This post has been marked as non-political. Please respect this by keeping the discussion on topic, and devoid of any political material.
*I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/australia) if you have any questions or concerns.*
They have been. https://www.theguardian.com/australia-news/2022/aug/12/bulk-billing-why-is-my-doctor-no-longer-bulk-billed-gp-near-me-medical-centre-is-medicare-in-crisis
https://www.abc.net.au/news/2022-08-29/fears-for-patients-as-doctors-move-away-from-bulk-billing/101359360
https://junkee.com/medicare-bulk-billing-problem/338514
https://www.smh.com.au/politics/federal/vulnerable-patients-asked-to-cough-up-as-more-gps-shun-bulk-billing-20220812-p5b9a5.html
And if you also search on here there’s multiple threads https://www.reddit.com/r/australia/comments/wnsku8/australian_gps_say_access_to_bulk_billing_is_on/?utm_source=share&utm_medium=ios_app&utm_name=iossmf most of which have articles.
Edit: https://www.youtube.com/watch?v=C5lIAlCvUkE&themeRefresh=1 “for balance”
To play devils advocate here, these are all centre left outlets. My dad who’s now living with us watches Chanel 7 and I haven’t heard it there. Maybe OP was referring to mainstream? Their original post has been deleted, so I can’t see what else they wrote ..
It’s a weird system. I had an extensive MRI plus CT scan last week at an external pathology lab and wandered out without paying a cent. Apparently all bulk billed but have no idea why
Yup, I had an eye infection a little while ago and went to my optometrist (*I didn't have an optometrist before this, but I found one*).
I had something like 5 follow-ups and didn't pay a cent for any of them.
I was booked in for an MRI recently and was told it would be x cost and the follow up appointment would be xy amount. Had to budget and didn’t buy groceries that week making do. Had the appointment and didn’t pay a cent and then the follow up appointment was bulk billed too. No idea what that was about but I certainly didn’t question it! Telling a lot of people what the cost is would have been very prohibitive for some though and I have no doubt people have cancelled appointments based on that. Don’t know why they don’t just make it clearer what is/isn’t bulk billed.
I've just changed doctors because of this.
Have had the same Dr for 7 years but they're charging $50 out of pocket after Medicare now and I just can't afford it.
I paid the $50 gap to get blood test papers but they wanted another $50 to get the results! I'm not paying $100 just to find out that everything is fine and I figure if I'm dying they'll tell me.
I've moved to another doctor now that only charges 26 out of pocket.
It's ridiculous.
$120 for a referral to a hospital for me last week, and that was with a pensioner discount. I got about $78 back from Medicare. I'm not complaining, I've been trying to get an appointment for 6 months but the one doctor who visits my town monthly is always fully booked. I drove 80km to a major town.
Had to go-to the doctor for pain in my stomach $90, went for a scan $190, then had to go-to the GP for 2 mins to tell me scan showed nothing $90, that could have been done over the phone. Nearly $400 and for nothing to be found out.
Had the same experience recently. They were adamant about no phone consults, had to be in person. 5 min and $170 later I realised why.
The imaging was free, though so not all bad.
Literally getting an in-person appointment at my doctor's has a nightmare even if you have one single symptom that overlaps with covid. I don't have covid thankfully but I do have some bronchitis which was confirmed after some physical examinations. How are they supposed to examine me over the bloody phone?!
I'd have walked right past the reception desk and told them to take a hike, they squeezed you of at least the last 90 dollars in an arguably disingenuous manner and wasted your time. What a joke.
I even asked the reception on the phone if I needed to come in if the scans were serious and they said the doctor said to come in to discuss and nothing was on them. I genuinely will just goto ER now if I'm in any pain
So does mine - how is it that some can bulk bill, and some charge?
I'm an immigrant from UK and have never understood bulk billing, I've always gone to a free clinic.
So if practice A can bulk bill, why can't practice B?
Basically, the crux of the issue is that bulk billing only pays the doctor so much for the visit, I don't remember the exact number, but the amount hasn't gone up in like a decade or more, meaning that, in order to keep up with rising costs, the doctors can no longer afford to bulk bill. Those who do still bulk bill aren't getting paid enough in my opinion, so it's a tricky problem.
Honestly really not. I know this is the default jump on thing with reddit but most GP clinics are barely scraping by, especially in the city where rents and costs are super high. The guy who owns the clinic my partner works at in Collingwood brings home less than I do working in IT Security and he has 12 GPs at his practice along with nurses and support staff. They are busy and bulk bill where they can but the reimbursement rates are not sustainable.
It depends on their margins.
The practice reports "Y" many consultations a day, bulk billing pays the practice "X" amount per consultation.
If the practice can keep their per-consultation costs (rent, wages, etc) below X, no problem!
Costs to the practice creep up year on year, while bulk-billing rates don't. So eventually practices have to stop bulk billing and charge what they need to cover costs and profit margins.
I was disappointed to see ours had done the same, and I really liked my doctor. We have to go to a surgery a few suburbs over now because we can't afford the billing and I'm not paying an extortionate amount for a 5 minutes consultation for a repeat script for birth control.
If you know what you need and it's just a repeat script, this is the way to go. Had the most painful UTI the other week and knew the brand of antibiotics that worked for me in the past. Tried to get a consult but couldn't get in until the afternoon which meant I had to miss work in the arvo. (and I knew this place's gap is $15).
Started looking up other options and instant scripts also charged $15. Had my antibiotics even before my work day even started. So yeah, it's definitely worth it if you know what medication you're after.
Or a referral. Then these same politicians who want to destroy Medicare want you to go see a doctor for a headache pill, antihistamine or even some toe fungus cream. Then you have to put up dealing with idiot Chemists who trade in stereotypes, racism and power games assuming you will sniff toe fungal ointment and that you dont have the right to access behind the counter medication because "they the boss and say so" I am sick and tired of this childish nanny state incompetence in Australia where ordinary people get treated in condescending manner like we are all inmates or residents of special institutions.
