Why Tony Abbott wants to charge a fee for visiting bulk-billing doctors Healthcare budget stress: Prime Minister Tony Abbott. Why would the government consider an unpopular new fee on bulk-billed GP visits? Answer: because there are few budget challenges bigger than healthcare costs. Medicare is a huge item of federal government expenditure. A list of its 20 most expensive federal programs published in May underscores this. Medicare came in fourth on the list, just after the aged pension and family support. This year the federal government will spend more than $19 billion on Medicare services. But it's not just the price tag for Medicare that makes budget managers twitch. It's also the rate of growth. Commonwealth spending on health care in general, and Medicare in particular, is rising more quickly than almost every other policy priority. The budget in May forecast health spending by the federal government to balloon by more than $5 billion by 2016-17. And Medicare is one of the causes. Last financial year it cost $18 billion but by next financial year the Medicare bill will be nearly $21 billion. The ageing of the population is one reason health costs are likely to grow rapidly in future. But an even bigger factor is the rapid improvement in health technology and medicines. These medical advances are delivering popular new treatments but they are also very expensive. The combination of a growing band of elderly patients wanting more expensive treatments means permanent upward pressure on health costs. This is not just a problem for the federal government. Those factors are also putting state government health budgets under growing stress. For that reason, the states won't like it if the federal government does adopt some sort of Medicare co-payment to visit the doctor because that could encourage many more low-income earners to go to a (still free) state-run public hospital rather than the GP. Even so, for a government desperate to make budget savings, finding ways to offset the cost of health is an obvious strategy.