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Reality behind "good news" bulk-billing revealed

07 September, 2018

‘A recent report by the Australian Institute of Health and Welfare (AIHW) shines a light on just how misleading bulk-billing figures can be’, Australian Healthcare and Hospitals Association (AHHA) Chief Executive Alison Verhoeven said on August 16.

‘Governments are continually claiming bulk-billing figures of around 85% for services typically provided out of hospital by GPs, specialists, and imaging and obstetric services.

‘This gives the impression that in 85% of all GP and similar doctor consultations, the patient doesn’t pay a cent.

‘The reality, seen in the AIHW report, is that across Australia 1 in every 2 such patients accessing Medicare-subsidised services had to pay something out of their pocket in 2016–17’, Ms Verhoeven said.

‘And this varied widely among the nation’s 31 Primary Health Network (PHN) regions—in the Northern Territory 31% paid something, whereas in the ACT 69% did.

‘Of those who had to pay, the median amount paid per year varied among regions by a factor of almost 100%.

‘The report also shows that patients spent $29.4 billion out of their own pockets on all health-related expenses in 2015–16, or an average $1,195 per person—not including health insurance premiums or travel costs.

‘Governments, private health insurers and accident compensation schemes collectively paid about $141 billion.

‘The out-of-pocket costs situation is especially grim for those who are referred to specialists.

‘72% of people seeing a specialist outside of a hospital paid something out-of-pocket, and the median amount spent per service varied widely. At the 90th percentile the amount varied from an average $97 per service in Country South Australia PHN to $167 per service in Northern Sydney PHN.

‘Because some of the figures in the AIHW report are now quite dated, the impact on people’s hip pockets today is probably greater than suggested.

‘When one looks into the figures by geographic area and socioeconomic status, it appears that costs to the patient beyond the Medicare rebate have little to do with the ideals of a universal healthcare system, and everything to do with supply, demand and what the local market will bear,’ Ms Verhoeven said.

‘We do not want to go down the path of an Americanised system where the more you can pay, the more access you have to care, and if you are poor, your access to care is limited.

‘This is not the fair go that most Australians want. This report should be a wake-up call for those who don’t recognise the growing impact of out-of-pocket costs and the need to ensure health reforms protect healthcare for all Australians.’

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