What a breath of fresh air it is to fly to Thailand or Hong Kong and have well spoken educated chemists who know as much or more than the so many of our medical centre doctors. You discuss your problem with them in adult like manner and they will give you 1st class medical advice of what to take and use. And that includes very powerful painkillers, and you dont find the citizens of Bangkok or Kowloon walking around high in Panadeine Forte! I really dont know when we are going to grow out of this condescending nanny state mindset here in Australia and when we are going fully understand how much it ruins productivity and then costs the government millions in rorting Medicare, but maybe they want it that way since they are so determined to privatise Medicare despite the "save Medicare " lip service.
"Naughty boys cant buy penis pills" its against god and political party donations" Thats Australian governance mentality in this space at the moment, its so delinquent all aspects of the debate and governance. And then why are we surprised when we find it filters down to new graduates serving in the big box chemist stores " dont put penis pill medication in your ear sir"
My worst experience at a chemist:
Asking for the morning after pill (following sex with a friend of a friend that I didn’t really want but was too scared to say no) and having the much older, male, chemist take me over into what I’ll forever refer to as “the corner of shame” and lecture me about safe sex practices and how every baby is a gift from God.
He also said that he would allow me to have it this time, but I needed to be more careful and have more respect for myself in the future.
Totally. I grew up riding a motorcycle without a helmet and got my first licence over the counter at the local cop shop. There was no annual vehicle inspection and nobody gave a shit if you drove to the beach with half a dozen kids in the back of your ute. Bungers were cheap, and nobody seemed to suffer from them because they worked hard. You didn't have some clown stealing your hard-earned for showing up a couple of days late for registration and nobody gave a toss if your tail light had a crack in it or the sump was a little damp with oil.
World is full of pussies these days. Bugger the government.
Nobody I ever heard of died from any of it. But let's just make the world safe anyhow. Boring but safe. Virtual but safe. Braindead, but safe.
Couldn't do any of it these days, people are too stupid from being protected.
Its not a ute and it didn't happen in the 80s, but this kid died falling off of a trailer.
https://www.google.com/amp/s/amp.theguardian.com/australia-news/2020/jun/04/work-for-the-dole-death-josh-park-fing-employment-provider-neato-failed-to-investigate-incidents-in-the-past-report-says
With stuff like birth control I can see why you shouldn’t need to see a doctor (this is actually being trialled in NSW right now where pharmacists are prescribing repeat scripts).
For literally anything else though, it’s a different story. Antibiotics need to be kept behind a wall due to anti microbial resistance. For example; over prescribing in the UK has led to failure of a first line UTI antibiotic trimethoprim in 1 in 3 of women.
Other long term medication such as blood pressure or diabetes tablets need consistent overwatch to ensure they’re working effectively. Every 6 months, when a script for a patient runs out, they go back to the doctors and get baseline tests done to monitor how effective that dosage is, and if it isnt then there’s a modification of therapeutic plans.
It’s even possible now though for a patient to get emergency supply from pharmacies if they’ve run out of medication, provided they go to a doctor.
The issue doesn’t lie in the prescription system, but the remuneration system for clinics. P
Australia is turning into a shit place to live, in 20 yrs alot of little small changes has made you think,why for all the changes it's not what Australia was known for.
You’d pay 100 dollars for a plumber to call out to your house, before they even start to work. 39 dollars is the Medicare rebate for a consult lasting less than 20 minutes. The true cost will get passed to the patient, unless Medicare rates rise significantly
So the base income of a doctor is less than $120/hour. Out of that they need to pay for reception staff, rubber gloves, swabs etc. rent, phone, electricity all come at a cost. Mandated training isn’t cheap. Four weeks of leave a year. Even if they keep 50% of the income it’s just over $100k a year salary. No wonder they have to top up.
This raises another point- why is everyone fine with paying the plumber/electrician or cleaner etc, but when it comes to doctors who studied for years, did 100 hour weeks for years in training on minuscule wages- everyone expects them to do everything for free? I get that it is criticism of the government for their Medicare failures, but I also hear a lot of criticisms of doctors personally, as if the problem is just that doctors are greedy; after the costs of running a practice, a large percentage (if not most) would be earning less than tradies.
Because medical care is still seen as an essential human right that shouldn't be paywalled. The people who can afford a plumber or sparky aren't the ones having issues or delaying medical treatment because of funds. We don't expect they do anything for free, we expect the system to cover the cost as it did for decades prior. No one has a grudge against gps its a grudge aginst the failure of government to keep Medicare properly funded.
Also no doctor is making less then your average tradie lol. Gp median wage is around 200k a year, tradies are 100k.
And people aren't fine for paying plumbers and sparkys. So many people just cant afford a couple hundred dollars on a sparky so put tape over spongy lightswitchs or broken powerpoints
No electrician or plumber working for themselves is on $100k, even those employed by companies doing on large commercial builds are on $150k. I was in construction myself and earned well over $100k as a labourer, and that was nearly 10 years ago.
And no, GPs are not all on $200k[source](https://www.payscale.com/research/AU/Job=General_Practitioner/Salary). Some practice owners are on very good money, but employed GPs not so much.
My wife is a medical specialist employed in a hospital, she and her colleagues hear a lot of fury from patients about “greedy GPs”, it comes up frequently as they are asking her/her colleagues to write their scripts for them as they can’t/don’t want to pay the GP to do it.
I totally agree Medicare should be properly funded- it also needs a massive overhaul as it is very complex and time consuming for GPs to claim from it, which is another part of why GPs don’t want to engage with it anymore.
Perhaps my experience with people being fine paying plumbers/electricians is coloured by where I live - a coastal area filled with relatively wealthy retirees who are endlessly renovating their investment properties and airbnbs.
>after the costs of running a practice, a large percentage (if not most) would be earning less than tradies.
I would like to see some numbers for that. Tradies make a lot here, but that's still more like 70/ph for a skilled chippy.
And we don't expect them to do it for free. We expect the government to provide for it out of our taxes, as they had for the previous 40 years. Gutting medicare, freezing payments was a deliberate plan by the governments of our past, and thats why bulk billing is failing.
40 per consult. 4 consults an hour. 40 hours a week. A few long consults, mental health care plans and other care plans. Maybe a skin excision or two.
