On the one hand, price transparency. On the other, inflexibility and the inability to bulk bill on a case-by-case basis.
GPs should be listed on the federal government’s Medical Costs Finder website, alongside their non-GP specialist colleagues, to give patients clarity about what costs they will face walking into their appointment, says a health economist.
The Medical Costs Finder provides a portal for the public to compare non-GP specialist fees and have a reasonable idea of the out-of-pocket costs that they will face at their next appointment.
Professor Anthony Scott, from the Centre for Health Economics at Monash Business School, told The Medical Republic that the metrics used for measuring bulk billing rates were service-centred.
“But actually, as a patient, I want to know whether I can go to a GP and be guaranteed to be bulk billed before I go,” he said.
“I don’t want to turn up and be told, okay, yeah, we’ll bulk bill you, or not.
“I want to know before I go, because if I don’t know before I go, I might not go at all.
“GPs’ information on their billing should be up on the Medical Costs Finder website or on Healthdirect or similar, where the patients can see, for example, this doctor or this practice bulk bills 80% of their patients.
“And if you’re not going to be bulk billed, this is what you will pay. That’s all you need. That should be mandated as well, because patients don’t know this in advance when they’re choosing a practice or choosing a GPP, and at least they get some idea of the chance that they might be bulk billed,” said Professor Scott.
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While price transparency is an undoubted advantage, at least for accountability, it could make GPs less flexible about who they bulk bill, said another expert.
Professor Richard Norman, a health economist with the School of Population Health at Curtin University, said making GPs commit to an umbrella bulk-billing policy was a double-edged sword.
“As an economist, I would say that price transparency is always a good thing, because a well-informed consumer going into a consultation understanding the cost that will accrue is good from an economics point of view,” he told TMR.
“The counterpoint – the nagging naysayer on my shoulder – says that the decision to bulk bill is one a GP makes on a case-by-case basis.
“So transparency [like Medical Costs Finder] is going to be very challenging to a GP, because they may see a patient who it becomes clear to the GP that if you impose a cost on them, then that will be a real barrier to them filling out a script.
“It’ll be a real barrier to them coming back for a follow-up appointment, and they may decide, therefore, to bulk bill.
“But in a world of price transparency, that’s not possible.
“For [the price of] petrol, it’s terrific. For health, I’m less convinced. Taking that [ability] to change fees downwards in a consultation is something we shouldn’t take away if we do impose some sort of transparency,” said Professor Norman.
