Cost to See a Doctor Increases in Australia, With Less Clinics Bulk Billing

Fewer than one in four Australian GP clinics are now offering bulk billing, a recent report shows.

A doctor speaks with a patient during triage at the St George Hospital in Sydney, Australia, on May 15, 2020. Lisa Maree Williams/Getty Images

A new report shows less than one in four Australian doctors are now offering bulk billing consults to adults through Medicare.

The data reveals the number of general practitioner (GP) clinics providing bulk bill consults has fallen by more than 11 percent in a year.

Nationally, the bulk billing rate has dropped from 34.7 percent in 2023 to 23.6 percent in 2024, a Cleanbill 2024 Blue Report (pdf) showed.

The average out-of-pocket cost to see a GP in Australia is $41.68 (US$28), up 3.1 percent from $40.45 in 2023 across the nation.

The report surveyed 6,091 clinics nationwide, including 2,098 in New South Wales, 1,488 in Victoria, and 1,264 in Queensland.

From 2023 to 2024, New South Wales’s bulk billing rate has dropped by 11.4 percent from 48.6 percent to 37.2 percent.

Despite this, the state provides more consults without out-of-pocket fees for patients than any state in the nation.

In South Australia, just 9.5 percent of GP clinics bulk bill in 2024, a significant decrease from 23.1 percent in 2023.

Western Australian bulk billing rates plummeted by 16.9 percent, Victorian rates by 9.7 percent, Queensland by 9.4 percent, Northern Territory by 9.1 percent, Tasmania by 5.3 percent, and 1.9 percent in the Australian Capital Territory.

The report authors noted that fewer Australian clinics are offering bulk billing to patients in 2024, leading to higher out-of-pocket costs.

“Fewer than 1 in 4 Australian GP clinics offer bulk billing to all adults through Medicare in 2024, and this number has fallen by over 11 percentage points on a clinic-by-clinic basis in just the last year,” the authors wrote.

They noted that 514 clinics, which bulk billed all patients at the start of the year, had stopped by November 2023.

“At the over 75 percent of clinics that do not offer bulk billing to adults, patients now face average out-of-pocket costs in excess of $40 almost uniformly across the country,” the authors added.

“This is paid on top of the $41.40 Medicare rebate already provided for a standard, 15-minute consultation.

“In these circumstances, it’s easy to see why over 1.2 million Australians didn’t go to see a GP in 2022-23 because of concerns surrounding cost; twice as many as in 2021-22. This should not be happening.”

The most expensive place to see a doctor in 2024 is Tasmania, where the average out-of-pocket cost to the patient has risen by 8.5 percent to $51.67.

In New South Wales, on average, it costs $42.37 to see a doctor in 2024, up 3.1 percent in a year. This compares to Victoria, where the cost of seeing a doctor has risen by 2.5 percent in a year to $41.19.

Queensland doctor fees for the patient have lifted 2.8 percent in a year to $41.13, while Western Australia has seen the cost go up by 1.2 percent to $41.04.

In South Australia, it costs on average $38.57 to see a doctor, up by 7.2 percent in a year.

In the ACT, the out-of-pocket cost is up 1.5 percent to $49.79 in 2024, while this figure is $39.59 in the Northern Territory, up 8.3 percent.

RACGP Raises Concerns

The Royal Australian College of General Practitioners (RACGP) said the new data from Cleanbill highlights the cost pressures on general practice and the increasing out-of-pocket costs for patients.

RACGP President Nicole Higgins said the report shows more needs to be done to address the rising costs for care in Australia, highlighting patient financial issues were a top concern raised by GPs in the 2023 Health of the Nation report.

Dr. Higgins noted the government’s measure to triple bulk billing incentives has helped more GPs bulk children, pensioners, and healthcare card holders, but “more needs to be done” to make care affordable for the “rest of the population.”

She attributed the current situation to the 10-year freeze on Medicare rebates.

“This ripped funding from general practice, so now even though more people access general practice than any other health service, it gets just 6.5 percent of the total government spend on healthcare,” Dr. Higgins said.

“Practices are also facing the same inflationary pressures as other businesses.”

She highlighted that in multiple states, GPs are increasing patient out-of-pocket fees to cover higher state payroll tax on practitioners.

Dr. Jamal Rifi performs a routine health check at home with Hagge Amine in Sydney, Australia, on Oct. 3, 2021. Lisa Maree Williams/Getty Images

“While practices have always paid payroll tax on their employees, it never applied to GPs because they work under independent agreements, but this changed after a new interpretation of payroll tax law,” she said.

Further, Dr. Higgins said it is “vital” that general practice care is affordable, noting it enables people to live healthier lives and reduces pressure on hospitals.

“The government knows action is needed and they’ve committed to rebuilding Medicare and general practice,” she said.

“While there’s no quick fix, we do need to keep up the momentum to secure the financial sustainability of general practice, enable bulk billing for those who need it, and ensure GP care is affordable for everyone.”