What is bulk-billing (direct-billing)?
Bulk-billing is part of the Medicare health insurance system devised by the
Australian federal government and implemented in 1984. It provides for a
payment of an insurance rebate to Australian citizens with a Medicare
number who attend doctors, including registered GPs. In bulk-billing,
the patient signs a Medicare voucher, which 'assigns' the amount the
patient would normally receive from their insurer, in this case the
federal government, to the doctor.
For the bulk-billing system to apply,
the doctor must be prepared to accept the value of the assigned rebate
as full and final payment for the service, no other amount can be
charged by the doctor for that particular service, even for medical
consumables such as bandages.
The doctor then remits the vouchers to
Medicare 'in bulk' to finally receive payment. The advantage for
patients is that they do not have to pay any money to the doctor out
of their own pocket.
Why don't you Bulk-Bill everybody?
There is a serious problem with the basic bulk-billing system - it does not provide
anywhere near the true cost of supplying quality general practice services to
patients. This has been confirmed by the federal government's own review, the
Relative Values Study.
The federal government unilaterally determines what the value of the Medicare rebate
will be, doctors do not play any role in this, the rebate is simply what the
government of the day is prepared to pay (the Auditor-General has previously
stated this). Under the bulk-billing system, doctors are generally forced to
cut costs to the bone, force patients through at a very high rate, or be forced
to accept a low rate of after-tax pay which is not commensurate with either the
difficulty of nor the years of training required to properly care for patients.
I have private health insurance, why can't that cover any 'gaps' in my doctors' fees?
The federal government has previously passed laws which prevent private health
insurance providers from covering any 'gaps' in GPs' fees. The federal
government is in effect a monopoly insurer for GPs fees, which some think
is anti-competitive - click here to find out more about competition in the
Australian marketplace (ACCC).
We believe that private health insurers should be able to offer this service to
their clients in return for the premiums that they pay over and above the
compulsory Medicare levy tax. If you want to do something about this, you
should complain to your private health insurer, and contact your local member
of parliament (click here for the Bass electorate.
What is the Medicare Plus Safety-Net?
The Medicare Plus Safety-Net is a system introduced in 2004 (twenty years after
the introduction of Medicare) by the federal government to help reduce your
out-of-pocket costs. Out-of-pocket costs can arise due to 'gaps' between the
Medicare rebate and a doctor or medical organisation's fee.
Advantages are that the safety-net will cover more than one person (eg. an entire family
enrolled on the same Medicare card), and covers all out of hospital
Medicare-rebatable services, not just GP visits at a particular surgery.
We recommend that every patient 'signs-up' for Medicare Plus, particularly if you have a large family
(whose names are on your Medicare card) and/or if you visit the doctor frequently.
Click here to visit
Medicare's site for more information.