Latest / The You Project / #2084 Are We Paying More Or Less For Health Care? - James Gillespie

Transcript

#2084 Are We Paying More Or Less For Health Care? - James Gillespie · The You Project

• 0:01
  Speaker 1: I'll good to him. It's the project that's you.
• 0:03
  Speaker 2: It's Craigan Harpert sadly, as I'm recording the tenth of
• 0:06
  Speaker 2: the first year of our Lord. As my mother says,
• 0:10
  Speaker 2: twenty twenty six, speaking of Mary, bloody hell, she's eighty
• 0:14
  Speaker 2: six years old and just a weapon. As we speak,
• 0:18
  Speaker 2: speaking of weapons, a man who is at the opposite
• 0:22
  Speaker 2: end of his lifespan because he's I don't know, he's
• 0:24
  Speaker 2: probably not twelve, but he looks twelve. His name is
• 0:29
  Speaker 2: James Gillespie, son of the Great gillespo who is you
• 0:32
  Speaker 2: all know is a regular on this show, A lover
• 0:36
  Speaker 2: of research and science and all things controversial, but not
• 0:42
  Speaker 2: a lover of psychology, as we know. Did you know
• 0:46
  Speaker 2: that your old man is constantly making fun of me
• 0:48
  Speaker 2: mate about my PhD in psychology?
• 0:51
  Speaker 1: Did you know that?
• 0:52
  Speaker 3: No, I did not know that he targeted you on
• 0:55
  Speaker 3: that one.
• 0:55
  Speaker 2: Oh yeah, not a fan at all, And like sadly,
• 1:00
  Speaker 2: some of what he says I agree with. It's a
• 1:04
  Speaker 2: it's a pretty it's a pretty dodgy science, to be honest,
• 1:08
  Speaker 2: But it's you know, when you're getting all these kind
• 1:11
  Speaker 2: of individual subjective assessments which are based on how someone
• 1:16
  Speaker 2: feels or thinks in the moment.
• 1:19
  Speaker 1: It's not really hard science, is it.
• 1:20
  Speaker 2: But anyway, speaking of research and science and making a difference. Now,
• 1:27
  Speaker 2: some of my listeners have never heard of you. Some
• 1:30
  Speaker 2: are familiar with you. But a few years ago you
• 1:34
  Speaker 2: decided that you would take a deep dive into having
• 1:37
  Speaker 2: a look at how the medical system works in Australia
• 1:40
  Speaker 2: and bulk billing and payment and what was available and
• 1:43
  Speaker 2: not was available, and who was advantaged and who was disadvantaged.
• 1:47
  Speaker 2: And I'm probably fucking this up a little bit. So
• 1:51
  Speaker 2: you created a thing called clean Bill and I think
• 1:55
  Speaker 2: that's right, and the Blue Report, so give just give
• 1:59
  Speaker 2: us a one minute synopsis of that before we dive
• 2:02
  Speaker 2: into what you've just what you're bringing out on Monday,
• 2:06
  Speaker 2: which will be close to when people hear this.
• 2:10
  Speaker 4: Absolutely so with clean Bill, I started it just from
• 2:14
  Speaker 4: the basic idea that people will You can increase medical
• 2:17
  Speaker 4: accessibility enormously by showing people all of the options around
• 2:21
  Speaker 4: them and letting them filter those options by price, because
• 2:24
  Speaker 4: of course price is an increasingly important part as fewer
• 2:27
  Speaker 4: and fewer doctor's bulk bill of figuring out whether or
• 2:30
  Speaker 4: not you can go and see a doctor who you
• 2:31
  Speaker 4: want us and go and see. And so I started
• 2:34
  Speaker 4: this initiative called clean bill, and it's a free website
• 2:37
  Speaker 4: called cleanbill dot com at clean build dot com dot
• 2:39
  Speaker 4: au where we go out we find every single doctor
• 2:43
  Speaker 4: of a particular type across the country and then we
• 2:45
  Speaker 4: contact them to get their pricing information, and we keep
• 2:48
  Speaker 4: contacting them until we're able to.
• 2:49
  Speaker 3: Get their pricing information.
• 2:51
  Speaker 4: We then put this pricing information as well as all
• 2:55
  Speaker 4: of the other information we've been able to find about
• 2:56
  Speaker 4: the clinic online on cleanbill dot com dot au. It's
• 2:59
  Speaker 4: a completely free directory and anyone can then go and
• 3:02
  Speaker 4: search for all of these clinicians and clinics, see every
• 3:06
  Speaker 4: single option that's around them, and filter them by price
• 3:08
  Speaker 4: to find one that meets their affordability criterion. You can
• 3:12
  Speaker 4: see the prices that those clinics charge right there on
• 3:15
  Speaker 4: the website. And of course, we had all of this
• 3:18
  Speaker 4: data which no one else has on pricing information, so
• 3:21
  Speaker 4: we decided to aggregate it up into reports. And our
• 3:25
  Speaker 4: yearly Blue Report takes the gp information that we've collected
• 3:28
  Speaker 4: over the course of the previous year, over the last
• 3:31
  Speaker 4: couple of months of the previous year, and look and
• 3:34
  Speaker 4: provides a comprehensive picture of what's going on for GP accessibility,
• 3:38
  Speaker 4: not only right now, but as it compares to the
• 3:41
  Speaker 4: last three years that we've been collecting this report as well,
• 3:44
  Speaker 4: so that we're starting to get a really really strong
• 3:47
  Speaker 4: idea of what the flows are in GP accessibility over time,
• 3:51
  Speaker 4: which is really good too.
• 3:53
  Speaker 2: Just going into this, when you started clean Build, what
• 3:58
  Speaker 2: was the hope. How when you do a project, you've
• 4:01
  Speaker 2: got your hypothesis and your aims, and like, what were
• 4:04
  Speaker 2: your aims?
• 4:05
  Speaker 1: Like, what did you want?
• 4:07
  Speaker 2: Obviously you wanted to bring this information to light and
• 4:10
  Speaker 2: to be able to provide a resource for people to
• 4:12
  Speaker 2: be able to access things more easily, more affordably.
• 4:16
  Speaker 1: I guess that was the intention. Was there anything other than.