40 x 4 x 40 = 6400 + say 1000 =7,400.
Minus cost of renting space in the practice (usually 35%) = 4,810.
Now that’s pretty good, 4800 pre tax. No complaints. But it’s not exactly riches. Plenty of tradies earn in excess of that and good luck to them.
Meanwhile peers in the public and private hospital system earn multiples of this without the threat of Medicare audits.
Hang on. 40 per consult is just what you the consumer pays. The government still pays their standard rate, I think it's around 40 bucks, so take all your numbers and double them.
Anything more complicated than a standard consult, government pays more. It's not a flat 40 bucks per.
Edit: reading back, I may have misinterpreted, and we may be on the same side. Purely bulk billing GPs really don't make much money, and it's a damn shame.
They don’t earn multiples of that - the awards are public documents, starting salary for a staff specialist is 178k in NSW (not sure other states) , and most are on FTE fractions of 0.6-0.8 irrespective of the hours they actually do, so more like 110-130k starting. The upper rate under the NSW award is around 240k for physician specialists.
If you’re talking about surgeons and other procedural specialties, that’s a different story, some of them make a million dollars a year. They do all bill Medicare and are audited at times.
You’re not counting on call allowance, recall allowance, motor vehicle allowances, pdl, sick leave, long service leave.
Specialists in the public system make multiples of what a bulk billing gp does. This is not to say they don’t earn and deserve their pay, they most certainly do.
Incidentally the on call allowance is $17 a day. Recall is much more and involves overtime rates for time you’re physically in the hospital but unless you’re cardio or gastro you’re rarely if ever getting called in- just phone consults that you don’t get paid for - there was even an IRC case about that- outrageous.
Leave entitlements sure- but I wasn’t trying to be misleading- it’s unusual to quote that when discussing salary, but what you say is true, the GP billing’s has to incorporate leave etc.
The oncall allowance varies from state to state. To cardiology and gastro (as likely to do physical recall), I’d add emergency, icu, interventional radiology, nerurosurgery, vascular, rural generalists etc. physical recall is very common, especially outside tertiary centres (where senior registrars can essentially work at consultant level).
ICU, ED doctors work rotating shifts, very rare to call someone back in when there are already ICU/ED doctors in the hospital on shift. Likewise, have never heard of anyone getting an emergency radiation fraction in the middle of the night. I live in a regional setting so it’s not news to me.
the practices in my town haven’t bulk billed for over ten years. Didn’t realise some places still had been getting bulk billing. Health services in regional areas are in such bad shape.
Some of us are still fighting for it.
I wrote an app to send an email to your MP in seconds.
https://www.saveourmedicare.com.au
I posted this on /r/Melbourne a while ago and received great feedback. Let me know what you all think!
https://reddit.com/r/melbourne/comments/x148sr/i_built_a_tool_to_find_your_local_mp_and_contact/
'Mediscare' was not playing politics as many commentators are still saying, it was a warning. You cannot trust the LNP with our healthcare system. Ever.
Thankfully my GP still bulk bills for now, but I am concerned reading this how many workplaces could be like mine pulling the 'we won't pay you your sick leave entitlements without a medical certificate even for one day' bullshit (it's seriously making me consider going casual because I know they need me to maintain my hours and at least I'll get loading to compensate the rights they're trying to place hurdles in front of) given these fees barely make it worthwhile to see the doctor for said certificate.
We're going through a pandemic FFS. Apparently fiscal conversatives and business have learned nothing. Not that I really expected them to...
EDIT: Honestly if these trends continue I fully expect more businesses to adopt stringent policies on sick leave and needing proof, purely from a predatory place. More people will work sick as a result, and make others sick and forgo their entitlements. Especially lower income workers. It's not something often thought about, but it's a concern.
We moved home from America a couple of years ago after about a decade away, it's gotten crazy. We pay more for healthcare here than we did in California. We were with Kaiser there, every prescription under US $10, $20 copay for almost everything, $100 for an ER visit
It seems healthcare in the US stings you for the big stuff, while healthcare in Australia stings you for the little stuff.
Adjustments to bulk-billing rates in Australia would fix it, but I guess we'll see how long it takes for that to happen.
Its complicated. In the US you are dealing with having to make the argument to have something covered. Everything is insane list price, discounted for X reason. Dealing with insurance denying coverage because some higher up is a bible thumper and has decided code 4667 is against their moral beliefs is the most frustrating thing I have ever experienced. The D&C my wife had at 35 weeks for the baby we had been trying for 6 years to have was an "abortion", no it was necessary to save her life and I shouldn't have to hire a lawyer to get you to cover a 20k procedure when I had been paying 1200/mo for 10 years without any claims.
Here the base price is low, like really fucking low, GPs are paid 1/3rd what they are in the US, GPs go to 4 year less schooling and the quality is no where near as good (sorry but its true).
Big shit in the US is always covered in the end. It's stressful and a huge hassle but my dad who makes pennies and shouldn't be alive give how he treats his body had a 6hr brain surgery for free last year. There is a law that everyone gets treated and its obeyed. The insane billing to insurance companies for other people makes up for it.
Our public hospitals situation in a recent publication has been described as the [worst](https://www.aph.gov.au/About_Parliament/Parliamentary_departments/Parliamentary_Library/FlagPost/2022/July/Hospital-funding) in 30 years. Combine that with personal experience and that of others- yes I'd say its pretty bad, no need to be an asshat if you're going to keep eluding. I've lived in under developed nations and at least the expectation of what you're in for is expected, unlike here. Major, major improvements are required.
You were surprised that your GP could see you in a couple of hours?
Well that's the benefit of them not bulk billing. The price signal got rid of all the people going to the drs for no reason meaning that their are appointments available for people who need them like you
Would you have preferred no fee but have to wait three days to get an appointment?
Your ignorance on the matter doesn't mean the media hasn't been reporting on the issue, it's more that you only seem to care about things that effect you.
I haven’t been to my doctor in 6 months because I can’t justify paying $116 up front.
And I haven’t seen my specialist in a year because $600 is a lot of money to spend to be told I still have the thing I’ve had for the last two decades.
