Medical costs up, bulk billing down across Australia: report
Financial Review
Feb 9, 2025
New research has found that the number of GP clinics bulk billing patients has fallen over the past two years under Labor and the practice is no longer available in 10 per cent of federal electorates, challenging government data that suggested Australians are paying less to see a doctor.
Online healthcare director Cleanbill on Sunday said a survey of practices in October last year showed there had been a decrease in bulk billing in 131 of the country’s 151 electorates and an increase in out-of-pocket costs in 136 of them.
Health Minister Mark Butler disputes new data which says Australians are paying more to see the doctor than they were two years ago.
There were 15 electorates with no bulk billing clinics, up from four at the start of 2023. Out of the 12 electorates with bulk billing rates exceeding 50 per cent, nine of them were in western Sydney.
The Cleanbill data, which looks at the percentage of clinics it finds are available to bulk bill a non-concession adult for a standard consultation, clashes with the government’s figures that consider incentives introduced in 2023 for doctors to bulk bill children and older patients.
Labor has pledged more investment in bulk-billing – meaning GP visits are fully covered by Medicare – urgent care clinics and doctor numbers as it goes hard on its health credentials heading into a federal election fought on cost of living pressures.
The government on Sunday announced a $573 million package of measures to improve women’s health, including the first Pharmaceutical Benefits Scheme listing in more than 30 years for oral contraceptive pills, larger Medicare payments for IUDs and birth control implants, and more Medicare support for menopause.
Labor upped incentives for doctors not to bulk bill children and concession payments in the 2023 budget as it sought to discredit Opposition Leader Peter Dutton’s policies when he was health minister in the Abbott government.
The Cleanbill electoral breakdown, which builds on state-by-state data released last month, found Australians had high out-of-pocket costs for GP visits of as much as 25 per cent. There was on average $42.37 in out-of-pocket costs to see a doctor, up $4.14 from $39.23 two years ago.
The largest increase was in the NSW electorate of Watson to $36.52, while costs increased to $65.35 from $56.25 in the Sydney seat of Wentworth. In Parramatta in Sydney, costs fell $21.15 to $35.70. The data was compiled from calls to 6925 clinics.
The only electorate outside of NSW and Victoria with more than 30 per cent of its clinics bulk billing is Wright in Queensland.
The government rejected the report’s findings as inaccurate and misleading and said overall bulk billing visit numbers including concession cardholders and patients under 16 showed an increase.
“Official data shows our record investment to strengthen Medicare has stopped the freefall in bulk billing that was created under the Coalition government,” Health Minister Mark Butler said.
“After we tripled the bulk billing incentive for GPs, bulk billing has started rising again in every state and territory – delivering an additional 5.8 million free visits to the GP in just 13 months.”
Government data shows 77.2 per cent of all GP visits were bulk billed in November 2024, an increase of 1.6 percentage points from October last year, before the investment took effect. It said every state and territory now has more bulk billing.
Doctors said the government has stabilised the collapse in bulk billing with incentives to help concession cardholders, pensioners and children but more investment in GPs was needed. Productivity Commission data released last week showed the number of non-referred patients who were fully bulk billed had fallen.
“Affordability concerns continue to delay Australians from seeking health care. More Australians are delaying seeing a GP, filling a prescription and seeing a mental health care professional because of cost,” Productivity Commission chairwoman Danielle Wood said.
Terry Barnes, a healthcare consultant and former adviser to Howard government health ministers, said neither Labor nor the Coalition were expected to come up with any meaningful healthcare reforms before the election – and tinkering with bulk billing rates was just a distraction.
“When it comes to health as a political issue, this is going to be a Seinfeld election – an election about nothing. That’s because both major parties are saying nothing about innovation and reform,” he said.
“It’s already a ‘he said, she said’ scare campaign about bulk-billing and Medicare, and it’s not very edifying. Voters should be appalled.”
He said while the data suggested GP bulk billing overall had fallen, it was more important for politicians to focus on giving Australians better access to doctors rather than ensuring every visit was free when many people could afford to pay $60 to see a doctor several times a year.
“GP bulk billing is lower than it was in May 2022. The Coalition is right about that when you look at the official data trends, and the Cleanbill analysis bears it out,” he said.
“Timely and affordable access to doctors is the primary care issue that should matter most.
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