Bulk billing doctors and GPs in SA, rising fees and costs
South Australians are being left up to $74 out of pocket to visit their GP, contradicting claims by Anthony Albanese that people would only need a Medicare card – not a credit card – to visit the doctor.
It comes as the Australian Medical Association SA says the state should follow Queensland's lead and abolish payroll tax on GPs.
A check of many Adelaide GP clinics by The Advertiser revealed a Medicare card can only get you so far, with nearly all metropolitan clinics only offering limited bulk-billing services to select groups of the community, such as veterans or children.
Most are charging patients an out-of-pocket expense of $49 for a standard consultation, with prices broadly tied to suburbs.
North Haven and Port Adelaide offered one of the cheapest gap fees at $35, while Glenelg had one of the highest at $68.
Unley and its surrounding suburbs also had high gap fees, ranging from $61 and $74.
Some centres had low gap fees such as $30 but then charged patients 'admin fees' between $5 and $10, while others had card payment surcharges on top of the fees.
AMA SA president Peter Subramaniam said SA's payroll tax on GPs means patients here are paying more than those interstate.
'The payroll tax on GPs was abolished with bipartisan support in Queensland last year, because both major parties recognised it was costing patients more and costing the system more,' Associate Professor Subramaniam said.
'This isn't just a tax on doctors – it's a tax on access to healthcare. When patients can't afford to see their GP, they get sicker,' he said.
'That puts pressure on overcrowded emergency departments, adding to the stress and costs on the system.'
According to the AMA, the cost of seeing a GP in South Australia has increased by roughly $10 per visit as a direct result of the payroll tax – a cost Queenslanders are now not paying.
Prof Subramaniam's comments come as new figures show Australians paid more than $151m in June to visit their GP, highlighting the mountain the Prime Minister has to climb to fulfil his pledge.
Following a week in which Mr Albanese stood in parliament and repeated his election campaign shtick of waving around his Medicare card, new data from the Australian Institute of Health and Welfare showed Australians have also paid more than $2.2bn out-of-pocket to see a doctor in the past year.
Labor's election pledge to ramp up bulk-billing with an $8.5bn investment, which it says will enable an extra 18 million bulk-billed visits a year, is yet to start, with figures showing Australians continue to take a hit to the hip pocket.
'Anthony Albanese promised Australians that 'All you need is your Medicare card, not a credit card' and that it would be 'free to see a GP',' Opposition health spokeswoman Anne Ruston said.
'While he was waving around his Medicare card and misleading the public, Australians were forking out billions of dollars in out-of-pocket costs – presumably charged to their credit cards.'
Health Minister Mark Butler said increased bulk-billing would begin in November.
'We know too many Australians are paying too much out of pocket when they go to the doctor because of the Liberals' cuts to Medicare,' he said.
'On November 1, we will expand bulk-billing incentives to all Australians and create an incentive payment for practices that bulk-bill every patient.'
Mr Butler said the move would result in nine out of 10 GP visits being bulk-billed by 2030.