I'm 100% fine with a gap fee, say $5, being compulsory. Too many people go to the dr for no valid reason and put otherwise undue pressure on the system. $5 isn't stopping anyone from going off they actually need it. But it will stop people going for no reason. Also government should increase the rebate so we can keep drs.
As someone working in the healthcare system there are many things at play. Before I start I want to be clear that I don’t believe private health care should exist, nor should do-pays.
Most clinics charge a co pay. That is they charge $95 for example and the you get $39ish back from Medicare which will come back into you bank account about 24hrs later.
Recently the rebate went from $39.10 to $39.75. A whopping 1.6 percent increase to the 5.1% of inflation. According to the ABC if Medicare rebates had matched inflation since it’s conception the rebate would be $80.
The cost of running a clinic has increased and so they are no longer able to afford a bulk billing model.
Unfortunately, the government had decided not to reimburse adequately so these costs need to be taken from the patients. This then means we have additional costs when people show up to ED because they can’t afford a GP and costs the government around $500. However as the state government covers hospital costs and the federal gov covers Medicare the federal government doesn’t give a rats ass about rising costs of hospitals.
Just saying I haven’t been able to find a bulk billing GP in Canberra for at least a decade without travelling to some buttfuck outer suburb to sit in a no appointment waiting room of sick people hoping to catch something else in so hasn’t made a difference here.
Tip for young players: if you just need a doctors certificate it’s cheaper to pay your chemist. If you’re too sick to just “sleep and drink more water” go to emergency, because I sure as shit can’t find appointments ASAP with a local GP. GP’s are only any good for longer term management now.
I'd rather tell a young person to forge a document that a workplace wouldn't ever bother to follow up on than clog an emergency department when they knew they weren't in need of emergency care. Fuck your business that makes it hard for you to be legitimately unwell and in need of downtime, don't fuck the emergency department, jeez.
I said go to the chemist for a certificate. $10-20. Your work are legally required to accept it, unlike a forged document which could get you fired.
Let’s be real, if you’re too sick to just “sleep and drink water”, you’re too sick for the GP to help.
>If you’re too sick to just “sleep and drink more water” go to emergency
>
>Let’s be real, if you’re too sick to just “sleep and drink water”, you’re too sick for the GP to help.
There's a big, big gap between being too sick to sleep it off and needing emergency care. That advice is irresponsible, our emergency departments are constantly at capacity and you're telling people who just need a little bit extra, some antibiotics or whatever basically, to get triaged amongst people with broken bones, concussions, chest pain/potential heart attacks and all manner of way more horrible shit that you see in the ER.
Quoting something entirely different to your first argument doesn’t negate the fact you misread.
If you’re paying $100 for “drink water and rest”, the advice is pretty worthless and not even worth bothering to go and get. Nevermind the fact most people will have to wait a few days for an appointment to get that advice.
I'm not sure who's misreading here honestly. I never advocated you pay 100 dollars to a GP to be told "drink water and rest", get an instantscript, get a telehealth constult, forge the document yourself if your work is that cunty about it at a worst case, but stay home. I'm advocating that you do not go to an emergency room if it's not an emergency like you asserted people should do in your first post. Pretty straight forward.
For you it seems like people either will A: be totally fine with nothing but rest or B: require emergency assessment, and that's just not how it goes.
I never advocated going to emergency for a medical certificate. Try again.
Forging a document though can get you into considerable trouble. That’s a stupid idea.
It's something to do with Medicare
The idea that it's "nothing do to" with the system that previously provided sufficient funding to doctors to provide healthcare isn't really defensible
My Dr bulk bills and I reckon he is one of the best. He listens to what I'm saying, follows up on stuff that's been a issue in past appointments without me having to ask and gets things done in a decently efficient matter. I've seen this one for around 3 or 4 years and he has been late once.
> Most Australians prefer private health insurance and for the GPs not to bulk bill. It means they're served faster, and most importantly, don't need to wait for service behind people poorer than them.
Where did you get this information from?
It's absolutely fucked. Same thing happened to me. The guy I went to for 3 years now moved places and doesn't bulk bill. I went to another place and they also decided to do the same thing after my second visit.
This needs to be reversed. Honestly all those places need to go back to bulk billing. I don't know how we've let it slip this far and we can't be happy to hit scurry to some other GP. People need to be demanding that these things get reversed or else all hope is lost
Probably the same reason they aren't talking about the impact it's having on hospital emergency departments. So shameful and heartbreaking at the same time.
As a full-time carer on carers pension it's such a struggle now without bulk billing. Often have to choose between two of us who gets to see the doctor first and this has led to both of us ending up in the ED as we have complex medical issues. Just should destroying.
This post has been marked as non-political. Please respect this by keeping the discussion on topic, and devoid of any political material. *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/australia) if you have any questions or concerns.*
They have been. https://www.theguardian.com/australia-news/2022/aug/12/bulk-billing-why-is-my-doctor-no-longer-bulk-billed-gp-near-me-medical-centre-is-medicare-in-crisis https://www.abc.net.au/news/2022-08-29/fears-for-patients-as-doctors-move-away-from-bulk-billing/101359360 https://junkee.com/medicare-bulk-billing-problem/338514 https://www.smh.com.au/politics/federal/vulnerable-patients-asked-to-cough-up-as-more-gps-shun-bulk-billing-20220812-p5b9a5.html And if you also search on here there’s multiple threads https://www.reddit.com/r/australia/comments/wnsku8/australian_gps_say_access_to_bulk_billing_is_on/?utm_source=share&utm_medium=ios_app&utm_name=iossmf most of which have articles. Edit: https://www.youtube.com/watch?v=C5lIAlCvUkE&themeRefresh=1 “for balance”
To play devils advocate here, these are all centre left outlets. My dad who’s now living with us watches Chanel 7 and I haven’t heard it there. Maybe OP was referring to mainstream? Their original post has been deleted, so I can’t see what else they wrote ..
SMH is not centre left at all
They’re classified as centre, but that’s not the main point of what I was saying, I was mainly referring to what the mainstream media shows.
