Bulk-Billing

Bulk-Billing

Introduction

In Australia, the general practitioners have a unique system of payment for their services. The general practitioners use the bulk billing system that allows them to earn income after they have provided services to patients for the entire month. Practitioners that use this system of payment are generally on the governmental panel. It is the responsibility of the government, Australian federal and local state government, to pay the doctors or practitioners for their service. Medicare, the federal healthcare system in Australia, sets a certain schedule fee or Medicare Benefit Service (MBS) for every service that is provided to patients. The practitioners are then paid a set proportion of the fees that patients pay. The public contribution in this system is 85 percent of the fees. This fee is also called Medicare rebate. In order to receive these payments, it is necessary for a practitioner to have a referral that would allow reimbursement for specialist services. Consumers or patients have the option of choosing from a panel of practitioners. According to data, in 1998 the average number of patients consulting a practitioner was 6.4 persons. Since then, this number had decreased to 5.8 persons. The debate is aimed at why did the decrease in number of patients occur? What were the possible reasons for the decline?

The most commonly accepted cause of this decline is the reduced supply of general practitioners. This is due to the reducing number of immigrants and lower medical school intake. Another reason is the restrictions that have been put in place on general practitioners with regard to access to Medicare. The average number of hours of a practitioner has also declined over the years. Medicare does not charge the patients for consultation. This allows the practitioner to charge according to the service they provide. However, the MBS fee is determined in the way that the government sets a floor price or a minimum fee. Over the past decade, the use of bulk billing by practitioners has seen an increase of more than 3% annually. The initial percentage of usage was 52.5% which has now risen to 84.4%. As stated earlier, the percentage has dropped by to the decreased supply of GP's in Australia due to various reasons.

According to data published by Medicare in 2003, there has been a decline in the percentage of bulk billing services by practitioners for thirteen 13 quarters. In 2004, this rate ...