If doctors want Medicare funding, they should have to bulk-bill their patients

Résumé détaillé

The government needs to consider real changes, not just Band-Aids.

Restricting Medicare payments to doctors who bulk-bill would benefit many Australians who face problems with the cost of living.

According to the 2026 Consumers Health Forum of Australia about 50 per cent of consumers delayed or skipped some form of recommended medical care or appointments because of financial reasons. A survey by Private Healthcare Australia found over the past three years almost 30 per cent of Australians have delayed or cancelled specialist care (such as psychiatry or surgery) due to out-of-pocket costs and other reasons.

There has been a 33 per cent increase in real out-of-pocket health expenditures over the past 10 years. Medicare now covers only 55 per cent of specialist fees, down from 72 per cent in 2004. The Department of Health and Ageing reports the average out-of-pocket cost of an initial specialist consultation is up 67 per cent from 2016 to 2025, double the inflation rate.

The GP bulk-billing rate in Australia has risen to 84.1 per cent for the June 2026 quarter. The highest rate is in the Northern Territory: 90.8 per cent. The lowest rate is in the ACT: 59.3 per cent. More than 3800 general practices across Australia are fully bulk-billing, representing about half of all clinics.

What can be done to relieve the financial pressure particularly on low-income earners who must put off necessary doctors' appointments?

Because the government pays a very significant percentage of doctors' remuneration there is a duty to ensure that the taxpayer-funded subsidy is used most effectively and efficiently by paying Medicare only when doctors bulk-bill.

Historically governments have hesitated to make fees conditional in this way because of the constitution's prohibition on "civil conscription". However, treating access to the rebate as a privilege, not a right, might not be considered civil conscription. See High Court decision of 2009.

In this case the Commonwealth was represented by S.J. Gageler SC, solicitor-general of the Commonwealth.

It is time…

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