Doctor Payment Plan Defended


The Hamilton Spectator – August 01, 2015

HAMILTON Medical Group has defended its new ‘pay on the day’ policy for GP appointments, which was announced last Saturday and will take effect on September 28.

The clinic has pointed to a freezing of Medicare rebates to GPs since November 2012, under both Labor and Coalition Governments, as a partial reason for its payment policies.

A statement from Federal Health Minister Sussan Ley said doctors should not use the rebate freeze as an excuse to unfairly increase prices.

The clinic’s announcement was heavily criticised on Facebook and it also reignited a long-running debate about the local availability of bulk bulling for GP visits.

The clinic stated via an advertisement in The Spectator that “in view of the Government freezing of the Medicare rebate, in order to sustain a medical service and attract doctors to come and work in Hamilton, the Hamilton Medical Group will be changing its billing policy.”

From Monday, September 28, 2015 full payment will be required for all consultations on the day of service

“Rebates can be paid directly into your account on the same day.”

At the time of publication, 158 comments had been posted on the ‘I’ve Lived in Hamilton, Victoria’ Facebook page listing issues with Hamilton Medical Group’s payment policies.

There were also messages in support of the clinic, including one popular comment that asked locals to consider “how lucky are we to live in a country that allows us to access medical treatment for many issues”.

Prior to the ‘pay on the day’ policy announcement, The Spectator had asked users of its own Facebook page about their opinion of bulk billing.

A number of users said the non-bulk billed cost of repeated GP visits, often because of having multiple children or a chronic illness, was a major issue.

Hamilton Medical Group board chair Dr Dale Ford told The Spectator that the new payment policy would have exceptions for financial hardship and was not the only medical clinic to adopt similar measure.

“We are going to try to move to a ‘pay on the day’ policy,” he said.

“The reason for that is: as a result of what happened in recent months and years the amount of money outstanding has increased significantly and we are trying to move to have ‘pay on the day’ whenever possible.

“We understand that sometimes it’s not going to be possible, but that will also be part of the policy.”

For many families facing multiple GP visits, there has always been calculation of whether it would be cheaper to drive to Penshurst, Coleraine, Portland or Warrnambool rather than attend a non-bulk billed appointment in Hamilton.

One woman who contacted The Spectator said she considered herself to be one of the “working poor” and was battling the cost of GP visits while managing a chronic illness.

“I have many friends with young children who simply can not afford to go (to the doctor),” she wrote.

The Hamilton Medical Group states on its website that it is “a private medical practice, not a bulk billing clinic.”

Dr Ford said that despite this policy there was a “significant percentage of consultations that are bulk billed” as the option was at the discretion of doctors.

“Bulk billing is becoming far less common in the medical community because there has been no increase in any bulk billing rebates since November 2012,” he said.

“And that has been the stated intention of this Government that there is no increase in rebates from now into the distant future.

“The issue with that, for not just this practice but every other practice, is that costs clearly continue to increase.

“Our rent, the utility fees, the wages, insurance, materials, accreditation go up in the medical sector by an average of 10 per cent per year, and that’s been the case since November 2012.”

Dr Ford said the clinic wanted to “be a part of the community” and make arrangements for people in difficult circumstances.

“We do our best to look after those people that have issues, but at the same time we don’t want to abandon our approach to be a quality practice, which means getting the best doctors that we can to work here and delivering the best standard of care we can,” he said.

Dr Ford described the cost impact on poorer people of managing a chronic illness as a “national issue”.

“Is there a better way of trying to organise it? I’m sure there is but we don’t get to make the rules, we have to live by them,” he said.

“If the rebates had continued to keep pace with inflation since 2012 this may be a different story.

“This has been a political decision that I can only see as being an attempt to reduce the amount of bulk billing.”

The Spectator asked Wannon Federal MP Dan Tehan to comment on bulk billing issues in Hamilton but he referred the query to the Federal Health Minister’s office.

A statement from Ms Ley said the ‘temporary GP rebate pause’ shouldn’t provide an excuse for any unfair “sneaky price increases”.

Ms Ley’s statement said Health Department modelling suggests the rebate for GPs would only be $0.65 lower in 2015/16 and $2.10 lower in 2017/18 under the freeze.

“At the end of the day, doctors are in control of what they charge patients and I expect vulnerable and concessional patient to continue to be protected” Ms Ley said.

“I have also made it clear that I am open to reviewing the rebate indexation pause in the future as part our ongoing work with doctors and patients to reform Medicare.”