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No answers from Minister on bulk billing or gap payments.

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Stephen Smith MP Member for Perth Shadow Minister for Health and Ageing

100/2002 Monday 18 November 2002


The Minister for Health, Senator Patterson, today failed to offer any solutions to the catastrophic decline in the rate of bulk billing by general practitioners or the continuing problem of increased gap costs for privately insured patients.

Bulk billing

New figures released by the Health Insurance Commission on Friday for the September Quarter show that bulk billing is in free fall.

The rate of bulk billing by GPs peaked at 80.6% shortly after the Howard Government came to office. Now, only 71.2% of GP services are bulk-billed - down 4.9% in the 12 months since September last year and down 9.4% since the Howard Government came to office.

In every year from the commencement of Medicare in 1984 to the end of the former Labor government in 1996, bulk billing rates for GPs increased. In every year since the election of the Howard Government, bulk billing rates have decreased.

The record on bulk billing speaks for itself.

But during today’s Question Time in the Senate, Minister Patterson’s only response was to blame Labor.

Last time I looked, the Howard Government had been in office since March 1996.

Minister Patterson is correct to draw the link between doctor shortages and the availability of bulk billing.

But one of the first actions in health policy by the incoming Howard Government in 1996 was to impose a cap on the number of GPs who could be trained each year, directly restricting the number of GPs to enter practice.

The Howard Government’s first budget introduced postgraduate training requirements for GPs but made only 400 training places available each year.

It was not until the year 2000 - four years after the Howard Government came to office - that the Government recognised that this was contributing to a shortage of rural GPs and allocated an additional 50 rural training places in the 2000 budget.

Now bulk billing is in serious decline, and Australian families are finding it harder and harder to find a bulk billing doctor and as the rate of bulk billing by GPs has fallen by almost 10% since the Howard Government came to office, the average cost of seeing a doctor who does not bulk bill has also risen by more than 50% to $12.57.

Out-of-pocket “Gap” Payments

At the same time, Minister Patterson had nothing of substance to say in response to questions in the Senate about the problem of rising out-of-pocket “gap” costs and, in particular, the proposal by private hospitals to introduce special gap payments next year to cover their rising medical indemnity insurance expenses.

Privately insured patients are still hit with out-of-pocket costs for one in every five privately insured medical services provided in hospitals, and the average out-of-pocket payment for medical services for privately insured patients was $74.28 in the June quarter, up from $67.38 in March this year.

Today in the Senate, Labor asked whether the Minister was aware that all privately insured Australians could face additional out-of-pocket gap expenses as high as $150 for hospital treatment next year to cover the cost of medical indemnity insurance of private hospitals.

Labor also asked Minister Patterson whether she acknowledged that a significant gap problem continues to exist which undermines the value for money that those Australians with private health insurance receive.

In response, other than to doubt the extent of the medical indemnity insurance problem that private hospitals are facing, Senator Patterson had nothing to say about the spectre of additional gap costs being passed on to patients, let alone the ongoing problem that one in five privately insured patients still face significant out-of-pocket expenses.

Gap costs are a continual source of frustration for patients who are already being asked to pay higher and higher private health insurance premiums.

Already this year we have seen an average increase of 7% in private health insurance premiums, the automatic CPI-linked premium increase of 3.2% already approved for next year, and the removal of premium discounts of up to 6% by Medibank Private.

Before last year’s election, Prime Minister Howard and his Government said that private health insurance would be “more affordable and attractive” to consumers.

Nothing that has occurred since the election supports that claim.

Media Contact: Andrew Dempster (02) 6277 4108 or 0407 435 157