Peach Posted December 13, 2014 Share Posted December 13, 2014 I'm very definitely not a supporter of this current government but believe reduced bulk billing is a good outcome for two reasons. 1. Far too many people go to the doctor when they don't need to. They get a simple cold or their child has a temperature .5 degree above normal and no other symptoms, and they're off to the doctor. If it costs them something, they will (hopefully) think more carefully about whether or not they really need to see a doctor. Fewer visits means lower costs to Medicare and we all benefit. 2. Doctors in bulk billing practices don't spend enough time with most patients because their income relies on seeing large numbers of patients. Currently, if the patient walks out with a scrip after a 3 minute visit, they seem to think they're achieved something and they're satisfied. If the doctor has to spend 10+ minutes for the same return per patient, the additional time may allow them to actually give some informed and considered advice instead of hurriedly writing a scrip and shoving them out the door for the next patient, an outcome which may even also have an additional effect on reducing over prescribing of antibiotics and other drugs. Your points are factually incorrect.. I haven't been bulked billed since arriving in Australia, normally costs me $30 or so out-of-pocket to see a GP for less than ten minutes. Also, it ignores services such as: http://www.familycare.com.au/ which offer bulk billed out of hours home visits -- which would be impossible to divy up the day into six minute allotments. Link to comment Share on other sites More sharing options...
Harpodom Posted December 13, 2014 Share Posted December 13, 2014 I'm very definitely not a supporter of this current government but believe reduced bulk billing is a good outcome for two reasons. 1. Far too many people go to the doctor when they don't need to. They get a simple cold or their child has a temperature .5 degree above normal and no other symptoms, and they're off to the doctor. If it costs them something, they will (hopefully) think more carefully about whether or not they really need to see a doctor. Fewer visits means lower costs to Medicare and we all benefit. 2. Doctors in bulk billing practices don't spend enough time with most patients because their income relies on seeing large numbers of patients. Currently, if the patient walks out with a scrip after a 3 minute visit, they seem to think they're achieved something and they're satisfied. If the doctor has to spend 10+ minutes for the same return per patient, the additional time may allow them to actually give some informed and considered advice instead of hurriedly writing a scrip and shoving them out the door for the next patient, an outcome which may even also have an additional effect on reducing over prescribing of antibiotics and other drugs. 1. The obverse of your argument is that if you deliberately set about making it financially harder for people to seek medical advice, inevitably some illnesses will fester for longer, and in many cases, to the point that the illness will get more serious. Think of a child with a 'cold', who turns out to have meningococcal septicaemia. Inevitably patients will die as a result. You might think I'm being melodramatic but if you're going to use such crude methods, you're going to have to live with the results. Also, ED rooms will clog up with with people who don't want to pay to see their GP. 2. I agree that encouraging good patient care is obviously a good thing. What the govt has done here is make the GP the bad guy for working in a bulk billing practice. There are already measures in place to crack down on '3 minute medicine': the fee is much less for a 3 minute consultation already and GPs already face being audited under the PSR (professional services review) if they are found to be abusing the system, whereby they can face massive fines for rorting the system. What your argument shows quite clearly is that this evil, incompetent govt has managed to deflect the heat away from their incompetence and obfuscation and onto GPs. I fear that general practice is on a slippery slope, similar to what happened in the UK, thanks to politicians and the media. Link to comment Share on other sites More sharing options...
carlhall Posted December 13, 2014 Share Posted December 13, 2014 Bulk billing doctors currently make what they feel is an acceptable income by seeing large numbers of patients for very short consultations of under 10 minutes (usually well under). Under the new measures, if the doctor spends 10 minutes or longer with the patient, the Medicare rebate will be cut from the current $37.05 to $32.05 (i.e. the 'new' $5 co-payment as advertised). However, the rate for a shorter consultation will only be $11.95. With a greatly reduced rebate for very short consultations, far fewer practices will continue to bulk bill all comers. IMO, a good outcome. I fail to see why ending of Bulk Billing would be a good thing? If a GP decides to Bulk Bill a patient then that his his decision and has absolutely no impact on you, so why should you be so against Bulk Billing. My wife is severely disabled and and as such has a Disabled Pensioner card because she is physically unable to work. I am her full time carer and as such get an allowance to care for her. We both see our GP at least once a month, My wife in the last few weeks has had two X-Rays, CT Scan with another one scheduled for Tuesday next. Bowl cancer tests, ECG, ultrasound and various blood tests. If we would have had to make a $5 payment for all the visits and tests (as was the original co payment idea), we would not have visited the Doctor as much the tests would not have been done. We have a limited income and if we had been forced to make the $5 payment for each visit or consultation then we would either be eating a lot less or just a lot unhealthier because of financial restraints. I find it utterly selfish of people to spout off about bulk billing when they do not understand or want to understand other peoples situations. Link to comment Share on other sites More sharing options...
