Fifty per cent of Australian patients pay part of the cost of non-hospital Medicare services, according to a new report from the Australian Institute of Health and Welfare (AIHW). And 1.3 million people reported delaying or not seeking treatment because of costs.
The report, Patients’ out-of-pocket spending on Medicare services 2016–17, looks at health services delivered outside of hospitals and subsidised by Medicare and included GP, specialist, imaging and obstetric services. It found that while governments contributed $19 billion towards these services in 2016–17, patients paid $3 billion.
The median amount spent was $142 per patient, but 10 per cent of people spent at least $601 or more through the year.
Seven per cent of people aged 15 and over – or about 1.3 million – said they delayed or opted not to seek specialist, GP, imaging or pathology services when they needed them for cost reasons.
The report mirrors a recent Grattan Institute study, Mapping Primary Care in Australia, which showed many poorer Australians can’t afford to go to a GP when they need to or a dentist when they should, and that people in rural and remote areas found it too hard to get to a pharmacist or a medical specialist.
Earlier this year, a Four Corners exposé on patients who reported thousands of dollars of out-of-pocket medical costs brought swift criticism from key medical bodies with calls for a royal commission, greater transparency of fees and a limit on doctors’ freedom to set whatever prices they want.
The Consumers Health Forum (CHF) says that the random scale and nature of out-of-pocket fees charged by specialists highlights the need for more equity and transparency in the health system.
“That many people do not access the specialist care that has been recommended by their GP presents a disturbing insight into the unbalanced access to care that is a reality in Australia today,” said CHF chief executive Leanne Wells.
“The AIHW report shows that 72 per cent of specialists’ patients incur an out-of-pocket charge and the national median cost is $64. The report demonstrates that patients from higher socio-economic status areas are more likely to have out-of-pocket costs for all Medicare services. This suggests that high costs are not necessarily related to the quality of service, but that there is a link between capacity to pay and the cost charged.
“While the latest bulk-billing figures for GP services show that 86 per cent of services are bulk-billed, there were still more than seven million GP patients a year who had to pay an out-of-pocket charge.”
She said the impact of out-of-pocket medical bills was underscored by the even greater costs for dental care.
“The figures show that Australians paid a total of $5.7 billion for dentists – nearly double the figure paid in out-of-pocket medical costs.”
Matt Grudnoff, senior economist at The Australia Institute, told YourLifeChoices that while quality healthcare is considered essential, the reality is that it is increasingly fracturing into a two-tier system.
“It might be time for the Government to consider whether the $6.4 billion it will spend on subsidies to private insurers next year might be better put directly into the healthcare system,” he said.
YourLifeChoices members have long been vocal in condemning Australia’s “two-tier” health system, with the following comments being typical.
“It is a two-tier system – those who can afford private (whether with an insurance company or not) and those who have to wait on public lists. With dental for example, I have been waiting four years for a check-up. I needed a tooth filled due to pain; they did that and noticed other fillings that needed doing. I am still on the waiting list.” Tisme
“I was forced to opt out of private health care when I could no longer afford the premiums, not to mention the gap fees. It is becoming worse, and the waiting times for public health services are ridiculous. I waited 12 months just to get an appointment with a foot specialist. Health care is a right, not a privilege.” Patti
Are you coping with medical expenses? Are you out of pocket for some services?