Originally published as Rising GP fees leave SA patients out of pocket despite Anthony Albanese's Medicare claims Read related topics: Anthony Albanese
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NSW Health's former top doctor, Kerry Chant, said wood fire heaters were so detrimental to health that she would consider banning them. "Long-term exposure to particulate pollution, especially finer particles (PM2.5), can cause heart and lung disease while brief exposures can aggravate asthma and worsen pre-existing heart and lung conditions," she said. Children, the elderly, and people with existing health issues were most at risk. NSW Health advises that "instead of using a wood-burning heater in your home, consider using heating alternatives that cause less pollution, such as reverse cycle air-conditioning, flued gas or electric heaters". New modelling from the Centre for Safe Air at the University of Tasmania shows the toll of wood fire heater pollution. The modelling estimated long-term exposure to smoke from wood heaters contributed to 729 premature deaths every year in Australia. In regional and rural locations, where it is colder and more people use wood heaters, emissions are highest. Regional locations take out the top five worst areas for wood fire heater pollution. Find out the emissions for your area: Launceston and Hobart in Tasmania, the Adelaide Hills in South Australia, Armidale in the Central West in New South Wales, and Bunbury in Western Australia top the list for wood-heater pollution. Centre for Safe Air director, professor Fay Johnston, told ACM the modelling found the areas with the most wood heater pollution tend to be "cooler places where wood burning is common and where towns and cities are located in valleys and basins that trap air pollution during winter". The most premature deaths associated with wood heaters, however, tend to be in areas with the highest population densities. "Sydney's basin-shaped topography and high urban density result in over 300 earlier-than-expected deaths every year, more than any other Australian city," Professor Johnston said. Professor Johnston said that many people are surprised by the impact of wood heaters. "When it comes to air pollution, many people think of exhaust pipe emissions from cars and trucks, smoke from coal-fired power stations or hazard reduction burns," she said. "It is often a surprise to learn that the health impacts of wood heaters are much greater than any of these sources of pollution in most Australian towns and cities." Melbourne community advocate for clean air, Arabella Daniel, said wood pollution was behind a raft of neighbourhood disputes. "People exposed to wood smoke often don't get empathy from a neighbour who is burning," she said. "Those who complain can often experience sociopathic revenge behaviour and retaliation." Managing wood smoke pollution is the responsibility of local councils, which were either reluctant to deal with the problem or not resourced to police chimney smoke, she said. "We are stuck without a remedy. We need state and federal laws to protect health." In 2023, the ACT Government announced that it would phase out wood heaters in the territory by 2045. Ms Daniel said it was a welcome step, but the timeline "was absolutely not good enough". "We consider this a public health emergency," she said. "There is very little political will. We need a hero to step up." She wants no new installations of wood heaters and a subsidised phase-out replacement program converting to split systems. Canberra University's Environmental Public Health Professor Sotiris Vardoulakis told ACM that "decisive and rapid policy action" was needed on wood heater pollution in Australian cities and towns. "This is a major public health issue in many ways similar to smoking in public places, which needs to be urgently addressed," he said. Prof Vardoulakis said new installation of wood heaters need to be banned in new and existing properties in urban areas and suburbs. Mandating the removal of wood heaters before a property can be sold would also reduce the number of older wood heaters, he said. Targeted financial incentives also need to be considered, particularly for low-income households. Queanbeyan-Palerang Regional Council is currently reviewing a draft policy that would restrict the installation of wood heaters in some urban areas. For some, any action comes too late. Tasmanian resident Jane (surname withheld) still lives with the trauma from wood fire heaters. She was living in a rural town in north-west Tasmania when friendly relationships with neighbours turned sour after she approached them about their wood heater. "The situation caused a lot of trauma and despair," she said. "I lost work days because I was so sick." She said the smoke intensity coming into her weatherboard house became "alarming". The council would only act if she provided evidence of 10 minutes of footage of the burning. She went to the EPA in Tasmania, which calculated that the emissions from the heater were at dangerous levels, but the council still would not intervene. "Why does it appear that people with wood heaters have all the rights?" she said. "I understand they are cosy, but they are a significant health compromise. How can the government say on one hand smoking kills, but allow heaters to burn 24 hours a day?" Do you know more? Email the journalist: Lisa Cunial cannot go for a walk in the beautiful wetland behind her house. A few minutes in the garden and she can't breathe. "Gardening is one of my passions," she tells ACM. "It is such a shame." Ms