Medicare overhaul to hit bulk billing

The federal government’s proposed changes to Medicare bulk-billing arrangements are causing concern amongst people living with HIV/AIDS.

Although the government has not yet released its plan for an overhaul of Medicare, there are indications that significant changes to bulk-billing arrangements are being considered under which doctors would charge patients an additional fee on top of the Medicare rebate, which would be directly billed.

Under the new arrangements, doctors would be free to set consultation fees at whatever level they deemed appropriate, and consumers would for the first time be able to take out private insurance to cover the gap.

The government is also reportedly considering incentive payments to GPs to bulk-bill pensioners and concession card holders, but these payments would be biased in favour of rural and outer suburban areas, raising significant concerns for Disability Support Pensioners living with HIV in inner city areas with better access to HIV-experienced medical practitioners and community-based services.

Labor Party leader Simon Crean lashed out at the leaked policy, which he claimed would be equivalent to introducing means testing for Medicare.

Health policy spokesman for the Australian Consumers Association, Martyn Goddard, insists that the proposed changes will not work, and will come at significant cost to consumers.
The changes “will destroy Medicare as we know it,” he said. “By entrenching the up-front fee, the government will create underclasses in health care.”

“At the top of the heap will be those who can afford to pay whatever the doctor wants to charge. Beneath them will be pensioners and other concessional patients who won’t earn their doctors as much. Experience tells us that in some cases they will be treated accordingly,” Goddard said.

“And on the bottom of the heap will be those who won’t be able to afford to go to the doctor in the first place. Even now, the average top-up fee paid by non-bulk-billed patients is $12 — but is often as high as $20. These changes will encourage doctors to put up their prices, so that amount will rapidly rise,” he said. “More and more Australians — like many millions of Americans — can no longer afford to get sick.”