• 4:20
  Speaker 4: That, Well, it was really twofold, So part of the
• 4:24
  Speaker 4: intention absolutely was on increasing accessibility for individuals. One of
• 4:30
  Speaker 4: the things that I noticed amongst my peers, and I
• 4:33
  Speaker 4: think anyone would have noticed over the last couple of years,
• 4:36
  Speaker 4: is it's gotten more and more expensive to go and
• 4:38
  Speaker 4: see a doctor, and nothing was being done about it.
• 4:42
  Speaker 4: So improving people's individual access to medical care seemed like
• 4:46
  Speaker 4: a good enough mission on its own. But I also wanted,
• 4:49
  Speaker 4: and this is partly why we published the Blue Report.
• 4:52
  Speaker 4: I also wanted the unique data that we were collecting
• 4:55
  Speaker 4: to be able to be used by decision makers when
• 4:58
  Speaker 4: determining what choices should be made about our healthcare system,
• 5:02
  Speaker 4: to improve that accessibility for people on the ground. So
• 5:06
  Speaker 4: I wanted these reports in this data to be available
• 5:08
  Speaker 4: to politicians and governments across the country so they had
• 5:12
  Speaker 4: the best data at their fingertips necessary to make calls
• 5:15
  Speaker 4: about policy. And we've already seen it have that effect.
• 5:19
  Speaker 1: Wow, that's good. That's good.
• 5:21
  Speaker 2: I mean because correct me if I'm wrong. Only as
• 5:24
  Speaker 2: much as I love you and massively, I only think
• 5:27
  Speaker 2: about this really once a year when.
• 5:29
  Speaker 1: You call it.
• 5:31
  Speaker 2: But you were pushing metaphoric, you know what, uphill for
• 5:37
  Speaker 2: a while, weren't you. You were, as I said to
• 5:39
  Speaker 2: you before the start, before we started rolling, you were
• 5:43
  Speaker 2: for quite a while, really swimming against the tide. It
• 5:46
  Speaker 2: seems like, no pun intended, the tide has turned. Slash
• 5:50
  Speaker 2: is turning a little bit.
• 5:52
  Speaker 1: Yeah. Yeah.
• 5:53
  Speaker 4: So when we first started Clean Bill, it was just me.
• 5:56
  Speaker 4: I was just I was paying. I was working full
• 5:59
  Speaker 4: time job, and it was full time salary that was
• 6:01
  Speaker 4: paying everyone who was working on Clean Bill to build
• 6:04
  Speaker 4: this out and make it something that people could use,
• 6:07
  Speaker 4: and that was the case for about a year and
• 6:08
  Speaker 4: a half before we started licensing the data that we
• 6:10
  Speaker 4: put into these reports, so the granular level data that
• 6:13
  Speaker 4: we have on clinics, and they're billing practices to primary
• 6:17
  Speaker 4: health networks, to corporate so to HCF, which has been
• 6:22
  Speaker 4: one of our clients for health so they can get
• 6:25
  Speaker 4: a better idea of what's going on in the primary
• 6:28
  Speaker 4: care industry as well. And it's not just GP data,
• 6:30
  Speaker 4: it's dental data. We also have dermatologist data and so
• 6:33
  Speaker 4: that started to provide a bit of background for it
• 6:36
  Speaker 4: as well. But we also see increasingly and I mean
• 6:38
  Speaker 4: they'd never admit to it, but increasingly see the government
• 6:41
  Speaker 4: engaging on the data that we've been putting out there.
• 6:45
  Speaker 4: For example, the large increase the bolt billing incentive expansion
• 6:49
  Speaker 4: which came into effect on one November this year, was
• 6:51
  Speaker 4: the big Medicare promise from the government which was announced
• 6:55
  Speaker 4: in February of last year. That came out and was
• 7:00
  Speaker 4: announced only a couple of weeks after our Blue Report
• 7:03
  Speaker 4: and targeted the specific patient sets that our Blue Report
• 7:07
  Speaker 4: was looking at. So whilst they would never admit it,
• 7:10
  Speaker 4: I have to imagine that we had a role to
• 7:12
  Speaker 4: play in making sure that that happened.
• 7:14
  Speaker 1: It's so funny, so funny.
• 7:16
  Speaker 2: Wouldn't it be nice if I've spoken about this many times?
• 7:19
  Speaker 2: Like imagine politicians or the government, a government that just said, hey,
• 7:23
  Speaker 2: we've got a few things wrong, so we're going to
• 7:26
  Speaker 2: do something about it.
• 7:27
  Speaker 1: Hey, James, by the way, thanks for all that data.
• 7:29
  Speaker 1: That's really helpful.
• 7:30
  Speaker 2: And it's given us a real kind of clarity around
• 7:32
  Speaker 2: the few things go You like that didn't have to
• 7:35
  Speaker 2: pay for it, even you're kind of doing the work
• 7:38
  Speaker 2: that they should be doing.
• 7:41
  Speaker 3: Well. Look, I think, I mean, I think.
• 7:46
  Speaker 4: What we're doing is a real focus on ensuring medical accessibility,
• 7:52
  Speaker 4: regardless of what the government policy is. But if our
• 7:55
  Speaker 4: data is able to inform that policy and help decision
• 7:59
  Speaker 4: makers those calls, then you know, so far the better
• 8:03
  Speaker 4: from my perspective.
• 8:05
  Speaker 2: Yeah, yeah, all right, So tell us what's the what
• 8:08
  Speaker 2: we're going to now we're obviously going to be sharing
• 8:12
  Speaker 2: this either on or after the twelfth, So yeah, tell
• 8:15
  Speaker 2: us tell us what the new Blue Report tells us.
• 8:21
  Speaker 4: So the twenty twenty six Blue Report is our fourth
• 8:24
  Speaker 4: annual Blue Report, and it looks at six eight hundred
• 8:28
  Speaker 4: and seventy seven GP clinics across the country, which is
• 8:30
  Speaker 4: as many as we were able to find. There may
• 8:33
  Speaker 4: in fact be more out there that have somehow eluded
• 8:36
  Speaker 4: our research. Our research is fairly comprehensive, but I would
• 8:39
  Speaker 4: imagine that it's a pretty pretty pretty close to perfect
• 8:43
  Speaker 4: picture of the number of GP clinics across the country.
• 8:46
  Speaker 4: And what we found by comparing the data from this
• 8:49
  Speaker 4: year to the data from previous years is that we've
• 8:51
  Speaker 4: seen a complete reversal in the trends that we've seen
• 8:54
  Speaker 4: for bolk billing over the last couple of years. So, Craig,
• 8:57
  Speaker 4: when I've come on and spoken previously about bulk billing
• 9:00
  Speaker 4: trends that we've seen, we've always been talking about bulk
• 9:02
  Speaker 4: billing going down, being less accessible, fewer clinics doing it.
