Most people seeing a doctor will remain ineligible for bulk-billing appointments at general practitioners despite the federal government's move to triple incentives for some members of the population, the Australian GP Alliance (AGPA) says.
Announced in Tuesday's federal budget, from November 1 the government will triple incentives for the most common consultations with children under 16, pensioners and other Commonwealth concession card holders.
It hopes it will put a stop to the rapid decline of bulk-billing rates, but AGPA deputy chairperson Mukesh Haikerwa says it will give little reprieve to others struggling with the rising cost of living.
"Unfortunately, for the vast majority of people who are coming to the practice, the rebate hasn't increased, and therefore the fees that currently exist still exist," he said.
"There will still be that ongoing gap."
He said that while clinics were not obligated to bulk-bill any patients, generally GPs were already offering it to those targeted by the government incentives and it was unlikely to be offered to other patients.
"In all honesty, across the country, they've continued to see bulk-billing despite the fact the [rebate] hasn't gone up," Dr Haikerwal said.
He said it was not just people on government benefits who were struggling to make ends meet.
Federal Health Minister Mark Butler has described it as "the largest increase to the bulk-billing incentive in the 40-year history of Medicare".
Dr Haikerwal said the changes might relieve some of the financial stress practices were feeling, and therefore could allow them to give those on the breadline some breathing room.
"In a practice like ours, we always try to bulk-bill people who are doing it tough," he said.
"It will allow us to keep bulk-billing older people, people on health care cards and their children and we'll probably find more children are bulk-billed."
He also said it could allow for practices to offer a reduced gap fee.
Growing costs for GPs
Dr Haikerwal said the rebate had only increased 5 per cent in the past 15 years.
"I think the issue is indexation hasn't been there. There are so many more cost involved," he said.
"We are all dealing with the cost of living at the moment, and because of the cost of inflation, medication inflation is obviously higher."
While Tuesday's announcement was a much-needed cash injection, he said the system still needed "smartening up" and called for an independent pricing authority to oversee incentives and rebates.
Bulk-billing in decline
Rural Doctors Association of Australia president Megan Belot said over the past 12 months regional and remote practices were moving away from bulk-billing.
"And from a remote perspective, sometimes you only have one practice in town, and these patients can't afford to pay the gap," she said.
"Some of these patients can't even pay for petrol to get to another town, even if they could be bulk-billed.
She said the incentives, while positive, fell short of a reform to primary care.
"We know that Medicare alone by itself is not enough to sustain our private practice and our healthcare in rural remote Australia," Dr Belot said.
"So what we would love to see … in subsequent budgets, is things like block funding that can be directed to a private practice so patients don't have to pay such a large gap."
She said there was also little incentive for medical specialists to leave capital cities.
"At the moment, I think people forget that GPs, as a whole, are basically either sole contractors, and we're just running a small business like any other small business owner," Dr Belot said.
"We want to see doctors' salaries on par to consultants in the city.
"Our expertise and our care, what we do for a living also needs to be respected, and we all need to pay our bills like everyone else."
