STUDY: At Least A Quarter Of All Australian Doctor Visits Will Cost More Than $7 Under The Budget Co-Payment Plan

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If you saw a doctor at a bulk billing medical centre it wouldn’t cost you anything today, but the proposed $7 co-payment could actually cost people more than that for a visit to the GP, independent analysis by the Family Medicine Research Centre at the University of Sydney has found.

The co-payment was announced in the May federal budget and means there will be no more bulk billing from July next year. Five of the $7 is to go to a medical research fund with the remaining $2 going to the doctor.

“It is the high users, usually the older, sicker people in our community who will be most affected,” the centre says.

However, everyone who previously used a bulk billing medical centre will face a fee greater than $7 if they need tests. GPs are also expected to be under pressure to charge more than $7.

More than one quarter of adult GP consultations involve at least one test. This means the minimum out-of-pocket cost for the consultation becomes $14 in co-payments.

About 3% of adult GP consultations involve imaging and pathology tests which will mean a minimum co-payment of $21.

The analysis estimates the average annual additional cost due to the patient co-payments is about $35 per year per child and about $94 for those aged 65 years and over.

And this doesn’t consider the possible impact of providers choosing to charge higher co-payments.

“Under the current proposal, there will be no incentive for providers to only charge $7 co-payments for general patients,” the analysis says.

Many providers, faced with the cost of setting up a new billing system, may choose to charge general patients privately, allowing them to charge more than $7 to recoup their expenses.

“Even with our conservative estimates, these proposed policies will create a larger price signal than that suggested in the media to date,” according to the report.

The combined annual effect of the GP, testing and medication co-payments is significant, it says.

A general patient with Type 2 diabetes, no matter what age, will pay an average additional $121.49 annually.

For those aged over 65, general patients will pay average $122.17 more per year and those with a concession card an average of $99.65.

This is because the Pharmaceutical Benefits Scheme increase, while only 80 cents for concessional patients compared with $5 for general patients, represents a greater increase for concessional patients, due to the number of medications that will be affected.

Here are some examples:

  • A young family of four with two children (aged under 16 years) and two parents aged 25-44 years would expect to pay an average of $170 in co-payments for GP visits and tests plus $14 for medications, about $184 more per year.
  • A self-funded retired couple aged 65 years or more without Commonwealth concession cards would expect to pay an average of $189 in co-payments for GP visits and tests plus $55 for medications, about $244 more per year.
  • An older couple who are pensioners aged 65 years or more, with concession cards would expect to pay an average of $140 in co-payments for GP visits and tests plus $59 for medications, about $199 more per year.

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