• 9:07
  Speaker 3: That's completely changed.
• 9:08
  Speaker 4: We've seen a reversal of that to the point that
• 9:12
  Speaker 4: the percentage of fully bolk billing clinics across the country
• 9:15
  Speaker 4: has almost doubled since our twenty twenty five report, which
• 9:19
  Speaker 4: is great news. What that looks like around the country
• 9:23
  Speaker 4: is New South Wales. In the New South Wales and
• 9:26
  Speaker 4: the Northern Territory, over fifty percent of GP clinics will
• 9:29
  Speaker 4: now fully bulk build every patient who walks in the door.
• 9:32
  Speaker 4: And in Tasmania, where last year we weren't able to
• 9:37
  Speaker 4: find a single available fully gold billing.
• 9:39
  Speaker 3: Clinic, I remember that.
• 9:41
  Speaker 4: Yeah, well last year when we did the research for that,
• 9:46
  Speaker 4: we checked it so many times because we thought it
• 9:49
  Speaker 4: couldn't possibly be that there are no available bulk billing clinics,
• 9:53
  Speaker 4: but there weren't. There weren't any. Now there are thirty seven.
• 9:57
  Speaker 4: So yeah, massive turnaround in fully bulk billing numbers across
• 10:02
  Speaker 4: the country, which is a really really good outcome for accessibility.
• 10:07
  Speaker 4: But on the other side, we've also looked at out
• 10:10
  Speaker 4: of pocket costs, so what it costs to go and
• 10:12
  Speaker 4: see the GP if you're not being bulk billed, And
• 10:16
  Speaker 4: what we found is that the average cost for a
• 10:18
  Speaker 4: standard consultation across the country for a regular adult has surged.
• 10:23
  Speaker 4: We're talking about thirteen percent higher today than it was
• 10:28
  Speaker 4: at the start of twenty twenty five nationwide. Now that's
• 10:32
  Speaker 4: partly because a lot of the less expensive clinics have
• 10:36
  Speaker 4: switched to fully bulk billing, so their lower out of
• 10:39
  Speaker 4: pocket costs are no longer included in the figures when
• 10:43
  Speaker 4: we're calculating out of pocket costs, which pushes the average up.
• 10:46
  Speaker 4: But it's also even once you control for those clinics.
• 10:49
  Speaker 4: We've seen a six point eight percent increase in average
• 10:52
  Speaker 4: out of pocket costs over the last year, which doesn't
• 10:55
  Speaker 4: sound like that much, but is actually sixty five percent
• 10:57
  Speaker 4: higher than it was between twenty twenty four and twenty
• 11:00
  Speaker 4: twenty five. So we've seen quite a considerable increase in
• 11:03
  Speaker 4: average out of pocket costs, So its not bad.
• 11:07
  Speaker 2: I don't know if this is not particularly relevant, it's
• 11:10
  Speaker 2: kind of adjacent. It's kind of relevant adjacent, But I'm
• 11:14
  Speaker 2: just interested. Is there meant to be a kind of
• 11:18
  Speaker 2: a when we go a standard consultation? Is that meant
• 11:21
  Speaker 2: to be a specific number of minutes across the board?
• 11:25
  Speaker 2: Or does just is that very center to center? Is
• 11:28
  Speaker 2: it arbitrary? Is it just decided on the clinic or
• 11:32
  Speaker 2: how does that work?
• 11:34
  Speaker 4: Well, it's actually set down in the Medicare benefits schedule.
• 11:37
  Speaker 4: So when we're talking about a standard consultation, what we're
• 11:40
  Speaker 4: talking about is what's.
• 11:41
  Speaker 3: Called a level B or Item twenty three consultation.
• 11:44
  Speaker 4: That's the name of the Medicare Benefit schedule item, and
• 11:48
  Speaker 4: it's between six and twenty minutes. That's what the Medicare
• 11:53
  Speaker 4: Benefit schedule defines it as between six and twenty minutes.
• 11:57
  Speaker 3: You commonly see that shortened to.
• 11:59
  Speaker 4: About fifteen because that's often how long doctors take for it.
• 12:03
  Speaker 3: But if your.
• 12:03
  Speaker 4: GP clinic is saying, well, we'll only talk to you
• 12:06
  Speaker 4: about one issue and we'll call it a standard consultation
• 12:10
  Speaker 4: if that issue takes you less than six minutes to
• 12:14
  Speaker 4: talk to them about, it's actually not a standard consultation anymore.
• 12:18
  Speaker 4: So it's not based on the number of issues that
• 12:20
  Speaker 4: you're going in to see the doctor with. It's based
• 12:22
  Speaker 4: on the amount of time that you're spending with the doctor.
• 12:26
  Speaker 1: That's amazing. It's I.
• 12:30
  Speaker 2: Went and saw a doctor that I don't normally see,
• 12:32
  Speaker 2: so I'm not throwing my normal doctor. And by the way,
• 12:35
  Speaker 2: I love doctors. Doctors are overworked there. They're amazing and
• 12:39
  Speaker 2: I don't know how.
• 12:40
  Speaker 1: You do it.
• 12:41
  Speaker 2: But I had to go see a doctor because my
• 12:44
  Speaker 2: doctor wasn't available anyway. It wasn't life or death, but
• 12:47
  Speaker 2: I reckon start to finish.
• 12:49
  Speaker 1: It took.
• 12:51
  Speaker 2: Seven, seven or eight minutes from when I walked in
• 12:54
  Speaker 2: the door and for ninety percent of the time he
• 12:59
  Speaker 2: didn't look at me because he was looking at all
• 13:01
  Speaker 2: my information on a screen, so which I understand, but
• 13:06
  Speaker 2: it was so funny.
• 13:07
  Speaker 1: It's like, oh my god, I'm glad. I'm not needy.
• 13:09
  Speaker 1: I'm glad.
• 13:10
  Speaker 3: I'm glad because of maintenance on this.
• 13:13
  Speaker 1: I just felt like, one champ, could you look at
• 13:15
  Speaker 1: me when you talk to me.
• 13:16
  Speaker 2: It's like, anyway it is. It is an overloaded system.
• 13:21
  Speaker 2: So you know, shout out to that dude.
• 13:23
  Speaker 1: It's all good. I got my I got my.
