Fast Forward - 17 July 2012

MO looks back 10 years, casting a fresh eye over what made news in 2002. Then we hit the fast forward button to see what’s changed.

GPs demanding better remuneration have been reminded to look to the past if they want to change the future, as next year’s federal election offers a chance for the profession to take a stand.

AMA Council of General Practice chair Dr Brian Morton said plummeting bulk billing rates 10 years ago, in the wake of the medical indemnity crisis, prompted the Coalition government to increase rebates from 85% to 100% of the Medicare Schedule fee.

MO reported at the time that GPs were “being advised to abandon bulk billing and begin a program of annual fee increases” as they struggled to absorb rising indemnity costs.

Then AMA Victoria president Dr Mukesh Haikerwal said GPs were being forced to pass the cost of medical indemnity on to patients following the “spate of premium hikes that had hit doctors harder than expected”.

Dr Morton told MO that GPs had heeded that advice at the time and the bulk billing rate, which fell as low as 67%, had as a result become an electoral liability for the government.

“The government raised the rebate and introduced bulk billing incentives in response,” he said.

“Those measures helped for a short time, and the bulk billing rate has risen since, but [the rebates] have not been indexed properly and many GPs are again under financial pressure.”

Dr Morton said the current bulk billing rate, which topped 81% of GP services in the March quarter this year, was propped up by GP management plan items and diagnostic tests.

“The government uses that figure as evidence GPs are happy with the ‘floor price’ offered by the MBS fee,” he said.

“The only way the government will listen to the message that GPs are struggling to make ends meet with the current MBS fees is if the bulk billing rate falls.

“We need to retrain the public as to what a general practice consultation is really worth.”

The sentiment would have been familiar to Dr Haikerwal in 2002, when he told MO: “I think everyone assesses their bottom line at the end of each financial year, and I have no doubt accountants will give doctors very strong advice about which way to go with fees.”