Cunial has lived in Orange in the NSW Central West for more than 25 years. "I used to live out of town as a kid and wonder why all my friends in town were always sick and had asthma," she said. Every year, winter brings the haze of wood fire smoke and she is "always on the cusp of a reaction". "Your sensitivity to the smoke gets worse". Agricultural burn-offs in the surrounding areas exacerbate the problem. After the bushfire season in 2019, she was diagnosed with Reactive Airways Dysfunction Syndrome (RADS), a type of asthma-like condition that develops after high-level exposure to an irritating substance such as corrosive material, gas, vapour or fumes. "I couldn't breathe," she said. "If I come across wood smoke, it impacts me immediately. I cannot get better." Ms Cunial's story is not unique. ACM has spoken to dozens of people from regional Australia dealing with wood heater pollution. Around 10 per cent of Australians use wood heaters as their main source of heating. For some, they have become a "lifestyle" accessory. But the health effects are dire. 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The modelling estimated long-term exposure to smoke from wood heaters contributed to 729 premature deaths every year in Australia. In regional and rural locations, where it is colder and more people use wood heaters, emissions are highest. Regional locations take out the top five worst areas for wood fire heater pollution. Find out the emissions for your area: Launceston and Hobart in Tasmania, the Adelaide Hills in South Australia, Armidale in the Central West in New South Wales, and Bunbury in Western Australia top the list for wood-heater pollution. Centre for Safe Air director, professor Fay Johnston, told ACM the modelling found the areas with the most wood heater pollution tend to be "cooler places where wood burning is common and where towns and cities are located in valleys and basins that trap air pollution during winter". The most premature deaths associated with wood heaters, however, tend to be in areas with the highest population densities. "Sydney's basin-shaped topography and high urban density result in over 300 earlier-than-expected deaths every year, more than any other Australian city," Professor Johnston said. Professor Johnston said that many people are surprised by the impact of wood heaters. "When it comes to air pollution, many people think of exhaust pipe emissions from cars and trucks, smoke from coal-fired power stations or hazard reduction burns," she said. "It is often a surprise to learn that the health impacts of wood heaters are much greater than any of these sources of pollution in most Australian towns and cities." Melbourne community advocate for clean air, Arabella Daniel, said wood pollution was behind a raft of neighbourhood disputes. "People exposed to wood smoke often don't get empathy from a neighbour who is burning," she said. "Those who complain can often experience sociopathic revenge behaviour and retaliation." Managing wood smoke pollution is the responsibility of local councils, which were either reluctant to deal with the problem or not resourced to police chimney smoke, she said. "We are stuck without a remedy. We need state and federal laws to protect health." In 2023, the ACT Government announced that it would phase out wood heaters in the territory by 2045. Ms Daniel said it was a welcome step, but the timeline "was absolutely not good enough". "We consider this a public health emergency," she said. "There is very little political will. We need a hero to step up." She wants no new installations of wood heaters and a subsidised phase-out replacement program converting to split systems. Canberra University's Environmental Public Health Professor Sotiris Vardoulakis told ACM that "decisive and rapid policy action" was needed on wood heater pollution in Australian cities and towns. "This is a major public health issue in many ways similar to smoking in public places, which needs to be urgently addressed," he said. Prof Vardoulakis said new installation of wood heaters need to be banned in new and existing properties in urban areas and suburbs. Mandating the removal of wood heaters before a property can be sold would also reduce the number of older wood heaters, he said. Targeted financial incentives also need to be considered, particularly for low-income households. Queanbeyan-Palerang Regional Council is currently reviewing a draft policy that would restrict the installation of wood heaters in some urban areas. For some, any action comes too late. Tasmanian resident Jane (surname withheld) still lives with the trauma from wood fire heaters. She was living in a rural town in north-west Tasmania when friendly relationships with neighbours turned sour after she approached them about their wood heater. "The situation caused a lot of trauma and despair," she said. "I lost work days because I was so sick." She said the smoke intensity coming into her weatherboard house became "alarming". The council would only act if she provided evidence of 10 minutes of footage of the burning. She went to the EPA in Tasmania, which calculated that the emissions from the heater were at dangerous levels, but the council still would not intervene. "Why does it appear that people with wood heaters have all the rights?" she said. "I understand they are cosy, but they are a significant health compromise. How can the government say on one hand smoking kills, but allow heaters to burn 24 hours a day?" Do you know more? Email the journalist:
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