A man with heart attack symptoms who waited two weeks to see a doctor; parents foregoing their own care to ensure their children are treated; and hour-long drives to the nearest bulk-billing practice: Guardian Australia readers have shared their experiences of accessing affordable healthcare in response to a callout as part our series on the decline of bulk billing in Australia.
One man on a disability pension, who asked that his name not be used, said he had called a home doctor service one evening because he was experiencing symptoms that are commonly associated with a heart attack. After being on hold for over an hour and a half with no answer, he called 1300 SICK and was advised to call an ambulance. Knowing he would receive a bill for this that he could not afford, he did not follow this advice.
“Instead I waited all night for my symptoms to subside and called the local GP clinic the next day for an appointment,” he said. “On the call I was told they had recently stopped bulk billing and as a new patient I would need to pay for an appointment upfront ($90) and then would have the rebate refunded into my account, leaving a gap of $15 that I would pay. I didn’t have $90 so I have had to wait a fortnight for my next pay so I could see a GP.”
Jenny d’Arcy, 50, from Adelaide, has been out of work for four years and was diagnosed as autistic 12 months ago. “I’m studying a bachelors degree part time and that meant that I could make use of the health clinic at uni. They have now decided to stop bulk billing,” she wrote. “I don’t know what I’ll do now – everything is so expensive and I’m very frightened.”
Another university student, in Sydney, explained that he had been on the books of a bulk-billing doctor for more than 10 years. He put off non-urgent visits during the pandemic, he said, but when he finally did try to make an appointment recently, the clinic no longer recognised him as an “existing patient” within their system, and was not taking “new” patients.
Those in rural and regional areas said they often had to travel long distances to access bulk-billing healthcare. One man from Adelaide Hills in South Australia, who has a back injury and mental illness, and is on jobseeker, said the nearest bulk-billing GP was four towns – 30km – away from where he lived. “So much for living in a decent country,” he said. “I have not felt part of this society for many years now.”
“It is difficult enough to find a GP appointment at all, let alone one that bulk bills,” wrote a family of three in rural Victoria. They described having to make a 140km round trip to access a doctor that would bulk bill all members of the family.
A mother of three in the Hunter Valley region of New South Wales said her GP used to bulk bill children under 15 prior to Covid lockdowns, but now charges nearly $90 for a 15-minute consultation. As three of her children have ongoing conditions, she frequently has to postpone her own medical needs to afford theirs. Even still, there was regularly a three- to four-week wait for appointments – in one instance, she had to take her child to emergency for a prescription for antibiotics as it was not feasible to wait weeks for treatment.
Readers in Tasmania, in particular, reported difficulties.
“It’s impossible to find a bulk-billing clinic,” wrote Tilly Clota from Hobart, who has endometriosis. “Wait times to book an appointment are generally two weeks as well. Because of this, I recently went to [the local hospital emergency department] for chronic pain in my abdomen and back, as I was worried it might not be endometriosis related, and couldn’t wait two weeks to find out.”
Another woman living in regional Tasmania said she travelled an hour each way to access a doctor, and that the clinic often has up to a four-week wait for appointments.
A resident of Canberra, where bulk-billing rates are also woefully low, wrote that she pays a $55 gap fee for a standard appointment with her doctor, and is $95 out of pocket for the long appointment required to renew her mental health plan.
“I recently was referred to one of the few psychologists in the ACT who currently has their books open to new patients,” she wrote. “An initial consultation with them was going to set me back over $400, and even after the Medicare rebate I was still going to be hundreds of dollars out of pocket.”
Readers who are nearing retirement expressed concern about how they will manage medical costs as they age.
Vivien Collins, from Perth, who has rheumatoid arthritis, said her doctor of nine years, whom she holds in high esteem, has recently stopped bulk billing. The costs of her regular appointments for medication renewal, the medications themselves, and her rheumatologist appointments have all gone up.
“I’m a 71-year-old woman still working in a bookkeeping and general administration role,” Collins said. “How on earth can I contemplate retirement when costs for my medical condition, something I have to accept and work with, have escalated so significantly? And that is before the effects of ageing or falling ill as people do, gets added to the equation.”
