Dr Nick Coatsworth exposes huge problem with government’s key budget pledge for Medicare

One of Australia’s top doctors exposed a major problem with the centerpiece of the federal budget last night.

Treasurer Jim Chalmers revealed that the government is investing $3.5 billion to triple the incentive paid to doctors who bulk bill certain patients, with the Labor administration estimating that this would enable 11.6 million people to be treated.

Bulk billing is the term used when the fee a primary care physician charges for a consultation is the same as what Medicare pays them for the service, meaning the patient pays nothing.

But dr. Nick Coatsworth, health reform ambassador at the Australian Patient’s Association, told Daily Mail Australia that while he welcomed the increase, he was deeply skeptical of the government’s figures.

“First, it’s better than the current situation and more people will be billed in bulk,” he said.

“But the impression given by the government that 11.6 million people will be billed in bulk is wrong – there won’t be that many.”

Dr. Coatsworth said the figures quoted would create an “unrealistic expectation” among Australians who will be billed in bulk.

“Most journalists, commentators and certainly the government have created the impression that an additional 11.6 million Australians will be bulk billed,” he said.

“But they used a subtle word there: ‘suitable’.”

The tripling of the bulk billing incentive only applies to those under the age of 16, retirees and concession card holders.

Treasurer Dr. Chalmers estimates that this will benefit 11.6 million people, including approximately five million children.

Currently, GPs in metropolitan areas get a $6.85 bulk billing incentive, while GPs in very remote areas get $13.15.

Starting Nov. 1, that will triple, meaning GPs who bill vulnerable patients in bulk will receive an incentive of $20.65 to $39.65, depending on where they are located.

But dr. Coatsworth, Australia’s former deputy chief health officer, said the announcement offers no guarantees and that the decision to bulk bill still rests with the GP and more often than not now the company that owns the practice.

“Of course GPs will do it if they can,” he said.

“But they don’t have to and the economy doesn’t support them to do it for all those 11.6 million.”

Dr. Coatsworth said a primary care physician charges an average of $80 for a 20-minute consultation. Previously, the government would pay $40, while the patient would pay the other half.

Now, under the new plans, the government will cover $62, but the patient will not contribute, leaving the GP with $18 out of pocket.

“They’re still going to get less from bulk billing than from out-of-pocket charging,” he said.

“So while it’s better, they’re going to have to absorb some sort of financial loss to do bulk billing.”

Dr. Coatsworth said it was “not health budget reform” and called for a hybrid system like in other countries where they don’t just operate on a “fee for service” basis.

“The problem with this budget is that it entrenches the old funding model – ‘fee for service’ – while all health policy experts say we need to reform to a different funding model,” he said.

He added: “It kind of goes against what Health Secretary Mark Butler’s own Medicare task force has said and what Butler himself has said, which is that current Medicare is not fit for the 21st century and a population that suffers from chronic diseases.

“That’s fine, but you just delivered a budget that reinforces the power of Medicare.”

The budget has set aside $5.7 billion to spend over the next five years on strengthening Medicare.

The allocation of this money includes $445 million to employ nurses and allied health professionals in general clinics to work alongside primary care physicians, $143.9 million to encourage practices to extend their hours, and $98.9 million to provide frequent transfer hospital users to GPs within their local community.

An additional $79.4 million will be spent treating people with chronic health conditions in underserved communities.

In addition to the $3.5 billion over five years to bolster bulk billing by tripling the stimulus, eight new bulk billing clinics are also promised in the budget.

The budget also allocated $824.4 million to modernize the My Health Record system and fund other digital health initiatives.

Some medicines on the Pharmaceutical Benefits Scheme will also be made available for two for the price of one in a move that could benefit up to six million Australians.

A total of 325 drugs are expected to be included on the list, treating a range of conditions from heart disease and Crohn’s disease to cholesterol.

Patients with stable, chronic health conditions can reduce the number of visits to the pharmacy by picking up medicines for two months at a time.

The budget estimates that this will save about $1.6 billion in out-of-pocket expenses.