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Unaffordable GP visits has become a pressing issue amid the increasing cost-of-living crisis. About 30% of Australians delayed or didn’t see a GP in 2023–24.
To solve this problem, Labor has proposed extending bulk billing incentives to all Australians. It hopes to increase bulk billing from 78% to 90% by 2030.
The Coalition has promised to match Labor’s plan.
Why not aim for 100%? It might seem a worthy goal to make GP care free for everyone, for every visit. But the evidence suggests there’s benefit to getting those on higher incomes to contribute a small amount to the cost of seeing a GP.
GP care should be free for these Australians
We should aim for access to GP care to be affordable and equitable. For some people, this should mean they can access the services for free.
Appointments for children should be free. Making health checks regular and accessible during childhood is an effective long-term investment which can delay the onset of disease.
GP visits should also be free for people with low incomes. Free primary care can mean people who would otherwise avoid seeing a GP can have their ongoing conditions managed, undergo preventive health checks, and fill prescriptions.
When people skip GP visits and can’t afford to fill their prescriptions, their conditions can worsen. This can reduce the person’s quality of life, and require higher-cost emergency department visits and hospital care.
Appointments in rural and remote areas should also be free. Australians living in rural and remote areas currently pay more to see a GP, have less access to care when they need it, and experience poorer health outcomes and shorter lives than their city counterparts.
Making GP visits free for rural and remote Australians would help reduce this rural–urban gap.
However, providing free GP care for everyone can cause unnecessary strain on health budgets and make the policy unsustainable in the long run.
What can happen if you make care free for all?
In general, when the price is low, or something is free, people use these services more. This includes medical care and medications. Free GP care may encourage more people to see their GP more than is necessary.
Previous research showed that free care increased the use of health care but does not necessarily improve health outcomes, especially for those who are relatively healthy.
If people are using GP services when they’re not really needed, this takes limited resources from those who really need them and can increase waiting times.
Australia is already experiencing a GP shortage. Higher patient volumes could leave existing GPs overwhelmed and overstretched. This can reduce the quality of care.
Countries that have made primary health care free for all, such as Canada and the United Kingdom, still report issues with access and equity. In Canada, 22% of Canadian adults do not have access to regular primary care. In the United Kingdom, people who live in poor areas struggle to get access to care.
Make co-payments more affordable
To balance affordability for patients with the financial viability of primary care, Australians who can afford to contribute to the cost of their GP care should pay a small amount.
However, the A$60 many of us currently pay to visit a GP is arguably too expensive, as it may prompt some to forego care when they need it.
A relatively smaller co-payment in the range of around $20 to $30 to visit the GP would help discourage unnecessary visits when resources are limited, but be less likely to turn patients off seeking this care.
Providing free GP visits for all may not be efficient or sustainable, but making it more affordable and equitable can lead to a more efficient and sustainable care system and doing so is within our reach.
Yuting Zhang, is Professor of Health Economics at The University of Melbourne.
Karinna Saxby is a Research Fellow with Melbourne Institute of Applied Economic and Social Research at The University of Melbourne.
This article is republished from The Conversation under a Creative Commons license. Read the original article.
The statements or opinions expressed in this article reflect the views of the authors and do not necessarily represent the official policy of the AMA, the MJA or InSight+ unless so stated.
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Sure,y the sensible solution is to make it possible to simply make a co- payment, with Medicare paying the doctor the schedule fee. While people on higher incomes and those with credit cards can afford to pay the lump sum, the difficulty occurs when patients struggle to have the cash in their accounts to pay the total account up front.
The current system where everyone has to pay upfront prevents many people accessing community care, particularly to see specialists, and increases the burden on hospitals.
I’d like to see politicians accepting a salary that was about 40% of what it was 40 years ago in real terms. A salary of say $100000 instead of $250000 and then be offered $5000 to accept the lesser amount.
This article could have been written in 1974, prior to the Whitlam labour government introducing Medibank. It disregards the lessons of history that followed which trace the decline of morale in general practice. It’s really very simple – create a free service, underfund it, pay lip service to the role of overworked GP’s, then stand back and watch quality workforce outcomes deteriorate. Having retired from general practice after fifty years, it is clear to me that risk exists when governments manage health systems for political purposes.