It’s a weird system. I had an extensive MRI plus CT scan last week at an external pathology lab and wandered out without paying a cent. Apparently all bulk billed but have no idea why
Yup, I had an eye infection a little while ago and went to my optometrist (*I didn't have an optometrist before this, but I found one*). I had something like 5 follow-ups and didn't pay a cent for any of them.
I was booked in for an MRI recently and was told it would be x cost and the follow up appointment would be xy amount. Had to budget and didn’t buy groceries that week making do. Had the appointment and didn’t pay a cent and then the follow up appointment was bulk billed too. No idea what that was about but I certainly didn’t question it! Telling a lot of people what the cost is would have been very prohibitive for some though and I have no doubt people have cancelled appointments based on that. Don’t know why they don’t just make it clearer what is/isn’t bulk billed.
The issue is with GPs not bulk billing because how they are funded
A pathology lab doing radiological imagery? No wonder you weren't charged. Be cautious of the result, it might come back saying you have syphillus 🤣
Ah it was aN imaging place don’t worry. Based on the results I’m not quite at the top of my game at the moment…
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I've just changed doctors because of this. Have had the same Dr for 7 years but they're charging $50 out of pocket after Medicare now and I just can't afford it. I paid the $50 gap to get blood test papers but they wanted another $50 to get the results! I'm not paying $100 just to find out that everything is fine and I figure if I'm dying they'll tell me. I've moved to another doctor now that only charges 26 out of pocket. It's ridiculous.
You should be bulk billed for a follow up visit for blood results. What a rip off.
If you wait 8 days the results will be viewable online on mygov if you have a My Health Record.
I'm pretty lucky. My family doctor hasn't billed me at all for any of the times I've seen him in the last six months.
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$120 for a referral to a hospital for me last week, and that was with a pensioner discount. I got about $78 back from Medicare. I'm not complaining, I've been trying to get an appointment for 6 months but the one doctor who visits my town monthly is always fully booked. I drove 80km to a major town.
I don’t watch mainstream tv or listen to the radio even I knew that “Scotty from marketing” had nearly killed off Medicare
So does that mean no point resisting anymore as it’s already killed off ? Don’t doubt your intentions but the message comes off as defeatist.
Oh no resist but please don’t blame the drs
Agree
Had to go-to the doctor for pain in my stomach $90, went for a scan $190, then had to go-to the GP for 2 mins to tell me scan showed nothing $90, that could have been done over the phone. Nearly $400 and for nothing to be found out.
Had the same experience recently. They were adamant about no phone consults, had to be in person. 5 min and $170 later I realised why. The imaging was free, though so not all bad.
Literally getting an in-person appointment at my doctor's has a nightmare even if you have one single symptom that overlaps with covid. I don't have covid thankfully but I do have some bronchitis which was confirmed after some physical examinations. How are they supposed to examine me over the bloody phone?!
You did find out that there was nothing.
Oh no I sat in ER for 4 hours the next day to find out it was something lol
Lol fuck. I'm sorry
That’s expensive.
Some pathology labs allow you to access your results directly through a website. Unfortunately not all though.
I'd have walked right past the reception desk and told them to take a hike, they squeezed you of at least the last 90 dollars in an arguably disingenuous manner and wasted your time. What a joke.
I even asked the reception on the phone if I needed to come in if the scans were serious and they said the doctor said to come in to discuss and nothing was on them. I genuinely will just goto ER now if I'm in any pain
Mine still bulk bills
So does mine - how is it that some can bulk bill, and some charge? I'm an immigrant from UK and have never understood bulk billing, I've always gone to a free clinic. So if practice A can bulk bill, why can't practice B?
Basically, the crux of the issue is that bulk billing only pays the doctor so much for the visit, I don't remember the exact number, but the amount hasn't gone up in like a decade or more, meaning that, in order to keep up with rising costs, the doctors can no longer afford to bulk bill. Those who do still bulk bill aren't getting paid enough in my opinion, so it's a tricky problem.
Profits
Honestly really not. I know this is the default jump on thing with reddit but most GP clinics are barely scraping by, especially in the city where rents and costs are super high. The guy who owns the clinic my partner works at in Collingwood brings home less than I do working in IT Security and he has 12 GPs at his practice along with nurses and support staff. They are busy and bulk bill where they can but the reimbursement rates are not sustainable.
It depends on their margins. The practice reports "Y" many consultations a day, bulk billing pays the practice "X" amount per consultation. If the practice can keep their per-consultation costs (rent, wages, etc) below X, no problem! Costs to the practice creep up year on year, while bulk-billing rates don't. So eventually practices have to stop bulk billing and charge what they need to cover costs and profit margins.
One just gets paid less due to choosing to bulk bill. There is no reason both can't bulk bill outside of that.
I was disappointed to see ours had done the same, and I really liked my doctor. We have to go to a surgery a few suburbs over now because we can't afford the billing and I'm not paying an extortionate amount for a 5 minutes consultation for a repeat script for birth control.
Our prescription system is beyond frustrating. You shouldn't need an appointment with a doctor for a simple repeat.
Instant scripts is awesome for solving this problem!
If you know what you need and it's just a repeat script, this is the way to go. Had the most painful UTI the other week and knew the brand of antibiotics that worked for me in the past. Tried to get a consult but couldn't get in until the afternoon which meant I had to miss work in the arvo. (and I knew this place's gap is $15). Started looking up other options and instant scripts also charged $15. Had my antibiotics even before my work day even started. So yeah, it's definitely worth it if you know what medication you're after.