Ozmaniac Posted December 13, 2014 Share Posted December 13, 2014 Your points are factually incorrect.. I haven't been bulked billed since arriving in Australia, normally costs me $30 or so out-of-pocket to see a GP for less than ten minutes. Also, it ignores services such as: http://www.familycare.com.au/ which offer bulk billed out of hours home visits -- which would be impossible to divy up the day into six minute allotments. It costs me more than $30 for each visit to the doctor for even a short consultation. I've never been bulk billed either and I wouldn't dream of going to a bulk billing practice - to me, they should be used only by people who can't afford to pay $30+. I stand by my assertion that if it costs something to go to the doctor, the people who currently go for no good reason will think twice before doing so. The Family Care and similar medical services don't need to divvy their day up into 6 minute allotments. The rebate for out of hours home visits is higher than for even 10 minute in hours consultations at the medical practice and they have evidently worked out that it provides them an adequate return. Link to comment Share on other sites More sharing options...
Peach Posted December 13, 2014 Share Posted December 13, 2014 to me, they should be used only by people who can't afford to pay $30+. On this vein, should wealthier people not claim anything back on their tax returns if they can afford to live without it? Link to comment Share on other sites More sharing options...
Skani Posted December 13, 2014 Share Posted December 13, 2014 1.Far too many people go to the doctor when they don't need to. Where are the stats to back up your claim? The only "stats" I've heard are GP's interviewed on radio who say they do occasionally have a patient who over uses their services...but a far greater problem is the number of people who don't visit a doctor when they should. Fewer visits means lower costs to Medicare and we all benefit. Fewer visits to GP's means (1) more people clogging up Emergency Departments for routine issues which could have been seen by a GP (2) chronic conditions clogging up hospitals because they weren't detected, monitored and treated at an early stage....and eventually costing the taxpayer a whole lot more than they should have. The only solution to an economically sound medical system is effective primary care for everyone, irrespective of their financial circumstances. The economic basis for this was explained in detail when the original co payment furore erupted: I'm sure the numerous articles could be found with some diligent googling. Link to comment Share on other sites More sharing options...
Guest The Pom Queen Posted December 13, 2014 Share Posted December 13, 2014 What this will mean in reality is GPs (not being completely daft) will stretch out a 6 minute consult to a 10 minute one, not in the interests of the patient, just to make it worth getting out of bed in the morning. Wouldn't you if the difference was between $12 and $28? Lol my GP usually locks me in his room for 30 minutes but he never charges me if it's based on my current conditions. If I go in with a new complaint then I pay but as I've gone over the safety net, I only end up out of pocket $11 Link to comment Share on other sites More sharing options...