• 13:26
  Speaker 2: Prescription, so you know, it was I have which everyone's
• 13:31
  Speaker 2: probably thinking, what does he get? I have hereditary blood
• 13:33
  Speaker 2: pressure everyone, which thanks to mom and dad. And it
• 13:36
  Speaker 2: doesn't matter how many lifestyle variables I optimize, I still
• 13:42
  Speaker 2: have it. So there, it is all right. So so
• 13:45
  Speaker 2: bulk bill and clinics across the country have double to.
• 13:48
  Speaker 1: Just over forty percent nationally, which is amazing.
• 13:51
  Speaker 2: What to what do we credit the the uptake or
• 13:57
  Speaker 2: the improvement or the growth of this is that have
• 14:00
  Speaker 2: they been incentivized to do so by the government.
• 14:03
  Speaker 4: Exactly take the words out of my mouth there, Craig.
• 14:06
  Speaker 4: So it is an additional incentive that GP clinics are
• 14:09
  Speaker 4: receiving from the government in order to become fully bulk billing. So,
• 14:13
  Speaker 4: following on from the release of our Blue Report at
• 14:15
  Speaker 4: the start of last year, the government, heading into the election,
• 14:17
  Speaker 4: announced seven point nine billion dollars to increase GP accessibility
• 14:22
  Speaker 4: and increase the number of fully bold built GP clinics
• 14:25
  Speaker 4: across the country if they were re elected. Some of
• 14:28
  Speaker 4: you may remember that the opposition came out and supported it,
• 14:31
  Speaker 4: so it was a done deal that this was going
• 14:33
  Speaker 4: to happen. And so from one November this year, GP
• 14:37
  Speaker 4: clinics continue to receive the standard Medicare rebate when they
• 14:42
  Speaker 4: see a patient. Now, they receive this whether they charge
• 14:45
  Speaker 4: an out.
• 14:45
  Speaker 3: Of pocket cost or not.
• 14:48
  Speaker 4: Then if that GP clinic bulk bills you as a patient,
• 14:52
  Speaker 4: they then receive an additional incentive now and then if
• 14:56
  Speaker 4: they bulk bill every patient who comes in the door,
• 14:59
  Speaker 4: they'll receive an additional incentive on top of that additional incentive,
• 15:03
  Speaker 4: which is which is equal to twelve point five percent
• 15:06
  Speaker 4: of the total incentive amount and is split equally between
• 15:09
  Speaker 4: GPS and clinics.
• 15:12
  Speaker 3: And in case that.
• 15:13
  Speaker 4: Wasn't already complex enough to navigate the amount of those
• 15:17
  Speaker 4: incentives that GP clinics are receiving on top of the
• 15:20
  Speaker 4: medicare rebate scales based on how remote the clinics are,
• 15:25
  Speaker 4: so the whole country is split into areas modified monash
• 15:30
  Speaker 4: areas one to seven, with one being the most metro,
• 15:33
  Speaker 4: seven being the most regional, and clinics in the most
• 15:38
  Speaker 4: metro areas receive less money than clinics in regional areas
• 15:42
  Speaker 4: do under this change. So it's very complex, But the
• 15:46
  Speaker 4: long and short of it is it encourages clinics to
• 15:49
  Speaker 4: become fully bulk billing by providing them more money from
• 15:52
  Speaker 4: the government for doing so. But whilst it does increase
• 15:58
  Speaker 4: fully bulk billing clinics, it has a limited effect or
• 16:02
  Speaker 4: no effect rather on out of pocket costs if that
• 16:05
  Speaker 4: clinic doesn't start bulk billing because the clinic doesn't receive
• 16:08
  Speaker 4: any more money from the government if they continue to
• 16:11
  Speaker 4: charge out of pocket costs.
• 16:13
  Speaker 2: What do you think, I mean, you're you'd be guessing,
• 16:17
  Speaker 2: but you're definitely going to have more insolt.
• 16:18
  Speaker 1: Maybe you're not guessing.
• 16:19
  Speaker 2: Maybe you know, what do you think if you were
• 16:21
  Speaker 2: one of those clinics, Like, what what's the pros and
• 16:25
  Speaker 2: cons if we if we do a like an analysis,
• 16:29
  Speaker 2: what's going to make someone go all right, we're going
• 16:32
  Speaker 2: to be fully bulk built or not at all? Like
• 16:35
  Speaker 2: it must just come down to I guess financial and
• 16:40
  Speaker 2: also practicality and ease of execution, Like would it just
• 16:44
  Speaker 2: be simpler for some businesses?
• 16:47
  Speaker 4: Well, you must imagine that some GP clinics will look
• 16:51
  Speaker 4: at that from that lens. This is the devil in
• 16:54
  Speaker 4: the detail of it, Greg, is how this plays out
• 16:57
  Speaker 4: for each individual clinic.
• 16:58
  Speaker 3: I think you and I spoke.
• 17:00
  Speaker 4: Last year about how difficult it is to model the
• 17:03
  Speaker 4: effects of this change ahead of time, because it's so
• 17:06
  Speaker 4: difficult to know what clinics value and what they'll be
• 17:09
  Speaker 4: taking into account when making decisions about whether they become
• 17:12
  Speaker 4: fully bulk billing. I mean, even if you're just looking
• 17:14
  Speaker 4: at from looking at it from an economics purely economics perspective,
• 17:19
  Speaker 4: it's not just the incentives you've got to look for.
• 17:21
  Speaker 4: For example, in New South Wales, GP clinics receive state
• 17:24
  Speaker 4: level incentives, so they receive tax rebates if they bulk
• 17:28
  Speaker 4: bill more than eighty percent of their patients and are
• 17:30
  Speaker 4: in Sydney, or if they're regional more than seventy percent
• 17:33
  Speaker 4: of their patients. So there are a lot of complex
• 17:36
  Speaker 4: moving factors coming into play when gps are making this call.
• 17:40
  Speaker 4: And as a result, when we were doing this collection
• 17:43
  Speaker 4: determining which GP clinics have become fully bulk billing and
• 17:45
  Speaker 4: what it costs to visit those that don't or haven't,
• 17:50
  Speaker 4: we were being told by a lot of clinics that
• 17:52
  Speaker 4: they were just trialing this. So where they switched to
• 17:54
  Speaker 4: fully bulk billing, they were trialing it for six to
• 17:56
  Speaker 4: twelve months, determining whether or not this is something that
• 17:59
  Speaker 4: they're going on keep going based on its effect on
• 18:01
  Speaker 4: their bottom line, and then you know, making the call
• 18:06
  Speaker 4: later on. So what will be really interesting as well
• 18:08
  Speaker 4: is not just this blue Report, but next year's Blue
• 18:10
  Speaker 4: report to see to what extent these fully bolt billion
• 18:14
  Speaker 4: clinics stay stuck as fully ball billing clinics or switch back.
