To the Editor: Equitable access to health care in Australia is facilitated by bulk-billing so that patients incur no out-of-pocket costs for medical services. From 1995 to 2001, there was a steady decline in bulk-billing of general practice consultations and rates of bulk-billing were lower for women living in rural areas than for those from urban areas.1 In 2004, Medicare incentives for bulk-billing were introduced — additional rebates for bulk-billed services provided to concession card holders or children under 16 years, and a higher rebate for services provided to eligible patients in rural and remote areas, selected metropolitan areas with a shortage of general practitioners or low bulk-billing rates, or anywhere in Tasmania.2,3 We assessed the bulk-billing rates for participants in the Australian Longitudinal Study on Women’s Health4,5 following the introduction of these items.
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This study was conducted as part of the Australian Longitudinal Study on Women’s Health. We are grateful to the Australian Government Department of Health and Ageing for funding, to the women included for providing the survey data, and to Medicare Australia for providing the data on general practice consultations.