Recent analysis from Cleanbill has raised questions about whether the federal government’s expanded bulk billing incentive will be enough to achieve the GP bulk billing rates pledged during the last federal election.
The modelling suggests that, without further policy changes, Australians may continue to face difficulties accessing affordable GP services.
Matthew Koce – chief executive of Members Health Fund Alliance, which represents not-for-profit health insurers – said the Cleanbill report highlights ongoing barriers for patients seeking bulk billed GP appointments.
“Despite all the bipartisan talk about strengthening Medicare during the recent federal election, the latest independent report from Cleanbill presents a stark warning to many Australians that their struggle to find a local bulk billing GP will likely continue,” he said.
Koce pointed to recent data from the Australian Bureau of Statistics (ABS), noting that cost is increasingly cited as a reason for delaying or missing GP appointments.
According to the ABS, 30% of individuals aged 15 and over reported waiting longer than they considered acceptable for a GP visit.
Koce said that such delays can have serious consequences for patient health, particularly in cases where early intervention is critical for managing chronic conditions and improving long-term outcomes.
“GPs sit at the frontline of our health system, which makes their role in maintaining good population health of fundamental importance,” he said. “Early diagnosis, fast treatment, and effective management of chronic disease delivers better long-term health outcomes for patients, saves lives, and reduces overall healthcare costs.”
The Members Health Fund Alliance is urging policymakers to reconsider existing restrictions that prevent private health insurers from covering GP consultations.
“Private health insurance has grown to cover well over half the Australian population. It makes no sense that health insurers can help cover the cost of allied health services, such as dental, optical, and physio but not something as important as a local GP visit,” Koce said.
Koce suggested that the government’s recent decision to allow coverage for certain natural therapies under extras policies could be a step toward broader reform.
“The government only this year ended the ban on health insurers covering a range of natural therapies under extras policies. The next step should be to engage in serious discussion about lifting restrictions on health insurers covering GP appointments,” he said.
He added that the current regulatory framework was established at a time when bulk billing was more widely available.
“The restrictions on health insurers helping to cover GP out of pockets were introduced in another era, when finding a bulk billing doctor was easy. Given the unprecedented cost of living pressures Australians are facing and modelling by Cleanbill on bulk billing rates, all options must be placed on the table for discussion if government targets are to be met,” Koce said.
The discussion around GP access comes as private health insurance premiums have risen, particularly for higher-tier policies.
Canstar’s recent analysis found that some Gold-tier hospital insurance premiums increased by an average of 13.8% after the government’s annual premium adjustment in April.
For individuals, this rise amounts to an extra $442 per year, while family Gold-tier policies reached an average annual cost of $7,207 in June, up $858 from March.
Despite these increases, a survey by Money.com.au indicated that many Australians still see value in health insurance, especially extras cover.
The survey found that 20% of respondents considered extras policies to offer the greatest savings, while 19% identified hospital insurance as providing the best value.
