Health Cost Crisis, Australians Choose To Postpone Check With Doctors

JAKARTA - The latest trend shows Australians are increasingly reluctant to visit doctors amid soaring living expenses. Medicare data, such as BPJS in Australia, which was released online without much attention, shows that the 'bulk-billing' rate remains stagnant even though the government has poured billions of dollars to support this scheme.

The 'bulk-billing' system allows the doctor's consultation fee to be directly borne by government subsidies. If the visit fee does not exceed the subsidy limit, the patient does not have to pay. However, if the cost exceeds that limit, the patient still has to bear the difference.

Data for the July 'September this year shows the 'bulk-billing' rate is at 77.6 percent, exactly the same as the previous year. On the other hand, the number of general practitioner services decreased by around 10 thousand consultations per day compared to the same period last year. The average cost to be paid by patients jumped from around 4 Australian dollars (Rp44 thousand) to 50.49 Australian dollars (Rp560 thousand).

Liberal Party Health Minister Anne Ruston stressed that this had a direct impact on the hospital system.

"Although there is a huge investment here, we see only a slight change in tariffs, which means we know residents avoid doctor consultations because they can't afford it," Senator Ruston said.

"Based on today's data, 10,000 consultations are reduced every day. That means there are 10,000 services for people who have the potential to be seriously ill before they get health services, while we know our hospital emergency unit is under tremendous pressure," he added.

Meanwhile, Health Minister Mark Butler is optimistic that this figure will increase with the presence of new 'bulk-billing' incentives that take effect this month.

"There have been more than 1,000 clinics that use a mixed billing system that have indicated they will switch practices to 'bulk-billing' services completely," he added.

"This adds to 1,600 common practitioner practices that currently fully use the system and more than 2,600 practices are expected to fully use this system across the country," read Mark's statement.

"We know this investment will be successful, because it has been successful for patients. This incentive is already in effect for retirees, concession card holders, and families with children," he added.

Australia's federal government in 2023 allocated USD 3.5 billion or IDR 38.8 trillion to increase incentives for doctors to examine children and concession card holders without charging direct fees. Although this step slightly holds back the decline in the 'bulk-billing' rate, the stagnant trend is again visible.

Data for the last 12 months showed a slight increase of 1.7 percent since triple incentives were launched in November 2023, to 77.9 percent in September. However, this figure is still far from the peak of the COVID-19 era of 89.2 percent, even below the pre-pandemic level which reached 85.2 percent.

In a federal general election campaign, the government promised to raise the 'bulk-billing' level again to around 90 percent by 2030. Although the opposition is skeptical, incentives only took effect earlier this month.

Senator Mark emphasized his commitment to Australians to get access to affordable and timely general practitioners. But he remains worried that residents will continue to avoid consultation due to costs.

"The costs that must be spent by individuals themselves continue to increase, it is reported that these costs will only be more expensive in the future," he said.

"The prime minister and the government continue to lie to Australians about the cost of visiting their doctors. The prime minister knows it's not true when you go to a doctor, all you need is your Medicare card," he added.

Even so, RACGP notes that Australia's latest Bureau of Statistics data shows the number of patients delaying visits as costs drop from 8.8 percent to 7.7 percent.

Health Department officials warn the benefits of this scheme will likely only be felt in the next four years, as general practitioners need time to adjust their business model. The average cost that must be borne independently by patients who do not participate in the 'bulk-billing' scheme is also expected to increase.

The Australian Department of Health's annual report acknowledges the target of more than 90 percent of citizens accessing the Medicare Benefits Schedule service, including 'bulk-billing', has not been achieved.

"The reduction in mass billing rates and the increase in direct costs, coupled with the increase in cost of living, has created obstacles for some patients when trying to access the treatments they need," the report notes.

"Since November 2023, general practitioners' 'bulk-billing' collection rates have begun to stabilize and increase. Performance with the target is expected to improve in line with the increase in general practitioner mass collection rates." he continued.