Some young Australians are putting off sexual health testing as the essential service becomes more unaffordable now general practices are phasing out bulk billing.
Up to 40 per cent of general practitioners (GPs) in Australia have already switched to mixed or private billing as they struggle to keep clinics open without adequate government funding under a bulk billing model.
A long consultation, which lasts 40 minutes, is advised for a sexual health screening and will set a patient back roughly $160 upfront, with an approximate $76 Medicare rebate.
Meanwhile a normal consult costs around $85 with a Medicare rebate of $39.
Royal Australian College of General Practitioners President Dr Karen Price said the phasing out of bulk billing at many GPs across Australia will “undoubtedly” impact the number of young people accessing sexual health care.
“Often younger people are uni students or are just starting work and have limited means. So clearly a move away from bulk billing is going to challenge that,” she said.
9News.com.au has surveyed a group of young people about whether rising costs could impact their decision to get tested for World Sexual Health Day.
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For Sydneysider Monique, without bulk billing she won’t be able to shoulder the financial cost of regular sexual health tests.
“We are meant to get sexual health tests every time we are with a new sexual partner,” she told 9news.com.au.
“With the removal of bulk billing, this would significantly impact how frequently I was able to get tested due to the financial burden.”
Ellie, also from Sydney, said going to the GP is way too expensive for her so she only goes if it is “completely necessary” meaning sexual health tests aren’t as regular.
The alternative is sexual health clinics which mostly remain free.
Although, Price said to call and check your local service as it depends on capacity as to whether the consultation will be subsidised.
But for Sydneysider Katie going to the GP to get a sexual health test done is the easiest option and now with more privatised billing, it will only be harder.
“For me, I would definitely put off regular checks due to added difficulty,” she said.
“My two most local women’s health centres are only business hours and I work full time.”
Melbournian Sarah said her local women’s health clinics cost more than a GP meaning she is stuck between two expensive options.
“None of the women’s health clinics near me are cheaper than a GP. The majority of doctors specialising in women’s health are entirely privately billed costing way more than a GP would,” she said.
Meanwhile, other young people are happy to shoulder the cost if it means they can get tested.
“I’d still get it,” Trent, from Sydney, said.
“I’m in a place where I can afford these sorts of things but sure maybe some people will avoid going to the GP if they have to pay but this won’t just be limited to sexual health,” Skye, from Adelaide, said.
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With the existing stigma around sexual health testing, Price said the change to private billing is only going to enhance the barrier for young people and their sexual health.
Price’s major concern is people under 18, also known as “mature minors”, are often afraid to ask for a sexual health tests and often this will be a move led by a GPs line of questioning.
“I don’t want to see them disadvantaged because the government hasn’t lifted the Medicare rebate enough to cover the cost of delivering a high-quality service,” she said.
“I know it takes 45 minutes to see a new adolescent, people say it’s just a prescription, but that’s when you do a sexual health history and make sure all of their life is functioning and it’s amazing what you can miss if you don’t ask.”
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Price recommended for young people to find a GP they trust as some doctors will help subsidise the cost of health services, including sexual health if they know the patient.
“What I say to young people it is really important they have a regular GP they know and trust so if they need to bring up sexual health, their doctor already knows them,” she said.
“Many doctors would make allowances for young people to pay if they’re a regular patient.
“I would suggest finding a GP they can talk to and navigate, ‘look this is what I can afford and what I can’t afford’ and check in with that GP about how they can manage their healthcare.”
What do sexual health tests check for?
Sexual health tests can check for a range of different sexually transmitted infections.
A routine check usually involves a blood test for HIV, Hepatitis B and Syphilis while a urine test will check for Chlamydia and Gonorrhoea.
But Price going to a GP for a sexual health check is more than just checking for sexually transmitted infections, the consult can also look at a young person’s relationships and mental health.
“Someone may get a new diagnosis of an STI so they need a lot of time to manage that, there may be coercive elements in their relationship, there are all types challenging situations that a GP can help this young person through,” she said.