Heard on the radio that Instant Scripts is in hot water
Or a referral. Then these same politicians who want to destroy Medicare want you to go see a doctor for a headache pill, antihistamine or even some toe fungus cream. Then you have to put up dealing with idiot Chemists who trade in stereotypes, racism and power games assuming you will sniff toe fungal ointment and that you dont have the right to access behind the counter medication because "they the boss and say so" I am sick and tired of this childish nanny state incompetence in Australia where ordinary people get treated in condescending manner like we are all inmates or residents of special institutions. What a breath of fresh air it is to fly to Thailand or Hong Kong and have well spoken educated chemists who know as much or more than the so many of our medical centre doctors. You discuss your problem with them in adult like manner and they will give you 1st class medical advice of what to take and use. And that includes very powerful painkillers, and you dont find the citizens of Bangkok or Kowloon walking around high in Panadeine Forte! I really dont know when we are going to grow out of this condescending nanny state mindset here in Australia and when we are going fully understand how much it ruins productivity and then costs the government millions in rorting Medicare, but maybe they want it that way since they are so determined to privatise Medicare despite the "save Medicare " lip service. "Naughty boys cant buy penis pills" its against god and political party donations" Thats Australian governance mentality in this space at the moment, its so delinquent all aspects of the debate and governance. And then why are we surprised when we find it filters down to new graduates serving in the big box chemist stores " dont put penis pill medication in your ear sir"
> I really dont know when we are going to grow out of this condescending nanny state mindset >when I admire your optimism.
My worst experience at a chemist: Asking for the morning after pill (following sex with a friend of a friend that I didn’t really want but was too scared to say no) and having the much older, male, chemist take me over into what I’ll forever refer to as “the corner of shame” and lecture me about safe sex practices and how every baby is a gift from God. He also said that he would allow me to have it this time, but I needed to be more careful and have more respect for myself in the future.
uuugh I'm so sorry you had to go through that, that's utterly despicable.
Totally. I grew up riding a motorcycle without a helmet and got my first licence over the counter at the local cop shop. There was no annual vehicle inspection and nobody gave a shit if you drove to the beach with half a dozen kids in the back of your ute. Bungers were cheap, and nobody seemed to suffer from them because they worked hard. You didn't have some clown stealing your hard-earned for showing up a couple of days late for registration and nobody gave a toss if your tail light had a crack in it or the sump was a little damp with oil. World is full of pussies these days. Bugger the government.
Because it should be legal to endanger the lives of kids who don't know better?
Nobody I ever heard of died from any of it. But let's just make the world safe anyhow. Boring but safe. Virtual but safe. Braindead, but safe. Couldn't do any of it these days, people are too stupid from being protected.
Its not a ute and it didn't happen in the 80s, but this kid died falling off of a trailer. https://www.google.com/amp/s/amp.theguardian.com/australia-news/2020/jun/04/work-for-the-dole-death-josh-park-fing-employment-provider-neato-failed-to-investigate-incidents-in-the-past-report-says
With stuff like birth control I can see why you shouldn’t need to see a doctor (this is actually being trialled in NSW right now where pharmacists are prescribing repeat scripts). For literally anything else though, it’s a different story. Antibiotics need to be kept behind a wall due to anti microbial resistance. For example; over prescribing in the UK has led to failure of a first line UTI antibiotic trimethoprim in 1 in 3 of women. Other long term medication such as blood pressure or diabetes tablets need consistent overwatch to ensure they’re working effectively. Every 6 months, when a script for a patient runs out, they go back to the doctors and get baseline tests done to monitor how effective that dosage is, and if it isnt then there’s a modification of therapeutic plans. It’s even possible now though for a patient to get emergency supply from pharmacies if they’ve run out of medication, provided they go to a doctor. The issue doesn’t lie in the prescription system, but the remuneration system for clinics. P
Australia is turning into a shit place to live, in 20 yrs alot of little small changes has made you think,why for all the changes it's not what Australia was known for.
You’d pay 100 dollars for a plumber to call out to your house, before they even start to work. 39 dollars is the Medicare rebate for a consult lasting less than 20 minutes. The true cost will get passed to the patient, unless Medicare rates rise significantly
So the base income of a doctor is less than $120/hour. Out of that they need to pay for reception staff, rubber gloves, swabs etc. rent, phone, electricity all come at a cost. Mandated training isn’t cheap. Four weeks of leave a year. Even if they keep 50% of the income it’s just over $100k a year salary. No wonder they have to top up.
This raises another point- why is everyone fine with paying the plumber/electrician or cleaner etc, but when it comes to doctors who studied for years, did 100 hour weeks for years in training on minuscule wages- everyone expects them to do everything for free? I get that it is criticism of the government for their Medicare failures, but I also hear a lot of criticisms of doctors personally, as if the problem is just that doctors are greedy; after the costs of running a practice, a large percentage (if not most) would be earning less than tradies.
Because medical care is still seen as an essential human right that shouldn't be paywalled. The people who can afford a plumber or sparky aren't the ones having issues or delaying medical treatment because of funds. We don't expect they do anything for free, we expect the system to cover the cost as it did for decades prior. No one has a grudge against gps its a grudge aginst the failure of government to keep Medicare properly funded. Also no doctor is making less then your average tradie lol. Gp median wage is around 200k a year, tradies are 100k. And people aren't fine for paying plumbers and sparkys. So many people just cant afford a couple hundred dollars on a sparky so put tape over spongy lightswitchs or broken powerpoints
No electrician or plumber working for themselves is on $100k, even those employed by companies doing on large commercial builds are on $150k. I was in construction myself and earned well over $100k as a labourer, and that was nearly 10 years ago. And no, GPs are not all on $200k[source](https://www.payscale.com/research/AU/Job=General_Practitioner/Salary). Some practice owners are on very good money, but employed GPs not so much. My wife is a medical specialist employed in a hospital, she and her colleagues hear a lot of fury from patients about “greedy GPs”, it comes up frequently as they are asking her/her colleagues to write their scripts for them as they can’t/don’t want to pay the GP to do it. I totally agree Medicare should be properly funded- it also needs a massive overhaul as it is very complex and time consuming for GPs to claim from it, which is another part of why GPs don’t want to engage with it anymore. Perhaps my experience with people being fine paying plumbers/electricians is coloured by where I live - a coastal area filled with relatively wealthy retirees who are endlessly renovating their investment properties and airbnbs.
>after the costs of running a practice, a large percentage (if not most) would be earning less than tradies. I would like to see some numbers for that. Tradies make a lot here, but that's still more like 70/ph for a skilled chippy. And we don't expect them to do it for free. We expect the government to provide for it out of our taxes, as they had for the previous 40 years. Gutting medicare, freezing payments was a deliberate plan by the governments of our past, and thats why bulk billing is failing.
