MEDICARE “BOOST”
You may have heard about changes to Medicare this month, which politicians claim should allow all GPs to bulk bill.
Unfortunately there has been a lot of misinformation around these changes. The sad fact is, if relying on Medicare rebates, doctors are paid more if they spend less time with each patient.
The rebate is the same for 6 minutes as it is for 19 minutes, leading to the term “6 minute medicine” as the system encourages quick consultations. There is no incentive for longer consultations, despite the value of time, which we know improve patient outcomes and your satisfaction with care. Only quantity, not quality of care, is being rewarded.
I prefer to offer longer consults to build rapport, gain a comprehensive patient-centred history, assessment and individualised management including education. Most perinatal care cannot be managed within a short consultation, as there are usually complexities at play, and an opportunity to provide anticipatory guidance on challenges that may arrive in the parenting journey.
In addition, antenatal care and mental health care are not eligible for the new incentives, meaning these consultations are remunerated less than any other presentation. Several mental health specific items were eliminated this month, limiting my ability to break a consultation down into the ‘physical health’ and ‘mental health’ aspects and reduce your out of pocket cost.
As much as I would love to provide bulk billing to all, it is not possible without reducing the quality of care, which isn’t something I can compromise on. I do bulk bill selectively, such as for the infant if also seeing the mother for a combined consultation, and for brief reviews. But where the majority of my consultations are undervalued by the government, I can’t do this across the board. The practice that I work within are not changing our billing policies as it would be impossible to provide the same quality of care we are proud to offer.
I understand that the cost of healthcare is a significant concern for many Australians. I encourage you to contact your local Federal Member of Parliament, to explain how these Medicare changes affect you. You could suggest that instead of forcing doctors to bulk-bill, the government should increase the Medicare rebate for all patients. That antenatal and mental health items recieve the same incentive as other consultations. And that the time spent on longer consultations is rewarded so that your complex health needs can be explored in the detailed way that you deserve.