Guest The Pom Queen Posted December 13, 2014 Share Posted December 13, 2014 I fail to see why ending of Bulk Billing would be a good thing? If a GP decides to Bulk Bill a patient then that his his decision and has absolutely no impact on you, so why should you be so against Bulk Billing. My wife is severely disabled and and as such has a Disabled Pensioner card because she is physically unable to work. I am her full time carer and as such get an allowance to care for her. We both see our GP at least once a month, My wife in the last few weeks has had two X-Rays, CT Scan with another one scheduled for Tuesday next. Bowl cancer tests, ECG, ultrasound and various blood tests. If we would have had to make a $5 payment for all the visits and tests (as was the original co payment idea), we would not have visited the Doctor as much the tests would not have been done. We have a limited income and if we had been forced to make the $5 payment for each visit or consultation then we would either be eating a lot less or just a lot unhealthier because of financial restraints. I find it utterly selfish of people to spout off about bulk billing when they do not understand or want to understand other peoples situations. Maybe people who have chronic conditions and need to see their GP on a regular basis should continue to be bulk billed at no charge, also people on a HCC, the young and the elderly. I think this would be fairer rather than stopping bulk billing full stop. I have to admit I am not one who goes to the doctor unless I really have to and usually when I do turn up Im told I should be in hospital etc. I am just very thankful that I have a good surgeon/specialist who has spent hours and hours with me via email and phone over the last 18 months. If I had to pay him it would have cost me over $100,000 and that isn't exaggerating, yes I may have got some back from medicare but you still have to find the money to pay it first. Link to comment Share on other sites More sharing options...
Ozmaniac Posted December 13, 2014 Share Posted December 13, 2014 1. The obverse of your argument is that if you deliberately set about making it financially harder for people to seek medical advice, inevitably some illnesses will fester for longer, and in many cases, to the point that the illness will get more serious. Think of a child with a 'cold', who turns out to have meningococcal septicaemia. Inevitably patients will die as a result. You might think I'm being melodramatic but if you're going to use such crude methods, you're going to have to live with the results. Also, ED rooms will clog up with with people who don't want to pay to see their GP. 2. I agree that encouraging good patient care is obviously a good thing. What the govt has done here is make the GP the bad guy for working in a bulk billing practice. There are already measures in place to crack down on '3 minute medicine': the fee is much less for a 3 minute consultation already and GPs already face being audited under the PSR (professional services review) if they are found to be abusing the system, whereby they can face massive fines for rorting the system. What your argument shows quite clearly is that this evil, incompetent govt has managed to deflect the heat away from their incompetence and obfuscation and onto GPs. I fear that general practice is on a slippery slope, similar to what happened in the UK, thanks to politicians and the media. I actually agree to some extent with both of your points however: 1. I simply don't believe that a $5 cost will stop people from going to the doctor if they really need to. If some parent whose child has a high temperature and/or other symptoms (note that in my original post, I said 'a temperature .5 degree above normal and no other symptoms') and they allow a $5 payment to keep them from seeking medical treatment, they probably wouldn't have been bothered taking them to the doctor anyway. Those parents even now wait until things get obviously serious and then take them to the hospital and will continue to do so so nothing will change. 2. Because they have been getting the same rebate for consultations lasting over a very short time (I think it's 5 rather than 3 minutes) and under 20 minutes, doctors in bulk billing practices apparently tend to do and bill for 6 minute consultations rather than shorter ones for which there is a lower rebate and can make what they apparently believe is an acceptable income. If they do a shorter consultation but bill for a longer one they are rorting the system and if they really were properly audited AND were actually given massive fines for rorting the system, that would be great but it doesn't happen in practice. If the new schedule forces them to spend longer periods with each patient, that must result in better patient outcomes and better value for what Medicare costs the community. I agree with you that this is an evil, incompetent government but I also believe that it's about time that bulk billing doctors who BB all and sundry regardless of their income and who make a good income by spending a less than optimum time with patients were made more directly accountable for their billing decisions. They shouldn't have to carry the cost of the lower rebates but should pass the additional costs onto patients to whom they apply and if that means that they have to wear a few patient complaints, tough! Link to comment Share on other sites More sharing options...
Peach Posted December 13, 2014 Share Posted December 13, 2014 I also believe that it's about time that bulk billing doctors who BB all and sundry regardless of their income and who make a good income by spending a less than optimum time with patients were made more directly accountable for their billing decisions. Do you actually have any figures or stats on the practices of surgeries that bulk-bill or is this just your highly prejudiced opinion? Link to comment Share on other sites More sharing options...
