Patients charged expensive co-payments because doctors stopped bulk billing | Panda Anku

Perth’s mum Jayme Lees has been billed by her GP for the last six years, but when she took her newborn son for a check-up in June she was hit with a hefty, unexpected fee.

“I was about to leave when they told me there was a prize…I was pretty shocked,” she said.

Some of her son’s fortnightly visits to the GP incur a $60 to $80 deductible, putting additional pressure on the income-dependent family budget.

“It’s been hard because of the increase in groceries, the cost of living and the fact that it’s like that now [we’re not] With doctors billed, it makes it a lot harder,” she said.

“Now we just have to be a little more careful about spending and if we have a deadline we just have to make sure we account for it.”

Mid-shot of Jayme Lees with her baby on her lap
Jayme Lees says she waited two weeks to get her son’s doctor’s appointment. (ABC News: Tabarak Al Jrood )

The 26-year-old is also concerned about the state’s doctor shortage after waiting two weeks for her son Ryder to be seen by a family doctor because of his sinus infection.

“It makes it a little scary to think about what if he was pretty sick and needed antibiotics pretty quickly, but he couldn’t come in for two weeks,” she said.

General practitioners had no choice

Doctor Lewis MacKinnon, who treats patients at his Armadale Clinic in south Perth, is one of many GP clinics across the state that have recently changed their billing model to allow patients to be billed privately.

He said the current funding system had become unsustainable.

Half shot of Dr.  Lewis sitting in a chair at his desk
Lewis MacKinnon’s medical practice in Armadale recently began paying patients privately.(ABC News: Tabarak Al Jrood )

“We are faced with a choice of either treating more patients per hour to cover our overhead costs, or passing the cost on to the patient in the form of a gap payment,” he said.

“Obviously that’s something that goes against our nature to make it difficult to access healthcare because you now have to consider your economic circumstances,” he said.

“But at the end of the day, the government hasn’t kept up with medical inflation, and patients are the ones who lose out.”

Last month, the federal government increased the Medicare rebate by 1.6 percent after it was frozen for more than a decade.

But dr MacKinnon said that’s nowhere near enough to cover the rising costs.

dr  Lewis wears a mask and places a stethoscope on the patient's chest
dr MacKinnon says he’s concerned patients will avoid seeing a GP because of the cost. (ABC News: Tabarak Al Jrood )

“Traditionally, we’ve tried to charge everyone who visited our clinic with a collective bill,” he said.

“But now we bill everyone who joins our practice privately, regardless of income status, because unfortunately we can’t afford to pass on huge rebates, which is what the government really expects of us with such a paltry Medicare rebate.

“I worry that patients are avoiding getting the help they need and may have a poorer clinical outcome.

“And I think the government needs to think very seriously about the role that funding is playing in that.”

Losing vulnerable patients

Emily, 34, relies on regular doctor visits to get prescriptions for ADHD medication.

General doctor and patient advice
More and more general practitioners are turning away from mass billing. (ABC News: Tim Swanston)

But since moving to Perth two years ago, she has changed GPs nine times after everyone stopped bulk billing.

“I don’t have the means to do it…to add like $100 to my weekly or monthly expenses when I had to see the doctor, it was a huge hassle to undertake, plus the added stress of skipping an appointment.” “, she said.

Emily said it was disappointing that vulnerable Australians were unable to access affordable basic health care.

A sign on the door of the doctor's office that reads "From June 1st, 2022, private fees will be charged for patients entering the practice.
Doctors, turning their backs on bulk billing, say the Medicare rebate isn’t covering the rising costs.(ABC News: Tabarak Al Jrood )

“I’m very excited about the system that we’re all contributing to in Australia and I got the impression that we’re a country where we’re proud of our Medicare and I was quite proud of that,” she said.

“When you see friends in the US where they don’t have that kind of care and it’s a really strained system, it’s really sad to say this is where this starts.”

Investment required to save lives

Doctor Ramya Raman, the WA chair of the Royal Australian College of GPs (RACGP), said the increasing number of GPs turning away from mass billing has been a “predicted storm” due to economic pressures.

Half shot of Dr.  Ramya Raman smiling at the camera
Ramya Raman calls for more investment in general medicine. (ABC News: Tabarak Al Jrood )

“We need to be able to retain and attract the best possible staff. We have utilities, rent and medical care [and] Health insurance,” she says.

“We also need to keep up with inflation rates and the associated costs, [but] with the lack of Medicare patient discount indexing, that hasn’t happened and it’s been really challenging…it’s gotten to a point where things are unsustainable.

WA Health Secretary Amber-Jade Sanderson said the issue has put pressure on already-overwhelmed emergency rooms.

“There is a significant shortage of primary health care in WA. It’s across the country but it’s particularly acute in WA and if you don’t have access to a GP you go to an emergency room and that’s what we see here,” she said.

WA Health Secretary Amber-Jade Sanderson speaks with a puzzled look.
Amber-Jade Sanderson is concerned about the pressure being placed on emergency rooms.
(ABC News: Keane Bourke)

The federal government has pledged to build at least 50 mass-billed emergency medical centers across Australia over the next four years.

The clinics would be based in general practitioner offices and community health centers in at least seven locations across WA to relieve the state’s beleaguered hospital system.

dr However, Raman said more investment in existing general practice is needed.

“Primary care is the bedrock of the healthcare system, and having very strong primary care and general health care in a country will ultimately ensure that we have a really healthy population,” she said.

“Investing in primary care and healthcare may not seem particularly sexy, but it’s what saves lives, what prevents admissions, and what improves patient outcomes.

“And as GPs, it’s about being valued for what we do.”

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