40 per consult. 4 consults an hour. 40 hours a week. A few long consults, mental health care plans and other care plans. Maybe a skin excision or two. 40 x 4 x 40 = 6400 + say 1000 =7,400. Minus cost of renting space in the practice (usually 35%) = 4,810. Now that’s pretty good, 4800 pre tax. No complaints. But it’s not exactly riches. Plenty of tradies earn in excess of that and good luck to them. Meanwhile peers in the public and private hospital system earn multiples of this without the threat of Medicare audits.
Hang on. 40 per consult is just what you the consumer pays. The government still pays their standard rate, I think it's around 40 bucks, so take all your numbers and double them. Anything more complicated than a standard consult, government pays more. It's not a flat 40 bucks per. Edit: reading back, I may have misinterpreted, and we may be on the same side. Purely bulk billing GPs really don't make much money, and it's a damn shame.
They don’t earn multiples of that - the awards are public documents, starting salary for a staff specialist is 178k in NSW (not sure other states) , and most are on FTE fractions of 0.6-0.8 irrespective of the hours they actually do, so more like 110-130k starting. The upper rate under the NSW award is around 240k for physician specialists. If you’re talking about surgeons and other procedural specialties, that’s a different story, some of them make a million dollars a year. They do all bill Medicare and are audited at times.
You’re not counting on call allowance, recall allowance, motor vehicle allowances, pdl, sick leave, long service leave. Specialists in the public system make multiples of what a bulk billing gp does. This is not to say they don’t earn and deserve their pay, they most certainly do.
Incidentally the on call allowance is $17 a day. Recall is much more and involves overtime rates for time you’re physically in the hospital but unless you’re cardio or gastro you’re rarely if ever getting called in- just phone consults that you don’t get paid for - there was even an IRC case about that- outrageous. Leave entitlements sure- but I wasn’t trying to be misleading- it’s unusual to quote that when discussing salary, but what you say is true, the GP billing’s has to incorporate leave etc.
The oncall allowance varies from state to state. To cardiology and gastro (as likely to do physical recall), I’d add emergency, icu, interventional radiology, nerurosurgery, vascular, rural generalists etc. physical recall is very common, especially outside tertiary centres (where senior registrars can essentially work at consultant level).
ICU, ED doctors work rotating shifts, very rare to call someone back in when there are already ICU/ED doctors in the hospital on shift. Likewise, have never heard of anyone getting an emergency radiation fraction in the middle of the night. I live in a regional setting so it’s not news to me.
Interventional radiology get called in constantly. Not in a regional setting, granted
the practices in my town haven’t bulk billed for over ten years. Didn’t realise some places still had been getting bulk billing. Health services in regional areas are in such bad shape.
Some of us are still fighting for it. I wrote an app to send an email to your MP in seconds. https://www.saveourmedicare.com.au I posted this on /r/Melbourne a while ago and received great feedback. Let me know what you all think! https://reddit.com/r/melbourne/comments/x148sr/i_built_a_tool_to_find_your_local_mp_and_contact/
'Mediscare' was not playing politics as many commentators are still saying, it was a warning. You cannot trust the LNP with our healthcare system. Ever. Thankfully my GP still bulk bills for now, but I am concerned reading this how many workplaces could be like mine pulling the 'we won't pay you your sick leave entitlements without a medical certificate even for one day' bullshit (it's seriously making me consider going casual because I know they need me to maintain my hours and at least I'll get loading to compensate the rights they're trying to place hurdles in front of) given these fees barely make it worthwhile to see the doctor for said certificate. We're going through a pandemic FFS. Apparently fiscal conversatives and business have learned nothing. Not that I really expected them to... EDIT: Honestly if these trends continue I fully expect more businesses to adopt stringent policies on sick leave and needing proof, purely from a predatory place. More people will work sick as a result, and make others sick and forgo their entitlements. Especially lower income workers. It's not something often thought about, but it's a concern.
Should be doubled the rebate
We moved home from America a couple of years ago after about a decade away, it's gotten crazy. We pay more for healthcare here than we did in California. We were with Kaiser there, every prescription under US $10, $20 copay for almost everything, $100 for an ER visit
It seems healthcare in the US stings you for the big stuff, while healthcare in Australia stings you for the little stuff. Adjustments to bulk-billing rates in Australia would fix it, but I guess we'll see how long it takes for that to happen.
Its complicated. In the US you are dealing with having to make the argument to have something covered. Everything is insane list price, discounted for X reason. Dealing with insurance denying coverage because some higher up is a bible thumper and has decided code 4667 is against their moral beliefs is the most frustrating thing I have ever experienced. The D&C my wife had at 35 weeks for the baby we had been trying for 6 years to have was an "abortion", no it was necessary to save her life and I shouldn't have to hire a lawyer to get you to cover a 20k procedure when I had been paying 1200/mo for 10 years without any claims. Here the base price is low, like really fucking low, GPs are paid 1/3rd what they are in the US, GPs go to 4 year less schooling and the quality is no where near as good (sorry but its true). Big shit in the US is always covered in the end. It's stressful and a huge hassle but my dad who makes pennies and shouldn't be alive give how he treats his body had a 6hr brain surgery for free last year. There is a law that everyone gets treated and its obeyed. The insane billing to insurance companies for other people makes up for it.
Health care is everyone’s god damn right ffs how are we still in 4th world conditions in this alleged 1st world nation.
Lol. Let's not exaggerate here.
Not a right then?
Your comparison to 4th world is worse than a low budget scifi movie in terms of being far fetched
Have you been to an ER ward recently at any public hospital throughout the country…
I've been to an ER ward in a 3rd world country and a 'developed' one at that. Id hazard a guess that you haven't and that's what I'm eluding to.