Parley Posted December 13, 2014 Share Posted December 13, 2014 Maybe people who have chronic conditions and need to see their GP on a regular basis should continue to be bulk billed at no charge, also people on a HCC, the young and the elderly. I think this would be fairer rather than stopping bulk billing full stop. I have to admit I am not one who goes to the doctor unless I really have to and usually when I do turn up Im told I should be in hospital etc. I am just very thankful that I have a good surgeon/specialist who has spent hours and hours with me via email and phone over the last 18 months. If I had to pay him it would have cost me over $100,000 and that isn't exaggerating, yes I may have got some back from medicare but you still have to find the money to pay it first. That is what is happening TPQ. Those groups are exempt. Despite the salacious headline, bulk Billing is not being stopped at all. Link to comment Share on other sites More sharing options...
MichaelP Posted December 13, 2014 Author Share Posted December 13, 2014 The real underhand trick the government has played on the public (and GPs) is to cut the Medicare rebate for short consultations from $32 to $12. I've been speaking to GPs this week and they have all said there is no way they can stay in business with a $12 rebate - even if the patient pays a $5 surcharge. They will just stop bulk billing and charge the full fee. And this will hit everyone - even if your doctor is not bulk billing at the moment. It means that you will see a doctor for 9 minutes and pay $60 or $70 and get $12 back. Anyone who thinks they will be paying a $5 optional co-payment after this has had the wool well and truly pulled over their eyes by Hockey and Abbott. You can't take $3.5 billion a year out of the primary care system and expect a few thousand GPs to pay that out of their own pockets. Nope, the Australian public are getting a Great Big New Tax. They're also losing their universal healthcare system. Suck it up. Link to comment Share on other sites More sharing options...
Harpodom Posted December 13, 2014 Share Posted December 13, 2014 You are talking sh1t and you know it. Why post a thread title that is a blatant lie ? What are gonna do, deport us? Link to comment Share on other sites More sharing options...
Parley Posted December 13, 2014 Share Posted December 13, 2014 What are gonna do, deport us? Unfortunately you can't be deported for being a liar. Link to comment Share on other sites More sharing options...
Harpodom Posted December 13, 2014 Share Posted December 13, 2014 Unfortunately you can't be deported for being a lier. whats a 'lier'? Link to comment Share on other sites More sharing options...
Parley Posted December 13, 2014 Share Posted December 13, 2014 Stop changing my quotes. The word is liar. Link to comment Share on other sites More sharing options...
MichaelP Posted December 13, 2014 Author Share Posted December 13, 2014 Worth reading this by one of the many angry GPs affected by this latest move: - 9 reasons why GPs (and all Australians) are being screwed by the government over copayments - by Dr Edwyn Kruys Link to comment Share on other sites More sharing options...
Skani Posted December 13, 2014 Share Posted December 13, 2014 Despite the salacious headline, bulk Billing is not being stopped at all. It will be severely cut because it will be unviable for many GPs to continue it - as explained by MichaelP. Then Abbott will shift the blame to the GP's - in his usual slippery manner. Link to comment Share on other sites More sharing options...
Guest The Pom Queen Posted December 13, 2014 Share Posted December 13, 2014 Stop changing my quotes. The word is liar. You know he didn't change your quote, remember I see the edit logs :wink: Although @Harpodom let's not turn in to grammar police. Link to comment Share on other sites More sharing options...
Peach Posted December 14, 2014 Share Posted December 14, 2014 "Make way for $100 GP fees" -- http://www.canberratimes.com.au/national/100-gp-fees-in-two-years-20141213-126ez7.html Link to comment Share on other sites More sharing options...
Petals Posted December 14, 2014 Share Posted December 14, 2014 Government obviously does not want to be re-elected. Fiddle with health at their peril. The thing is everyone is affected not just some of the population and everyone knows someone who is doing it hard. I mean if they think the emergency room is busy now, if they follow this path then they will be whole lot busier. What people forget is that the nice surgery we sit in, the ample no of receptionists they employ, the nurses etc all have to be paid. All costs have to be covered. Also why shouldn't docs get a decent good wage, they are the one profession who has to spend more time studying and working than any of the others. Paper pushers getting film star wages but they do not do 12 -14 hour shifts as an intern. Now is more tax was put on gambling and booze etc even though it would affect me to some extent at least I would have a choice, with health we often do not have any choice. My daughter needs an insulin pump $8,000.00. Link to comment Share on other sites More sharing options...
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