ANALYSIS
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What is this new $20 GP fee all about?
As part of a suite of health funding cuts announced by the Abbott government last year, the Medicare rebate for most consultations lasting up to 10 minutes is dropping from $37.05 to $16.95 starting January 19. If your doctor bulk bills (does not charge you anything), they will receive $20.05 less for such a consultation. If your doctor charges a private fee, you will receive $20.05 less back from Medicare, meaning your "out of pocket" or "gap fee" will increase by $20.05.
How many consultations are under 10 minutes?
Last financial year, about 35 million GP consultations, or 26 per cent of the 134 million consultations billed to Medicare, were less than 10 minutes.
Why is the federal government doing this?
The government says this will help save $3.5 billion by 2017-18 and make Medicare more sustainable. It will also combat "six-minute medicine", where doctors rush patients through their rooms to maximise revenue. The government says this change to rebates for short consultations may therefore encourage doctors to spend more time with their patients to reach 10 minutes so they receive $37.05 - the medicare rebate for 10 to 19 minute visits.
Is "six-minute medicine" a problem?
Last year researchers at the University of Sydney's Family Medicine Research Centre said data taken from an ongoing annual study of GP consultations showed "six-minute medicine" was a myth. Their BEACH study (Bettering the Evaluation of Health Care), which looked at almost 35,000 GP-patient encounters in 2012 and 2013, showed the average consultation was 14 minutes. This average has remained consistent for the past 12 years.
The research also showed that the median time for a GP visit was 12 minutes, so half of all visits were over 12 minutes and half were under. One in 10 consultations were 0-6 minutes and 16 per cent were 7-9 minutes.
What about the $5 co-payment?
The change to short consultations beginning on January 19 comes ahead of other changes to Medicare set to start in July. If the Senate does not block the changes, from July 1, medicare rebates for all GP consultations, including those up to 10 minutes will be cut by a further $5 for non-concessional patients. This means children under 16, pensioners, veterans and residents of aged care and nursing homes will be exempt from the change.
The $5 cut means that if your doctor bulk bills, they will receive $5 less for your visit. If they charge a private fee, you will receive $5 less back from Medicare for the visit.
So, as of July, Medicare will pay $11.95 towards a visit up to 10 minutes; $32.05 for 10 to 19 minutes, $66.70 for 20 to 39 minutes; and $100.55 for 40 minutes or more. If your doctor charges a private fee, you will have to pay the gap between the Medicare rebate and what your doctor charges.
What else is changing?
The government has also extended a freeze on indexation of Medicare rebates until July 2018. Doctors say this means the rebates are not keeping up with the rising costs of doing business, such as rent, electricity and wages.
What are the predicted impacts of these changes?
The Australian Medical Association says these three changes will discourage doctors from bulk billing and may prompt some to increase private fees.
At the moment, GPs fit into three groups:
- those that bulk bill every patient regardless of their ability to pay
- those that some that bulk bill some patients, such as pensioners, and not others
- those who charge everyone a private fee, leaving their patients to claim the medicare rebate and pay the difference between it and what they charge.
The AMA says these changes will prompt many bulk billing doctors to start charging private fees, making it more difficult to find free GP care. Those who already charge some patients or all of their patients privately may also increase their fees to make up for the cuts to Medicare rebates and the indexation freeze.
But isn't GP care free in Australia?
Not for everybody. In 2013-14, about 83 per cent of all GP visits were bulk billed, meaning the patient paid nothing.