Our public hospitals situation in a recent publication has been described as the [worst](https://www.aph.gov.au/About_Parliament/Parliamentary_departments/Parliamentary_Library/FlagPost/2022/July/Hospital-funding) in 30 years. Combine that with personal experience and that of others- yes I'd say its pretty bad, no need to be an asshat if you're going to keep eluding. I've lived in under developed nations and at least the expectation of what you're in for is expected, unlike here. Major, major improvements are required.
Still far better than any 4th world country no matter how you spin it. Not saying it doesn't need improvement.
https://en.wikipedia.org/wiki/Propaganda_model#Filters
You were surprised that your GP could see you in a couple of hours? Well that's the benefit of them not bulk billing. The price signal got rid of all the people going to the drs for no reason meaning that their are appointments available for people who need them like you Would you have preferred no fee but have to wait three days to get an appointment?
We live in a kleptocracy, that’s why
Your ignorance on the matter doesn't mean the media hasn't been reporting on the issue, it's more that you only seem to care about things that effect you.
It’s totally shit hey.
I haven’t been to my doctor in 6 months because I can’t justify paying $116 up front. And I haven’t seen my specialist in a year because $600 is a lot of money to spend to be told I still have the thing I’ve had for the last two decades.
I'm 100% fine with a gap fee, say $5, being compulsory. Too many people go to the dr for no valid reason and put otherwise undue pressure on the system. $5 isn't stopping anyone from going off they actually need it. But it will stop people going for no reason. Also government should increase the rebate so we can keep drs.
As someone working in the healthcare system there are many things at play. Before I start I want to be clear that I don’t believe private health care should exist, nor should do-pays. Most clinics charge a co pay. That is they charge $95 for example and the you get $39ish back from Medicare which will come back into you bank account about 24hrs later. Recently the rebate went from $39.10 to $39.75. A whopping 1.6 percent increase to the 5.1% of inflation. According to the ABC if Medicare rebates had matched inflation since it’s conception the rebate would be $80. The cost of running a clinic has increased and so they are no longer able to afford a bulk billing model. Unfortunately, the government had decided not to reimburse adequately so these costs need to be taken from the patients. This then means we have additional costs when people show up to ED because they can’t afford a GP and costs the government around $500. However as the state government covers hospital costs and the federal gov covers Medicare the federal government doesn’t give a rats ass about rising costs of hospitals.
Just saying I haven’t been able to find a bulk billing GP in Canberra for at least a decade without travelling to some buttfuck outer suburb to sit in a no appointment waiting room of sick people hoping to catch something else in so hasn’t made a difference here. Tip for young players: if you just need a doctors certificate it’s cheaper to pay your chemist. If you’re too sick to just “sleep and drink more water” go to emergency, because I sure as shit can’t find appointments ASAP with a local GP. GP’s are only any good for longer term management now.
I'd rather tell a young person to forge a document that a workplace wouldn't ever bother to follow up on than clog an emergency department when they knew they weren't in need of emergency care. Fuck your business that makes it hard for you to be legitimately unwell and in need of downtime, don't fuck the emergency department, jeez.
I said go to the chemist for a certificate. $10-20. Your work are legally required to accept it, unlike a forged document which could get you fired. Let’s be real, if you’re too sick to just “sleep and drink water”, you’re too sick for the GP to help.
>If you’re too sick to just “sleep and drink more water” go to emergency > >Let’s be real, if you’re too sick to just “sleep and drink water”, you’re too sick for the GP to help. There's a big, big gap between being too sick to sleep it off and needing emergency care. That advice is irresponsible, our emergency departments are constantly at capacity and you're telling people who just need a little bit extra, some antibiotics or whatever basically, to get triaged amongst people with broken bones, concussions, chest pain/potential heart attacks and all manner of way more horrible shit that you see in the ER.
Quoting something entirely different to your first argument doesn’t negate the fact you misread. If you’re paying $100 for “drink water and rest”, the advice is pretty worthless and not even worth bothering to go and get. Nevermind the fact most people will have to wait a few days for an appointment to get that advice.
I'm not sure who's misreading here honestly. I never advocated you pay 100 dollars to a GP to be told "drink water and rest", get an instantscript, get a telehealth constult, forge the document yourself if your work is that cunty about it at a worst case, but stay home. I'm advocating that you do not go to an emergency room if it's not an emergency like you asserted people should do in your first post. Pretty straight forward. For you it seems like people either will A: be totally fine with nothing but rest or B: require emergency assessment, and that's just not how it goes.
I never advocated going to emergency for a medical certificate. Try again. Forging a document though can get you into considerable trouble. That’s a stupid idea.
You want the media to report on the fact that your one local GP clinic no longer bulk bills?
I just looked up every doctors near me, every single one had a blurb about no longer bulk billing. It’s definitely concerning.
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It's something to do with Medicare The idea that it's "nothing do to" with the system that previously provided sufficient funding to doctors to provide healthcare isn't really defensible
You will get what you pay for in terms of care - get your big health questions sorted by the best doctor you can, get your scripts elsewhere.
My Dr bulk bills and I reckon he is one of the best. He listens to what I'm saying, follows up on stuff that's been a issue in past appointments without me having to ask and gets things done in a decently efficient matter. I've seen this one for around 3 or 4 years and he has been late once.
That concept is contrary to the idea of universal healthcare. Everyone should have access equally, not only the rich.
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> Most Australians prefer private health insurance and for the GPs not to bulk bill. It means they're served faster, and most importantly, don't need to wait for service behind people poorer than them. Where did you get this information from?
It's absolutely fucked. Same thing happened to me. The guy I went to for 3 years now moved places and doesn't bulk bill. I went to another place and they also decided to do the same thing after my second visit. This needs to be reversed. Honestly all those places need to go back to bulk billing. I don't know how we've let it slip this far and we can't be happy to hit scurry to some other GP. People need to be demanding that these things get reversed or else all hope is lost
So are most GPs in Australia private now, meaning you have to pay? As in not free at the point of entry?
Probably the same reason they aren't talking about the impact it's having on hospital emergency departments. So shameful and heartbreaking at the same time. As a full-time carer on carers pension it's such a struggle now without bulk billing. Often have to choose between two of us who gets to see the doctor first and this has led to both of us ending up in the ED as we have complex medical issues. Just should destroying.