Why doesn’t the practice bulk bill everything? When the government first introduced Medicare in 1985 the rebate was 85% of the Australian Medical Association (AMA) recommended fee. However successive governments have failed to increase the Medicare rebate in line with inflation, and now the rebate amount is less than half of what the AMA recommended appointment fee is (which has increased yearly in line with inflation). So, when patients are bulk billed, the Medical Centre receives only $42.85, instead of our standard fee of $85.00 (in line with the recommended AMA schedule). The graph below reflects the rising ‘cost of healthcare’ compared to ‘Medicare rebate’ since 1985. The fees generated from patient appointments have to cover all the expenses of running a medical centre, including wages of reception, administration and cleaning staff, building lease, electricity, phones, computer and software fees, insurance etc, all of which have been increasing with inflation. As the gap between rebate increases and cost increase widens, it has become more difficult to maintain a viable business by bulk billing all patients.