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Why it's almost impossible to find a bulk-billing doctor on the Sunshine Coast

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The number of bulk-billing practices on the Sunshine Coast has shrunk at an alarming rate, placing a burden on patients to pay out of their own pocket to see a doctor.

The government-funded Health Direct website currently lists only 10 bulk billing GP practices in the entire region from Noosa to Caloundra.

About 50 others offer partial bulk-billing of patients in the Sunshine Coast region.

It means patients already struggling with rapidly rising living expenses have no choice but to fork out the shortfall after rebate for a 10 to 15-minute appointment that costs about $85.

Pensioners and seniors are among the hardest hit by the higher costs.

Australian Pensioners and Superannuants League Caloundra branch president Frank Gower said his members were concerned about the shrinking pool of bulk-billing doctors.

Mr Gower said many doctors who had bulk billed in the past were now charging their patients.

But pensioners who wanted to remain with the doctors they knew and trusted were “locked in” to paying out-of-pocket expenses.

“Most regular seniors will have an average six-week appointment with their doctor, which is to their benefit – it keeps us alive,” Mr Gower said.

“Most seniors have been with their doctor for a period of time.

“They reluctantly wear the cost because they need that face-to-face communication. It’s a psychological comfort that they know that doctor, so they have to pay for it.

“There’s no alternative. They wear it reluctantly and something else (that week) suffers.

“Medications are going up, even though they’re subsidised. The general cost of living is going through the roof.

“It’s impacting seriously on (seniors). It’s just another added thing.”

Mr Gower described the whole rebate scheme as “a dog’s breakfast” because neither doctors nor patients seemed to be happy with the Medicare Benefits Schedule.

“A doctor is entitled to a fair wage – there’s no risk on that – but I think the whole system … needs overhauling because it’s getting out of hand,” he said.

One busy local clinic, Ochre Medical Centre Caloundra, has blamed the trend away from bulk billing on the fact Medicare rebates have not kept pace with medical centres’ costs.

“The situation has now reached a point where the average cost of delivering healthcare is more than double the Medicare rebate amount,” the clinic’s website explains.

“This situation has created a financial burden on GPs and medical practices that means most of them are simply not able to continue in business without increasing their consultation fees beyond the Medicare rebate levels.

“For us, this means that from 1 July 2022, our doctors will be charging private fees as per the updated fee policy and fee schedule.

“We would like to emphasise that these billing policy decisions have not been taken lightly.

“Unfortunately, they are necessary for us to be able to continue providing the quality healthcare all of our patients deserve.”

In advertising its schedule of fees, Ochre says doctors are independent practitioners, billing privately for both face-to-face and telehealth (video and phone) consultations.

The only exceptions are Department of Veterans’ Affairs cardholders and children under 16 years of age who are bulk-billed.

Pensioners, health care cardholders and students with valid identification are eligible for discounted fees.

A standard (15-minute) consultation is $88 (discounted fee $59.10), with a rebate of $39.75.

A long consultation is $126 (discounted fee $95.75), with a rebate of $76.95.

And a prolonged consultation is $162 (discounted fee $131.50), with a rebate of $113.30.

Ochre urges patients to write to their Federal Member of Parliament to express concerns and support their doctors further.

Calls are becoming louder for the whole Medicare Benefits Schedule to be overhauled for a better deal for doctors and patients.

Medicare in Australia pays a contribution towards a doctor’s fee on behalf of the patient (the Medicare Benefits Schedule).

When GPs accept this Medicare schedule fee as a full payment for the patient’s appointment, it is called bulk billing.

Since Medicare’s introduction in 1984, fees have been subject to annual indexation.

The freeze on fees was first introduced by Labor in the 2013–14 Budget as a temporary measure to July 2014. The Coalition reimposed the freeze in 2014–15 and then extended it in subsequent budgets to July 2020.

The reintroduction of indexation was applied in phases from July 1, 2017.

But the way the schedule is calculated means that increases have not kept up with inflation.

The Medicare Benefits Schedule indexation increased by 1.6% from July 1 this year – applying to most general medical services items, all diagnostic imaging services except nuclear medicine imaging, and some pathology items.

Yet the Australian Bureau of Statistics reports that over the 12 months to the June 2022 quarter, the CPI rose 6.1%.

A growing number of GPs are finding that this reimbursed amount is not enough to cover their costs, so their options are to:

  • take a pay cut
  • work longer hours to see more patients
  • cut costs in areas such as staff, new equipment, technology, training and building maintenance – with possible impact on patient care and comfort
  • charge more for their services.

Sunshine Coast News reached out to the Australian Medical Association Queensland and Sunshine Coast Local Medical Association for comments but did not receive replies.

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