country.
“To address this properly, we must invest in Medicare and bring rebates into line with the health needs of Australians today.”
The RACGP has also responded to Mark Butlers media rounds, reiterating that the college will work with its members to ensure reforms are sustainable for patients and practices.
“Practices and GPs across Australia will do what is in best long-term interests of their patients, their practices, and the communities they serve, that has not changed,” an RACGP spokesperson told TMR.
“The Royal Australian College of GPs will continue to support our members to understand the new incentives, so they can make an informed decision about whether they will work for them and their patients.”
