Radio interview with Minister Butler, 5AA – 5 November 2025

GRAEME GOODINGS, HOST: Well, new bulk billing incentives started this month, meaning more patients will be able to avoid out-of-pocket costs. Joining us now is Federal Health Minister Mark Butler. Minister, good morning to you.
 
MARK BUTLER, MINISTER FOR HEALTH AND AGEING, MINISTER FOR DISABILITY AND THE NDIS: Morning, Graeme.
 
GOODINGS: Now, before we start talking about bulk billing, I'd appreciate it if you listened to a call that we had on the show yesterday.
 
[Excerpt]
 
GOODINGS: Alex, good morning.
 
ALEX, CALLER: I have to have an eye injection every month, and the last time I went there, it was a month ago now, they said to me after I came out and had the injection, I went to pay them the gap, $117. And he said, no, we don't take that anymore, you've got to pay the whole lot. I said, what do you mean? He said, well, you've got to pay us $400. I said, well, hang on. You didn't send me any notification prior to me coming in to get my injection. And then it comes to, oh, well, we've been having a lot of trouble with Medicare, and we've been chasing them and it's taken us a long time. We've got to get people to come and pay the money for us and all that sort of stuff. I said, oh, well, that's really not my problem. But my problem is now, I've got to find another $300 now to pay.
 
[End of excerpt]
 
GOODINGS: Minister, can you respond to Alex's call?
 
BUTLER: I don't know the precise circumstances of that, but that's a pretty awful circumstance for Alex. I want to look into that, I might get some details from your producers later, Graeme, and look into that because I'm getting too many stories of this bill shock that people are getting without being told what they're going to be up for. I'm not sure what trouble this practice says that they're having with Medicare. We've got pretty good systems about payment, pay out billions and billions and billions of dollars every year to these providers that are pretty profitable businesses. It's a pretty awful story that Alex went through. I might get some details from you and follow it up later.
 
GOODINGS: Yeah, thanks for that, Minister. Alright, we'll move on. About bulk billing generally, new incentives. It's a situation that seems pretty grim. Only 20 per cent of clinics currently bulk bill, average gaps of $50. How did it come to this?
 
BUTLER: When you say 20 per cent of clinics only bulk bill, that's effectively clinics that bulk bill every single person that comes through their door. You've got to break it down a little bit, Graeme. The first challenge we had when we came to government a few years ago was that bulk billing overall was in freefall. That's what the GP’s College told us because the Medicare rebate had been frozen lot of years. Our first focus was turning bulk billing around for pensioners and concession card holders. In 2023, we tripled the incentive payment that Medicare pays to GPs for bulk billing pensioners, and that turned bulk billing around for that group of Australians and that's now over 90 per cent. It's currently about 92 per cent. But for people who don't have a concession card, that bulk billing rate was continuing to slide. Concession cards cut out pretty low, about $40,000 for a single a year, $70,000 for a couple. We're not talking wealthy households. Increasingly, they’re all being charged big gap fees and deciding not to go to a doctor because of cost, even when they needed to because of their health.
 
On the Saturday just gone, 1 November, for the first time ever, we extended bulk billing support to every Australian. GPs will receive that incentive payment for bulk billing every single person, not just a pensioner or a concession card holder, and that's a very big increase to their income. On top of that, if they bulk bill 100 per cent of their patients, we'll give them a 12.5 per cent loading on top of their Medicare income. Already, many, many practices are shifting to become 100 per cent bulk billing practices. In South Australia, in one week, the number of practices that are fully bulk billing has tripled. Up by 200 per cent in just one week, and that number is increasing every day.
 
GOODINGS: Is there any guarantee that they'll all become bulk billers?
 
BUTLER: I don't expect all practices to become bulk billers. Our modelling said that three-quarters of practices would be better off under the investment, the record investment that kicked in on Saturday if they bulk bill 100 per cent of their patients. For some other practices though, they'll probably continue to bulk bill their pensioners and children under the age of 16, and they'll bulk bill some people without a concession card. But I've been pretty clear, I think there probably will be some practices that will continue to charge gap fees to some of their patients. But three-quarters of practices will be better off if they bulk bill everyone. That's the scale of the investment that we announced earlier this year and flowed from 1 November. And that's why you're seeing a big shift. Already in one week, well over a thousand general practice clinics have said last week they were charging a gap, this week they will bulk bill all of their patients all of the time.
 
GOODINGS: We've heard that some local GPs who charge gap fees say even with the incentives, they'd be losing money.
 
BUTLER: That's not our modelling. I have access to every single dollar that GP clinics bill, whether it's them billing Medicare or whether it's charging a gap fee. We were able to crunch the numbers and work out a level of investment that meant the vast bulk of GP clinics would be better off as a practice and as individual doctors if they shifted to full bulk billing. I'll give you a sense of that, Graeme. In the major cities, if you were a full-time, fully bulk billing GP two years ago, you would have been earning about $280,000 a year after you paid your practice costs. This week, that same doctor doing the same work would be earning $415,000 a year. Our additional investment has lifted that income on average by about $135,000 a year in just two years. And it shows you the degree to which GPs and general practices are going to be better off if they take up this investment. Obviously, patients will be much better off and that's the most important thing from the government's point of view.
 
GOODINGS: Will increasing billing have an impact on the public hospital gridlock?
 
BUTLER: I don't think there's any question that it will. What we are finding is that a record number of people in the community on middle incomes are saying they're not going to the doctor when they feel they need to because of cost. We want a Medicare system where people feel they can go to the doctors when they need to rather than when they feel that they can afford to. That's why so much of our energy and investment has been focused on lifting bulk billing rates, free visits to the GP, and reducing the price of medicines. Because we were also finding that too many Australians were saying they were not filling a script that their doctor had said was important for their health because of cost. That's why we've done so much to cut the price of medicines. More free visits to the doctor, cheaper medicines, meaning that people are looking after their health earlier rather than later. Because if they don't look after their health at the earliest possible opportunity, they're far more likely to get sicker and end up in hospital.
 
GOODINGS: I don't doubt that most people appreciate bulk billing, the fact that they won't have to put their hand in their pocket for any money, but the taxpayer ultimately pays. What is this costing Australians generally?
 
BUTLER: We were very, very upfront with people about this. The total investment that we announced in February was about $8.9 billion. In addition to the bulk billing changes, we're investing in much more GP training. This year, we're training a record number of junior doctors as GPs. Next year, we'll break that record again. We need a lot more GPs in the system.
 
Many of your listeners would know GPs that they've been going to for years and years are starting to retire or certainly thinking of retiring in the next five to 10 years. And for the last decade or so, we just haven't been training enough GPs to replace them, we've had to bring in a lot from overseas. Some of that money was about training more doctors. Some of that money was about expanding the number of Urgent Care Clinics. Over the next little while, we'll be opening more Urgent Care Clinics in South Australia. But the vast bulk of the money was to invest in bulk billing.
 
What the AMA, the Australian Medical Association, pointed out was really the $8.9 billion that we are investing in Medicare effectively puts back in the money that was ripped out of Medicare when the rebate was frozen last decade.
 
GOODINGS: Now, Minister, I know you're under time constraints, so we'll let you go. Thanks so much for your time today.
 
BUTLER: Thanks Graeme.