It will take at least four years for the fruits of Labor’s bulk-billing incentive package to ripen, Senate estimates has heard.
Less than 1000 GP clinics have expressed interest in joining the new bulk-billing PIP program ahead of its 1 November introduction, a senior bureaucrat at the Department of Health, Disability and Ageing has revealed.
There are technically two bulk billing-related reforms coming into effect on that date; eligibility for the existing bulk-billing incentive will go from just under-16s and people on healthcare cards to all Australians, and practices that commit to universal bulk billing can receive a new PIP payment.
Speaking at the senate community affairs legislation committee estimates hearing on Thursday night, opposition health spokesperson Senator Anne Ruston questioned DoHDA representatives on just how fast the investment would alter bulk-billing rates.
In response to a question from Senator Ruston on when the average out-of-pocket cost for a GP level B consult would “be down to $0”, first assistant secretary of Medicare benefits Daniel McCabe said the average would likely increase even as bulk-billing rates increased.
“Senator, I think I we probably need to explain the way that an average way this average is calculated,” he said.
“It will probably go up as more people are bulk billed because we will have outlier GPs that are charging higher out-of-pocket expenses and if they continue to do that, the average for that subset of patients will be higher for a period of time.”
This is partially because the average out-of-pocket cost calculation only takes into account patients who did pay a gap fee; it excludes the patients who were bulk billed and therefore paid a $0 gap fee.
Part of the reason that the average fee is likely to go up is that GPs who were only charging a small out-of-pocket fee – thus dragging down the average – will likely switch to bulk billing.
Senator Ruston questioned DoHDA’s prediction that the GP non-referred attendance bulk-billing rate will hit 90% by 2030, and asked why rates would not improve faster.
“We looked at what happens historically in Medicare when governments make interventions around bulk billing,” Mr McCabe said.
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“And we had a similar issue with bulk billing back in the early 2000s, where the then Howard government had to make a significant set of measures to try to increase bulk billing.
“It took four years for GPs and GP practices to take on board all of those measures and roll them through.
“We expect that kind of behaviour will occur in this instance as well.”
DoHDA assistant secretary for MyMedicare and bulk-billing clinics Jo Da Rocha said that, as of Thursday morning, there were more than 900 GP clinics which had expressed interest in joining the BB PIP scheme.
There are roughly 850 existing universal bulk-billing clinics in Australia.
It is possible, then, that the number of universal bulk-billing clinics will not noticeably increase come 1 November.
Senator Ruston also accused Prime Minister Anthony Albanese of having “lied” about visits to the GP becoming free under the Labor government.
Multiple DoHDA representatives then pointed out that the opposition had committed to exactly the same investment.
