Patients may not see the benefits of higher bulk billing for years despite $8.5 billion being tipped into the GP subsidy scheme from November.
The health department conceded overnight it expected the benefits of that money to take about four years to flow through.
Officials also told a late-night senate hearing average out of pocket costs to see a GP will continue to rise under the signature election policy.
The federal government promised at the federal election to lift the incentive for GPs to bulk bill patients, which was quickly matched by the Coalition.
Labor said the $8.5 billion promise would increase bulk billing rates to 90 per cent by 2030, meaning that nine out of ten GP attendances would not require patients to pay a fee.
The bulk billing rate over the last financial year was about 78 per cent, well below the long-term average.
The promise was the centrepiece of Anthony Albanese’s re-election campaign, where he repeatedly flashed a Medicare card vowing it was the only card Australians would need to see a doctor.
The increased incentives are due to begin from November, but despite the instant injection, officials said it would take years for GPs to adjust their businesses to receive the incentive.
Asked by Shadow Health Minister Anne Ruston how soon the department expected the rate to improve, assistant health secretary Daniel McCabe responded that it could take about four years.
“We looked at what happened historically in Medicare when governments make interventions on bulk billing, we had a similar issue with bulk billing back in the early 2000s,” he said.
“It took four years for GPs and GP practices to take on board all those measures and roll them through.
“So we expect that kind of behaviour will occur in this instance as well.”
The department added it expected that to be the time for the significant funding investment to “wash through”, but how that occurs was not something they had “direct control over”.
Shadow Health Minister Anne Ruston questioned when the benefits of an $8.5 billion Medicare investment would be seen. (ABC News: Matt Roberts)
Officials said they expected to see about 3,600 practices sign up to the scheme over the first two years — meaning those clinics would have to fully bulk bill to receive the higher government subsidy.
But they could not provide figures for how bulk billing would improve before 2028-29, after this term of government ends, when they said bulk billing rates would lift to about 87.8 per cent.
The department said there was a “lot of modelling” but it was protected by provisions under the Health Insurance Act.
The Royal Australian College of GPs has cast doubt over whether the higher incentive would actually lift bulk billing rates to 90 per cent this decade, and a survey by the ABC found many GPs were not planning to adapt their business models to receive the payment.
Average out-of-pocket costs expected to rise
Assistant health secretary Daniel McCabe also told the Thursday night senate estimates hearing that for those who cannot get a bulk billed appointment, visits would become more expensive on average.
The average out of pocket cost for GP services was $49.14 last financial year.
Asked when people could expect that cost to fall, an official responded “in fact, it will probably go up as more people are bulk-billed”.
“We will have outlier GPs that are charging higher out-of-pocket expenses and if they continue to do that, the average for those sub-set of patients will be higher for a period of time,” Mr McCabe said.
Some doctors have told the ABC they would have to raise fees for non-bulk billed services when the higher bulk-billing incentive begins in November, because patients often required longer appointments than the bulk-billing incentives covered.
Senator Ruston said the government had been misleading when it said all people would need to see a GP is their Medicare card.
“Labor’s credibility on Medicare gets weaker and weaker by the day,” Senator Ruston said.
“Bulk billing rates remain 11 per cent lower than when the Albanese Government was elected and Australians are now paying the highest out-of-pocket costs on record.
“Now, we find out that despite all of the Prime Minister’s promises, not only will millions of Australians still have to pay with their credit card as well as their Medicare card, but costs ‘will continue to go up’.”
