Pathology companies say bulk billing is at risk from rebate freezes, but health experts say they are 'bluffing'   


Sat 26 Oct 2024
ABC News

If you've looked around the waiting room of your local GP clinic recently you may have noticed posters urging you to email your MP to "keep pathology bulk billed".

The posters are part of a campaign by Australian Pathology which represents the nation's private pathology companies.

It's pushing for more government funding, warning people may soon have to cough up a co-payment for pathology services, like blood tests.

The group recently launched TV and radio advertisements and billboards have sprung up around the country.

"Could you afford to pay? Could you afford not to?" the TV ad asks.




Australian Pathology recently launched this ad on TV and social media.

Pathology is big business, with more than 100 million Medicare-subsidised tests performed between 2022 and 2023, and demand is growing due to Australia's aging population and increasing chronic illness.

The sector has been plagued by a long history of government funding freezes, but data shows more than 99 per cent of out-of-hospital tests are still bulk billed.

Providers say this cannot continue, but health regulation experts say the ads are part of a long-running scare campaign.

What's the situation?
For 24 years Medicare rebates for pathology providers have remained stagnant.

That changed in May when the Albanese government decided to index the rebates for services it considers labour-intensive. These include haematology (the study of blood), tissue analysis, immunology and pregnancy.

The rebates for these items will increase from July 2025, in line with wages and price growth, costing $174 million over three years.

The government excluded many tests from indexing, such as urine and faeces screening, cholesterol testing, microbiology (the analysis of bacterial causes of infection) and genetic pathology.

Someone walks past a poster that says 'Keep Pathology Bulk Billed'
Australian Pathology says the campaign has led to 63,000 people writing to their local MP.

The government says rebates don't need to increase for these as testing is largely automated in labs and economies of scale mean it is cheaper to test them en masse.

"Technological advances are continuing to drive down the cost of providing and operating many pathology services," Health Minister Mark Butler said.

But pathology companies fiercely oppose this argument and say it's not grounded in evidence.

Australian Pathology CEO Liesel Wett said a lot of pathology was resource intensive and required qualified scientists to do analysis, especially in the field of microbiology.

A white woman with blonde hair standing and smiling in a laboratory
Liesel Wett says the sector wants to keep bulk billing but revenue is trending downwards.

Dean Whiting is the CEO of Pathology Technology Australia which represents manufacturers of the technology used in labs. He said Australia had reached the limits of automation-driven cost savings.

"We've got to the point where it's difficult to eke out any more efficiencies," the former clinical biochemist said.

"Increases in workload now will likely have to be met by increased costs with staff working more hours."

The two largest pathology providers in Australia, Healius and Sonic, say labour costs were the biggest contributor to their weak 2023-24 end-of-financial-year results.

A 'history of crying poor'
This new campaign by Australian Pathology is not a first – the group has rolled out similar campaigns in the past decade.

In 2016 a "Don't Kill Bulk Bill" blitz was launched after the then-government scrapped bulk billing incentives and companies said they would be forced to charge co-payments of between $20 to $50.

Then health minister Sussan Ley called it a "tacky scare campaign by stock exchange-listed pathology companies aimed at protecting their profits".

The campaign ended after the government agreed to do more to regulate the often-exorbitant rents pathology companies were charged to be co-located in GP clinics.

Australian Pathology is a regular donor to both major parties and health economist Stephen Duckett said they regularly used the threat of co-payments as a "bargaining chip in policy battles".

He said he believed the companies were "bluffing".

An elderly man with glasses in his office. He looks wise and concerned.
Professor Stephen Duckett says the history of rebate freezes isn't fair but this campaign is "outrageous".

"They're using this campaign, quite improperly in my view, to scare the patients to put pressure on the government," he said.

"We're six months up to an election, but I think the government needs to stand firm and say, 'we gave you a down payment but we're sick of you holding patients to ransom'."

Assistant professor in law at the University of Canberra, Bruce Baer Arnold, has a special interest in health regulation and said the industry was asking the public to do their lobbying for them.

"We're talking about a thriving sector with a long history of crying poor," Dr Arnold said.

Be good to see pathological behaviour bulk billed so as to cure some of the modern ills of society.   

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