Australia may have long taken pride in its low-cost health care, but the number of people unable to afford GP visits is soaring.

In the past four years, NSW experienced a 246 per cent rise in patients who delayed or didn’t see a doctor due to cost, according to research by social services body NCOSS and conducted by the University of Canberra.

Even those better off have felt an impact.

The report found the proportion of people on middle and high incomes delaying GP visits due to cost increased at about the same rate or slightly higher than the overall population.

‘Health system is broken’

“This report illustrates that the health system is broken,” NCOSS chief executive Cara Varian said.

“When people can’t afford the most fundamental medical care it leads to bad health outcomes and puts pressure on hospitals.

“The NSW and Commonwealth governments must take urgent action to address these matters.”

The increasing unaffordability of GP visits has not been restricted to a single state as people across the country have felt the pinch over recent years.

Some Australians are paying more than others for GP appointments. Note: Data from 2021. Source: Saxby, K., Yang, O., & Zhang, Y., (2024) HALE Hub Data: Australian Healthcare Atlas, Melbourne Institute: Applied Economic and Social Research, The University of Melbourne

Funding issues

Since January 2023, Medicare funded about 85 per cent of GP provider fees on average monthly.

This was a drop from a high of 95 per cent in April 2020, and is lower than the past two decades’ average of about 90 per cent.

Susan Méndez, senior research fellow of Melbourne Institute: Applied Economic & Social Research, told TND one of the biggest drivers behind the higher cost of seeing a GP was the Medicare rebate freeze introduced by the government in 2013 as part of a  budget savings plan.

Although the freeze began being lifted in phases in 2017, the Australian Medical Association found it had cost the primary care sector $3.8 billion.

The freeze meant GPs and other medical specialists were reimbursed by the government the same amount for delivering health services in 2020 as they were in 2014, no matter if they faced rising costs such as wages or utilities.

Medical practitioners had to either cover the difference themselves or pass it on to patients, which could have contributed to the current decline in bulk-billed options and a rise in costly gap fees.

Méndez said some doctors have also become more selective with who they bulk bill, offering the option more to those they consider more in need, such as children, pensioners and concession card holders.

Higher costs force dangerous choices

Newcastle-based Emma, 48, has Crohn’s disease and multiple co-morbidities.

She told NCOSS and University of Canberra researchers timely and free health care seemed “almost a surreal relic of the past”.

“In December 2022, my GP informed me she could no longer afford to bulk bill me the same week my counsellor was forced to raise my fees,” she said.

“Until that month both these wonderful professionals were effectively personally subsidising my care out of kindness.

“Now in September 2024, I’m overwhelmed by the constant diminishment of services coupled with new or increasing charges at every juncture.

“Some days I feel like I’m suffocating, burdened heavily with each new cost.

“I need major dental and periodontal work, but I can’t afford to see a dentist.

“I need to resume my regular counselling sessions, but I can’t afford to. I need a skin cancer check … The choices are getting harder and more dangerous.”

More action needed

The government has committed $3.5 billion to triple the payments paid to GPs for bulk billing patients, but critics say some state tax laws meant doctors and patients would not reap the benefits.

Méndez said affordable GPs were an essential tool to manage or defend against the long-term, costly illnesses.

“More access and more investment in primary care, that’s a key issue,” she said.

“Primary care is more preventative … prevention and early treatment … has a lot of potential to reduce high cost down the track.”

Source: TND/NCOSS

She said apart from affordability, accessibility of doctors also needed improvement as regional and rural regions struggled to attract – and keep – GPs.

There is also the issue of the vast majority of young doctors choosing to specialise.

A survey conducted in 2022 revealed the number of final-year medical students who chose general practice as their top career choice fell to 13.1 per cent, the lowest level since 2011.