• 18:18
  Speaker 2: So where's where's the place we don't want to live
• 18:21
  Speaker 2: in Australia from a financial point of view accessing you know,
• 18:26
  Speaker 2: the medical resources we need, Like where's by the way,
• 18:29
  Speaker 2: this is no disrespect. Let me let me ask a
• 18:32
  Speaker 2: better question. Which is the dearest Which is the dearest
• 18:35
  Speaker 2: state we love all the states even can we love
• 18:40
  Speaker 2: territories like where's the place that's the toughest From this perspective.
• 18:47
  Speaker 4: Well, all things being equal, otherwise, the Act is probably
• 18:52
  Speaker 4: the most difficult jurisdiction under this change, under the data
• 18:57
  Speaker 4: that we've got, and that's for two reasons. Firstly, the
• 19:02
  Speaker 4: number of fully bolked billing clinics in the Act is
• 19:05
  Speaker 4: a lot lower than in most other jurisdictions, and has
• 19:08
  Speaker 4: increased a lot less than in similarly similarly populated jurisdictions
• 19:13
  Speaker 4: like Tasmania. And the reason for that is again based
• 19:18
  Speaker 4: on how much the incentives that clinics receive scale. So
• 19:23
  Speaker 4: in Tasmania, for example, there aren't any metro areas, even
• 19:28
  Speaker 4: in a Hobart isn't considered a metro area in Tasmania,
• 19:32
  Speaker 4: whereas the entirety of the Act is considered metro. So
• 19:35
  Speaker 4: the entirety of the Act is receiving the lowest incentives,
• 19:39
  Speaker 4: whereas much of Tasmania receiving higher incentives.
• 19:45
  Speaker 3: The second point is that.
• 19:46
  Speaker 4: The Act already had very high out of pocket costs
• 19:49
  Speaker 4: even before going into this, So whilst you in the
• 19:53
  Speaker 4: Act you have fewer clinics that have switched to fully
• 19:55
  Speaker 4: bold billing, but you also have very high out of
• 19:58
  Speaker 4: pocket costs at the clinics that haven't, So the ACT
• 20:02
  Speaker 4: is probably the most difficult jurisdiction to access that care
• 20:08
  Speaker 4: Comparatively around the country.
• 20:11
  Speaker 2: Do we have more doctors in twenty twenty six than
• 20:14
  Speaker 2: we had in twenty twenty two or is it about
• 20:16
  Speaker 2: the same like out in the field so to speak.
• 20:21
  Speaker 4: Well, we're only just starting to collect data on doctor numbers.
• 20:24
  Speaker 4: To my understanding, it's largely the same and may even
• 20:27
  Speaker 4: have increased slightly. But we have seen declines in clinic numbers,
• 20:32
  Speaker 4: which is really interesting. So those doctors are organized clinics,
• 20:38
  Speaker 4: and we've seen, particularly over the last Blue Report, clinic
• 20:44
  Speaker 4: closures and clinic consolidations at higher rates than we've seen previously.
• 20:49
  Speaker 1: So what do you.
• 20:52
  Speaker 2: For one of a better question, what are you happy
• 20:54
  Speaker 2: with in this report and in the findings and the data,
• 20:58
  Speaker 2: and what do you wish h for.
• 21:02
  Speaker 1: Moving forward?
• 21:03
  Speaker 2: Like what would you like to see improve and what
• 21:05
  Speaker 2: do you think is so what are the positives and negatives?
• 21:09
  Speaker 1: Sure?
• 21:09
  Speaker 4: So, I think the unequivocal positive out of this report
• 21:12
  Speaker 4: is that we've seen a massive uptick in fully bold
• 21:15
  Speaker 4: billing clinics across the country. It is simply easier, no
• 21:18
  Speaker 4: matter where you live, to find an available fully bold
• 21:22
  Speaker 4: billing doctor today than it was a year ago. And
• 21:24
  Speaker 4: that's true nationwide. So that's an unequivocal good Craig.
• 21:30
  Speaker 3: Where where I think.
• 21:33
  Speaker 4: There's there perhaps downsides to the report is just looking
• 21:38
  Speaker 4: at the amount by which out of pocket costs have increased,
• 21:42
  Speaker 4: Because whilst there are more fully bold billing clinics, if
• 21:44
  Speaker 4: you don't belong to one of them, if you're not
• 21:47
  Speaker 4: going to see a fully boltd billing doctor, you're out
• 21:49
  Speaker 4: of pocket costs have increased at higher rates than they
• 21:52
  Speaker 4: have previously.
• 21:54
  Speaker 3: So I mean it.
• 21:56
  Speaker 4: It might sound like a bit of a broken record
• 21:59
  Speaker 4: at this point, but I feel like the answer to
• 22:02
  Speaker 4: all of this, at least at the moment and at
• 22:04
  Speaker 4: the individual level, is information. People need to know which
• 22:09
  Speaker 4: clinics around them have switched to fully bold billing, which
• 22:11
  Speaker 4: of those are taking on new patients, what it costs
• 22:15
  Speaker 4: to visit those clinics that aren't fully bulk billing, if
• 22:18
  Speaker 4: they're not able to get into a fully bold billing
• 22:20
  Speaker 4: clinic around them. And that's why, at least in my eyes,
• 22:24
  Speaker 4: it's so critical to have a resource like clean bill
• 22:27
  Speaker 4: that shows people that information because otherwise they're doing it
• 22:29
  Speaker 4: in the dark.
• 22:31
  Speaker 2: What's the average consult like a a standard consultation, And
• 22:37
  Speaker 2: I'm sure it varies, but what's the give or take
• 22:39
  Speaker 2: the average price of going to see a doctor, irrespective
• 22:42
  Speaker 2: of whether or not you know it's refunded in some way.
