Medicare Australia State of Play 2016-2018

The Australian Minister for Health and Liberal MP for Flinders Greg Hunt tweeted this on 16 August 2018:

Here are the facts on Medicare:
✅Today’s Medicare data shows a record bulk-billing rate of 86.1%
✅This is 4% higher than anything Labor could achieve
✅Almost 9 out of 10 trips to the GP are free
✅Funding for Medicare this year alone is $5.5 billion higher than Labor put in

— Greg Hunt (@GregHuntMP) August 16, 2018

So what is all this self-congratulatory chest-beating about?

According to the Department of Human Services in 2016–17 a total of 24.9 million people were enrolled in Medicare.

In 2017-18 Medicare recorded a total 419,852,601 Schedule Items on which Medicare benefits were paid.

This figure represents on average 1,672,091 items per 100,000 people.

According to Heath Minister Hunt the Medicare bulk billing rate in 2017-18 stood at 86.1 per cent of the total number of Medicare benefits claimed, leaving 13.9 per cent of Medicare benefits to be claimed by the patient.

Based on 2016-17 figures this would indicate in excess of 13.3 million of these Medicare benefits were claimed online by the patient.

Medicare also recorded 3,318,396 payments of Schedule Item 3 General Practitioner Attendances To Which No Other Item Applies, which is a medical service for which there is a 100% Medicare benefit.

That’s an average 13,216 items per 100,000 males and females between 0-4 years and 85 years or over.

However, none of these statistics reveal the number of GP or specialist doctor medical practices which charge patients an upfront amount above the scheduled Medicare benefit amount.

According to the Royal Australian College of General Practitioners (RACGP) the real percentage of patients who had all their GP visits bulk billed during 2016–17 was an est. 66 per cent.

Which meant that an estimated 34 per cent of GP patients in that financial year paid an upfront cost that might not have been able to be fully claim from Medicare.

The Australian Medical Association (NSW) in a 2018 statement suggests that these patients are likely to be paying an average of $48.69 in out-of-pocket fees.

The Australian Institute of Health and Welfare states in its Health Services Series Number 80  that in 2016-17 there were 7.8 million attendances at public hospital emergency departments and “at the conclusion of clinical care in the emergency department, 61% of presentations reported an episode end status of Departed without being admitted or referred”, which indicates that this percentage may contain an unspecified number of individuals who attended a public hospital emergency department because a bulk billing GP was not practicing in their local area and they were not able to readily afford an upfront fee or additional out-of-pocket expenses.

ABC News reported* on 17 August 2018 that:

> 1.3 million people delay seeing a doctor because of the cost;
> 1 in 2 Australian patients faced out-of-pocket costs for non-hospital Medicare services, with the median cost sitting at $142 per person;
> almost 35 per cent of out-of-pocket expenses were spent on specialist services, while almost 25 per cent went to GP gap payments; and
> a further 12 per cent was spent on diagnostic imaging services, like radiology.

Greg Hunt's tweet has definitely avoided facing the Medicare elephant in the room. 

* Based on MyHealthyCommunities: Patients' out-of-pocket spending on Medicare services 2016–17 released August 2018.