One aspect of the college’s election pitch has the potential to send bulk-billing rates up and practice viability down, says a prominent GP.
The RACGP’s proposal to extend the tripled bulk-billing rebate to all Australians under 35 is short-sighted and may ultimately harm general practice if taken up, according to a former candidate for college president.
Melbourne GP Dr Chris Irwin ran in both the 2020 and 2022 RACGP elections, and went on to found a lobby group called the Australian Society of General Practice.
ASGP’s Facebook page has not been active in over two years, and its website domain appears to have lapsed.
The RACGP’s official pre-budget submission recommends extending the tripled bulk-billing incentives, which currently only apply to people aged under 16 and people with a concession card, to all Australians aged 34 or under or with a concession card.
The tripled incentives introduced in late 2023 only applied to time-based consults and residential aged care facility consults and were tiered by remoteness.
If implemented, the RACGP predicted the expansion could cost anywhere between $1.6 billion and $2.2 billion over four years, but save the healthcare system $119 million annually.
For a Level B consult in a metropolitan area, the bulk-billing incentive payment is $21.35.
The average gap payment for a Level B, according to the latest Medicare data, is $42.81.
That leaves GPs about $20 worse off per appointment if they took up bulk billing for under-35s.
“If you believe in universal healthcare (and I do) – we have to ration the limited resources that government is actually willing to spend,” Dr Irwin said.
“Are we seriously suggesting a system where a 34 [year old] executive expects their GP to take a … pay cut with every consultation, and support a government to create a market situation that would force this?”
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An alternative proposal, he said, would be to tie the bulk-billing incentive to the average gap payment and decrease the Medicare safety net to $600 for all Australian families.
“The RACGP need to understand that the clear intent of this current government is to force GPs increasingly to bulk bill through extra incentives only available if items are bulk billed,” said Dr Irwin.
“They want to directly intervene in the economics of general practice clinics to make them even less viable while neglecting to ever actually fix the actual issue; rebates were frozen for a decade and now have no reflection of the actual cost of providing a service.
“We need to stop giving both sides of parliament a free pass while they continue to harm our country.”
In Dr Irwin’s opinion, the run-up to what is expected to be a relatively close election should be spent applying pressure on both parties for “real gains”.
“The absolutely best thing our profession has done is to actually set the market price for a service provided. We should do absolutely everything possible to keep that power away from those who choose to abuse it, while absolutely ensuring that the vulnerable are protected,” he said.
“This policy therefore does not help patients, it does not help general practice, and should be completely abandoned.”
Other items on the RACGP’s wish list for this year include increasing MBS rebates by 40% for all standard time-based consults, funding extra training places and making mental healthcare more affordable.
RACGP president Dr Michael Wright has previously reiterated that the college’s proposals were not designed to exert influence over member billing behaviour.
A date for the 2025 federal election has not been set at time of writing.