• 22:48
  Speaker 4: Well, we don't calculate the averages accounting for fully bold
• 22:52
  Speaker 4: billing clinics, but if you're looking at just clinics that
• 22:57
  Speaker 4: will charge an out of pocket cost, the average that
• 23:00
  Speaker 4: we're talking about for a standard consultation is just under
• 23:03
  Speaker 4: fifty dollars out of pocket. But again that changes a
• 23:06
  Speaker 4: lot from jurisdiction to jurisdiction. For example, in Wa it's
• 23:09
  Speaker 4: a little bit lower than that. I think it's around
• 23:11
  Speaker 4: forty six dollars, but if you're in Tasmania or the Act,
• 23:15
  Speaker 4: it's well over fifty dollars, And in Tasmania it's over
• 23:18
  Speaker 4: sixty dollars. So there is a lot of variability. And
• 23:23
  Speaker 4: it's worth remembering that these are just state wide averages.
• 23:25
  Speaker 4: So in each area across the country, there are clinics
• 23:28
  Speaker 4: that are charging considerably less or considerably more than this,
• 23:30
  Speaker 4: so it's important to have that information so you can
• 23:32
  Speaker 4: make that call.
• 23:34
  Speaker 2: Yeah, right, I had He's a little anecdote. So I
• 23:38
  Speaker 2: had an infection in my head, right, like a sinus infection.
• 23:44
  Speaker 2: I've had all these weird symptoms. This is I don't know, October,
• 23:49
  Speaker 2: September October. So I had to have all these tests
• 23:51
  Speaker 2: done and it comes back that I've got sinus infection.
• 23:55
  Speaker 1: But it was. It gave me a myriad of symptoms. Anyway,
• 23:58
  Speaker 1: I went to the doctor and.
• 24:02
  Speaker 2: I don't want to throw anyone under the bus, but
• 24:04
  Speaker 2: they prescribe We'll go with. They prescribed are two weeks
• 24:07
  Speaker 2: of a particular antibiotic.
• 24:10
  Speaker 1: So anyway, I.
• 24:10
  Speaker 2: Got to the pharmacy and I went bibd bobbedy boo,
• 24:14
  Speaker 2: gave my script and they gave me one week's worth
• 24:17
  Speaker 2: and I go, no, it's two, and he goes, it's one.
• 24:20
  Speaker 2: Have a look, and I went, oh, and it was.
• 24:25
  Speaker 2: It was after it was like a chemist, it's open
• 24:27
  Speaker 2: till ten. So I couldn't ring anyway, So the next
• 24:31
  Speaker 2: day I forgot because I was doing a million things.
• 24:33
  Speaker 2: But I already had a week, so I just wanted
• 24:35
  Speaker 2: to ring the place to go, Hey, they stuffed up.
• 24:39
  Speaker 2: They only wrote one week, it's meant to be two,
• 24:41
  Speaker 2: which it absolutely was.
• 24:43
  Speaker 1: And then so they're like, oh, so you want an appointment.
• 24:47
  Speaker 1: I go and no, I don't want an appointment.
• 24:49
  Speaker 2: I just want the script that was incorrectly given to
• 24:52
  Speaker 2: be corrected. So could you just send whatever? Oh, well,
• 24:55
  Speaker 2: you'll need to talk to doctor such and such. I'm like, cool,
• 24:59
  Speaker 2: So do you want to do a phone consult? I'm
• 25:01
  Speaker 2: like no, no, we don't. So what they tried to
• 25:05
  Speaker 2: do is charge me to fix a fuck up that
• 25:10
  Speaker 2: they made. I'm like, no, bro, I know what I
• 25:13
  Speaker 2: need and I was given this is what I was
• 25:16
  Speaker 2: meant to be given, and this is what I actually
• 25:18
  Speaker 2: was given. And you can ask the doctor if you like.
• 25:22
  Speaker 2: I don't need to have a chat. I just need
• 25:24
  Speaker 2: to be sent the correct a script.
• 25:27
  Speaker 1: And oh they were. They were not happy. I'm like,
• 25:30
  Speaker 1: I didn't fuck up. You didn't this fuck But.
• 25:35
  Speaker 4: This is an increasingly common story that you hear. I mean,
• 25:40
  Speaker 4: one of my one of my colleagues who works at
• 25:42
  Speaker 4: clean Bell, was telling me a very similar story just
• 25:46
  Speaker 4: a couple of weeks ago, where the prescription they'd gotten
• 25:49
  Speaker 4: was wrong. They wanted to get it updated, but in
• 25:52
  Speaker 4: order to do so, they needed to book in with
• 25:54
  Speaker 4: their doctor. Now, for them, it was that was actually
• 25:56
  Speaker 4: made more difficult by the fact that the doctor didn't
• 25:58
  Speaker 4: have free appointments quite some time. It was over a
• 26:01
  Speaker 4: week before their doctor had another free appointment. You can
• 26:04
  Speaker 4: see it from a clinics perspective, right, Craig, Like, they're thinking, well,
• 26:08
  Speaker 4: you know, if we're renewing this or fixing this error
• 26:13
  Speaker 4: with the script, then we'll need to get the doctor
• 26:16
  Speaker 4: to review it to make sure it's correct. But the
• 26:18
  Speaker 4: doctors can't charge you for that because they're just reviewing
• 26:22
  Speaker 4: the script and that's time out of their day. And
• 26:26
  Speaker 4: you know, in this circumstance, it's not your fault, but
• 26:30
  Speaker 4: in some circumstances, clinics may feel that it is the
• 26:32
  Speaker 4: patient's fault, and so there's a bit of friction there,
• 26:36
  Speaker 4: and there are whole industries now being built, Craig around
• 26:40
  Speaker 4: trying to remove that friction from the relationship. That's why
• 26:43
  Speaker 4: we've seen significant growth in telehealth services and in prescription
• 26:48
  Speaker 4: automatic prescription renewal services, just because people want to have
• 26:54
  Speaker 4: that flexibility to if a mistake's being made, fix it
• 26:58
  Speaker 4: without needing to book another appointment, And.
• 27:01
  Speaker 2: Can I say, before anyone gets mad at me, I
• 27:02
  Speaker 2: love doctors. Three of my friends are doctors and they
• 27:05
  Speaker 2: are fucking They're great. And also, by the way, podcasters
• 27:10
  Speaker 2: do stupid shit, so to exercise scientists, so to bloody
• 27:14
  Speaker 2: psychology researchers, and even the bloke who owns or created
• 27:19
  Speaker 2: clean Bill probably he does. All right, mate, what's the
• 27:24
  Speaker 2: wrap up? What's the takeaway? What do you want to
• 27:26
  Speaker 2: tell us that we don't already know? And let's that
• 27:31
  Speaker 2: and then I've got one more question for you.
