Labor and the unions have long been two backs of the same beast. But there’s one powerful union, perhaps the most powerful in the country, which is very far from a Labor lapdog: the Australian Medical Association.
Once again, the AMA and its members are throwing a spanner in the works of Labor’s flagship campaign policy.
Labor’s flagship $8.5bn election policy promising Australians won’t need a credit card to see a doctor has sparked a growing backlash from GPs and medical leaders, who insist many doctors won’t make the switch and not all patients will be bulk-billed.
As Anthony Albanese stood up in the battleground Tasmanian seat of Lyons on Tuesday and said three times more people would get to see a doctor for free under his policies, a growing cohort of doctors was warning patients not to expect a free consult by simply producing a Medicare card, and urging them to ask their GP if they would switch to bulk-billing.
Here’s the thing about bulk-billing: like any other ‘free’ government service, it’s not free at all. In this case, it’s funded by taking money out of doctors’ pockets.
Bulk-billing is when a GP charges the Medicare “schedule” fee: that is, what the government has deemed a doctor’s visit should cost. Meaning that there’s no out-of-pocket fee for the patient. But what the government reckons something should cost and what it really costs, in the real world, are, as ever, two very different things.
The inevitable result is that a doctor who bulk bills an appointment is taking a pay cut. Many stand to lose money and, naturally, they’re not happy about that.
The nation’s peak doctors’ body has flatly said that not all patients will be bulk-billed as a result of the incentives policy and also questions whether the majority of practices would be better off fully bulk-billing as rebates remained depressed. It also is disappointed that the incentives boosts run counter to serious health policy reform.
Other grassroots doctors’ forums have carried out straw polls in which doctors have expressed reluctance to shift to the new model because it would cost their practices money.
Now leading doctors’ organisations have echoed their concerns. Australian Medical Association president Danielle McMullen said people should not expect to walk into a GP practice and be seen for free.
But… but… muh free stuff from the gubmint!
“It’s always hard to know until the program starts, but certainly we don’t think it’s going to have the impact the government’s been saying, that nine out of 10 people will be able to walk into a general practice and have a bulk billed consultation,” said Dr McMullen, who is a GP.
“In a cost-of-living crisis, the idea that you could promise free healthcare in an election setting, that seems appealing at a first glance.”
At least, to the leaners who aren’t doing the lifting.
One big problem is that the government incentives to encourage bulk-billing don’t rise commensurate with the length of a consultation. Which leaves doctors with three options: take a pay cut, refuse bulk-billing to patients with serious or chronic illnesses which require commensurably long consultations or switch to a strictly six-minute sausage-factory model of consultation.
In all, GPs and their representative bodies are saying, Albanese’s promise of ‘free doctor’s visits for all’ is a blatant con.
Claire Jackson, a professor of general practice at the University of Queensland who has decades of experience as a doctor and still consults part-time in a Brisbane practice, is predicting that 80 per cent of practices would continue charging out-of-pocket fees to many patients […]
“The majority of practices are just unable to afford what will amount to a 30 per cent discount for many patients in the current economic environment, so they will just continue on largely unchanged, and that means no additional Medicare benefit at all for their patients.”
More likely, people won’t be able to find a GP at all as more and more clinics close, thanks to government meddling.
“Practices are trying to keep the doors open. We’ve seen so many general practices close over the last two years. It is terrifying […]”
Resentment is widespread among GPs at the many millions of dollars being poured into Urgent Care Clinics that are designed to take pressure off emergency departments, where the consultations cost taxpayers about five times more per patient than ordinary GP clinics.
The proliferation of these well-funded clinics while many ordinary GP clinics face financial viability crises and do not receive incentives to open after hours themselves is causing rancour. GPs also believe these clinics fragment and duplicate care.
Melbourne GP Karen Price, a former president of the RACGP […says] “The idea of seeing a GP for free, I mean, that’s just not honest. It’s not true.”
Not honest? Causing more problems than it pretends to fix?
Tell me this isn’t a Labor government operation.
