The Commonwealth Government, currently, does not have a primary health care policy. Instead, policy is heavily focused on general practitioners (GPs) and, in particular, on payment arrangements. Since 2000 bulk-billing rates have declined significantly in Australia, raising concerns about affordability and access to health care. This paper examines the relationship between affordability, health need, the supply of GPs, and capacity to pay. Bulk-billing and per capita consultation rates are likely to be higher and co-payments lower in areas where GP supply is higher, health needs are high and capacity to pay is low. Implications for the Commonwealth Government?s new MedicarePlus package are also discussed in light of the findings.