• 27:33
  Speaker 3: Yeah, absolutely.
• 27:35
  Speaker 4: Takeaway here is just that whilst these statistics do look good,
• 27:40
  Speaker 4: and they are good at least from a ball billing perspective,
• 27:43
  Speaker 4: and whilst they might look dire from an out of
• 27:45
  Speaker 4: pocket costs perspective, they are just averages and it is
• 27:49
  Speaker 4: possible in all areas to find either a fully balled
• 27:52
  Speaker 4: billing or a low out of pocket cost GP. It's
• 27:55
  Speaker 4: just about having the information necessary to find them, and
• 27:57
  Speaker 4: you can find all of that information on clean Bill.
• 28:00
  Speaker 2: As you move forward with the Blue Report year to
• 28:04
  Speaker 2: year one, I'm assuming, which might be an erroneous assumption.
• 28:08
  Speaker 2: You're on a that's you're kind of intending to do
• 28:12
  Speaker 2: it in you know, for as long as it's needed.
• 28:15
  Speaker 3: Right, Yeah, yeah, absolutely, So do.
• 28:18
  Speaker 2: You after four reports, do you go, hey, everyone, let's
• 28:22
  Speaker 2: sit down. What do you reckon that we could do
• 28:25
  Speaker 2: or change or improve or like? Do you are you
• 28:28
  Speaker 2: constantly kind of looking at different things reports report? Or
• 28:33
  Speaker 2: are you like, is there some focus that you might
• 28:37
  Speaker 2: have in next year's report that you didn't have in
• 28:40
  Speaker 2: this year's report. I mean, we're always talking about constant
• 28:43
  Speaker 2: improvement and adaptation.
• 28:45
  Speaker 1: What does that look like in the context of a
• 28:47
  Speaker 1: yearly report?
• 28:48
  Speaker 4: Yeah, so, Craig, that is absolutely the mindset that we
• 28:51
  Speaker 4: take towards it. There's no situation where we're resting on
• 28:54
  Speaker 4: our laurels and saying, Okay, we've collected enough data, that's
• 28:57
  Speaker 4: the Blue Report sorted, and you know, washing our hands
• 29:00
  Speaker 4: of it. Every single year that we've released the Blue Report,
• 29:03
  Speaker 4: it's been my goal to incorporate more information from it,
• 29:06
  Speaker 4: and that information is usually determined by conversations that we
• 29:10
  Speaker 4: have with people like yourself, Craig, or just regular patients
• 29:14
  Speaker 4: about the kind of information that they would find helpful
• 29:17
  Speaker 4: to have collected from GP clinics. So, between our first
• 29:20
  Speaker 4: and our second Blue report, we started collecting information from
• 29:23
  Speaker 4: clinics on one off fees, so membership fees that clinics
• 29:28
  Speaker 4: were or admin fees that clinics were charging on top
• 29:30
  Speaker 4: of their regular fee structure, so we could incorporate that
• 29:33
  Speaker 4: in and provide people with more information about Okay, this
• 29:36
  Speaker 4: clinic is a bulk billing clinic, but they'll charge you
• 29:38
  Speaker 4: a sixty dollars admin fee up front to see them.
• 29:42
  Speaker 3: The second time around.
• 29:43
  Speaker 4: The improvement that we were looking to make on it
• 29:46
  Speaker 4: was a massive increase in our research capability, so we
• 29:51
  Speaker 4: could be one hundred percent sure we were getting that
• 29:54
  Speaker 4: last one or two percent of clinics that were really
• 29:56
  Speaker 4: really difficult to find.
• 29:58
  Speaker 3: And in this time around.
• 30:00
  Speaker 4: Focus has been on expanding out the collections that we're
• 30:05
  Speaker 4: not just now looking at non concession patients. We've also
• 30:08
  Speaker 4: got pricing information for children now that's not yet available
• 30:13
  Speaker 4: on the website. We're working on making that available on
• 30:15
  Speaker 4: the website now, but we'll have children pricing information for
• 30:19
  Speaker 4: children information that'll be available on the website so people
• 30:22
  Speaker 4: will then be able to say, Okay, I'm not looking
• 30:25
  Speaker 4: for an appointment for me, I'm actually looking for an
• 30:26
  Speaker 4: appointment for my child. And because clinics will often charge
• 30:30
  Speaker 4: differently based on whether it's an adult or whether it's
• 30:32
  Speaker 4: a child coming into the clinic, that's really helpful information
• 30:35
  Speaker 4: to have. We're also collecting now information on practitioners, so
• 30:41
  Speaker 4: we can say, these are the practitioners who are working
• 30:44
  Speaker 4: out of the clinic, and this is you know if
• 30:48
  Speaker 4: you have if a practitioner has a particular area of interest,
• 30:51
  Speaker 4: we'll have that information on the page that someone can say, Okay,
• 30:55
  Speaker 4: I really want a practitioner who's particularly interested in men's health.
• 31:00
  Speaker 3: Example.
• 31:01
  Speaker 4: They'll then be able to search for that specifically and
• 31:04
  Speaker 4: find that practitioner specifically who not only needs their affordability criteria,
• 31:08
  Speaker 4: but is also meeting there their area of interest that
• 31:13
  Speaker 4: they're looking for, has the qualifications that they're looking for,
• 31:16
  Speaker 4: and offers online bookings as well. And so it's about
• 31:20
  Speaker 4: constantly expanding the information that we're offering to people when
• 31:24
  Speaker 4: they're using the website.
• 31:26
  Speaker 2: All right, my last one, I'm interested in, Like, I'm
• 31:29
  Speaker 2: interested in ideas that become things, and your idea became
• 31:32
  Speaker 2: a thing, right, and like the You Project was an
• 31:35
  Speaker 2: idea and now it's two and two thousand, one hundred
• 31:39
  Speaker 2: episodes eight years whatever, you know, But I mean, I
• 31:42
  Speaker 2: didn't invent podcasts, of course. But what I'm saying is
• 31:46
  Speaker 2: like everything that becomes a business or an organization or
• 31:50
  Speaker 2: a product or a service or a whatever or a
• 31:53
  Speaker 2: report or everything originally was an idea in someone's gone
• 31:56
  Speaker 2: that got operationalized. And I remember when you first started
• 32:01
  Speaker 2: you had a fair bit of resistance, and it's not
• 32:03
  Speaker 2: like you were everyone when oh thank god James and
• 32:07
  Speaker 2: his fucking reporter here.
