Bypass Medicare altogether and exchange your knowledge of URTIs and eczema for something practical.
A Sydney medical centre has given up on billing Medicare and charging gap fees and is using a bartering system to pay for appointments.
The Medical Republic spoke with Professor Candid who works at the Bulgakov Clinic in inner-outer Sydney.
“As you know, Medicare rebates were frozen a decade ago and while the current Labor government is happy to fund pharmacists to diagnose UTIs and pay nurse practitioners to treat complex patients, it continues to devalue general practice.”
The Bulgakov clinic was set up to serve a very socioeconomically deprived part of the city, where the median apartment price is barely $2 million.
“As you can imagine,” continued Professor Candid, “our patients weren’t too keen on paying a $40 gap fee. And so that’s when we hit on the idea of using a bartering system instead.”
Under the new system the patient receives medical care in exchange for goods. Professor Candid shared a typical list.
| Condition | Bartering Fee |
| Eczema | 2.5kg of turnips |
| Psoriasis | 5kg of spuds |
| Anal fissure | Bag of door handles |
| B12 injection | 2 metres of tartan fabric |
| Prolia injection | A roll of copper wiring |
| Methadone prescription | Laptop and 1 x mobile phone with cracked screen (probably stolen) |
| Viral URTI | Victorian garden lamp post |
| SOBOE | The Da Vinci Code by Dan Brown |
| ACL rupture | Cordless hedge trimmer from Aldi |
| Low back pain | Box of buttons (non-matching) |
| Migraine | 1 x Caprotti valve gear |
| Dry eye | Vintage black telephone |
| Type 2 diabetes | A brass rubbing from Salisbury Cathedral |
| Sub-fertility | Some thimbles |
| COPD | Pack of flavoursome menthol cigarettes |
“The bartering system seems to be working really well,” Professor Candid told TMR.
“I feel like I’ve got my self-respect back. Only last week I treated a man’s piles and got 4m of lead piping, a month’s supply of dog food and some boiler lagging!”
