Australia's bulk-billing rates continue to slide to dangerously low levels at the same time as out-of-pocket expenses steadily rise, a landmark report warns.
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The Blue Report by healthcare data company Cleanbill is the first in Australian history to provide a nationwide insight into GP billing arrangements across multiple years.
The report measures bulk-billing by the percentage of clinics that bulk-bill an adult patient.
The bulk-billing rate for adult patients nationally at the start of 2025 was a mere 20.7 per cent. This is compared to 35.1 per cent in 2023.
Significantly, in Tasmania, there are no longer any clinics available to bulk-bill adults.
NSW has the highest bulk-billing rate at 34.5 per cent followed by Victoria at 19.1 per cent.
Over half of the remaining bulk-billing GP clinics are concentrated in NSW, with NSW, Victoria and Queensland being the only places in Australia with bulk-billing rates topping 10 per cent.
This is despite a 14.5 per cent drop in the NSW bulk-billing rate in just the last two years.
Out-of-pocket expenses rise
Tasmania had the highest out-of-pocket GP expenses with adults spending $54 on average for a doctor's visit, $7 more than two years ago.
This is followed by the ACT at $52 and then NSW at $44.
South Australia and Victoria had the lowest out-of-pocket expenses at $42.
Healthcare accessibility
The impact of declining bulk-billing rates has been profound.
According to the Australian Bureau of Statistics the number of Australians avoiding seeing a GP because of cost concerns had grown from around 600,000 in 2022 to over 1.5 million in 2024.
Cleanbill founder and CEO James Gillespie described the results to ACM as "concerning" but "unsurprising".
"The trend has been this way over the last few years," he said.
Mr Gillespie said the results bode particularly badly for regional Australia.
"What we've seen in the past is that bulk-billing rates were highest in the cities and lowest in the regions," he said.
"It is our hope that this kind of geographic data can inform decision-makers in Canberra and at a state level to ensure that policy is targeting towards ensuring accessibility of care in the regions."
Carla Mascarenhas
Carla Mascarenhas is a journalist with Explore Travel and The Senior. She specialises in deep issues affecting Gen X and beyond, and the latest in travel news. Contact her on carla.mascarenhas@austcommunitymedia.com.au