• 32:09
  Speaker 1: You know, it's I feel like it was almost the opposite.
• 32:13
  Speaker 2: There any has have other companies kind of gone, or
• 32:18
  Speaker 2: organizations or whoever embraced you at all. Are there any
• 32:24
  Speaker 2: organizations that want to partner with you, support you, work
• 32:27
  Speaker 2: alongside you.
• 32:29
  Speaker 1: How's that gone?
• 32:31
  Speaker 4: Well, Look, our feeling, first and foremost is we want
• 32:33
  Speaker 4: to work alongside anyone that we possibly can who shares
• 32:38
  Speaker 4: the same goals that we do, which is increasing medical
• 32:41
  Speaker 4: accessibility for people and dental accessibility for people. Yes, And
• 32:46
  Speaker 4: to that end, we've been reaching out constantly to bridge
• 32:50
  Speaker 4: that gap and to find opportunities to work together with
• 32:53
  Speaker 4: organizations on that. When we first started, Craig, there was,
• 33:00
  Speaker 4: as you, as you said.
• 33:01
  Speaker 3: A lot of reluctance to work with us.
• 33:05
  Speaker 4: But it's also I think an element of that is
• 33:08
  Speaker 4: we started, and we started with a bit of a bang.
• 33:11
  Speaker 1: You know.
• 33:11
  Speaker 4: The first time that a lot of people got introduced
• 33:13
  Speaker 4: to clean BIL was with our first Blue Report, and
• 33:16
  Speaker 4: they saw it in the media, but they hadn't heard
• 33:19
  Speaker 4: of the website behind it, They hadn't heard of the directory,
• 33:22
  Speaker 4: they didn't know what we were doing. In fact, when
• 33:24
  Speaker 4: we first released that first Blue Report, we had a
• 33:27
  Speaker 4: huge amount of work afterwards correcting articles that had misattributed
• 33:32
  Speaker 4: the report to either the RCGP or the government because
• 33:35
  Speaker 4: they just didn't know where clean Bill had come from.
• 33:38
  Speaker 4: But we are slowly turning that tide, and not just
• 33:41
  Speaker 4: at the organization level, but at the individual clinic level,
• 33:45
  Speaker 4: because clean Bill has now made it so that there's
• 33:48
  Speaker 4: an expectation in patients minds and increasingly in clinics minds,
• 33:53
  Speaker 4: that pricing information will be available. When we first started
• 33:58
  Speaker 4: clean Bill, only around three quarters of GP actually sorry
• 34:03
  Speaker 4: three quarters as where as is now only around forty
• 34:05
  Speaker 4: percent of GPA clinics across the country had a website,
• 34:08
  Speaker 4: and of those that did, only around ten percent of
• 34:10
  Speaker 4: them had pricing information online.
• 34:14
  Speaker 3: Wow, that's that's.
• 34:16
  Speaker 1: Ten percent of the forty percent.
• 34:18
  Speaker 4: Yeah, ten percent of the forty percent, so that's four percent.
• 34:22
  Speaker 4: Four percent had pricing information online. Even fewer had availability information,
• 34:25
  Speaker 4: so whether or not they were taking on new patients.
• 34:29
  Speaker 4: That's completely changed. Now now you've got seventy five percent
• 34:34
  Speaker 4: of GP clinics across the country have a website, and
• 34:37
  Speaker 4: of those that have a website, it's around seventy percent
• 34:40
  Speaker 4: have pricing information on their website. Now that information isn't
• 34:45
  Speaker 4: always correct, it's not always kept up to date. We
• 34:47
  Speaker 4: at clean Bill don't even treat it as definitive evidence
• 34:51
  Speaker 4: of pricing. Will usually get secondary confirmation by contacting the
• 34:56
  Speaker 4: clinic as well to confirm it. But that shows that's
• 35:00
  Speaker 4: how much of a change in attitude you've seen over
• 35:02
  Speaker 4: the last couple of years, which is it's gone from
• 35:04
  Speaker 4: one where patients have no right to know how much
• 35:08
  Speaker 4: it's going to cost them to visit the doctor beforehand
• 35:11
  Speaker 4: to one where patients expect it, and if your clinic
• 35:14
  Speaker 4: isn't providing it, whether it be through clean Bill or
• 35:16
  Speaker 4: through its own website, then patients will just go somewhere
• 35:20
  Speaker 4: where they are providing that information.
• 35:22
  Speaker 2: Yeah, that makes sense, mate, Always good to talk to you. Congratulations.
• 35:29
  Speaker 2: Where do you want to direct people? So obviously it's
• 35:32
  Speaker 2: the twelfth or later. I'm not sure when people are
• 35:35
  Speaker 2: going to be hearing this, but it's definitely not today
• 35:37
  Speaker 2: the tenth. Where do you want to direct people? Where
• 35:40
  Speaker 2: can they go to learn more?
• 35:43
  Speaker 4: So cleanbill dot com dot au has all the information
• 35:46
  Speaker 4: you're looking for. You'll be able to read the full
• 35:48
  Speaker 4: blue Report that Craig and I have been talking about
• 35:50
  Speaker 4: on today's podcast. Right there, you'll be able to see
• 35:53
  Speaker 4: the whole thing. And from that website, you'll also be
• 35:56
  Speaker 4: able to search for GP clinics all around you. You'll
• 35:59
  Speaker 4: be able to see every single GP clinic around you,
• 36:02
  Speaker 4: and you'll be able to filter them by price to
• 36:04
  Speaker 4: find ones that meet your affordability criteria. And that's only
• 36:07
  Speaker 4: going to get more in depth with more information as
• 36:09
  Speaker 4: time goes on.
• 36:10
  Speaker 2: Yeah, well we'll say goodbye. Heare, but mate, super good.
• 36:14
  Speaker 2: What you do is amazing. Your energy and your kind
• 36:19
  Speaker 2: of altruism and your intention and your motivation behind.
• 36:23
  Speaker 1: All of this I love and I admire, so well.
• 36:25
  Speaker 2: Done to you and the team and we'll talk again, mate,
• 36:29
  Speaker 2: and good luck with the report coming out.
• 36:32
  Speaker 1: I hope it's well received.
• 36:34
  Speaker 3: Thanks very much, Craig looking forward to it.
• 36:36
  Speaker 1: Thanks buddy,