16th Aug 2018
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GP visits too costly for 1.3m needing treatment: report
Author: Janelle Ward
doctor and patient

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?

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    COMMENTS

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    16th Aug 2018
    5:24pm
    Health Insurance costs around $2500. Perhaps cut down on grog, smokes and fast food , then you get the benefit of health cover and at the same time need less medical attention
    koshka
    17th Aug 2018
    11:36am
    As I understand Health Insurances do no cover gaps when Drs. charge more than the schedule fees. It cost me $55.oo of the $115.oo fees my GP charge me for a 10 minutes visits a couple of days ago...We really need, urgently, a RI in medical business as well on Optometrists. Medicare is being abused, as well. Sometime GPs charge double time to MC to avoid charging the patient.
    Rae
    17th Aug 2018
    2:25pm
    The Medical Union AMA needs to be curtailed so more doctors can be imported to service country areas and areas where fees are excessive.

    This sort of salary claim would be illegal if it were any other union.
    Knows-a-lot
    17th Aug 2018
    4:02pm
    Perhaps if the rich (individuals and corporations) paid their fair share in taxes, then Medicare would have enough funds to cover such costs. The AMA promotes greed among its constituents.
    TREBOR
    17th Aug 2018
    10:18pm
    Yes - it's funny t hear the 'let the user pay' when in the clutches of THE most Unionised group in Australia - but when a building Union or truck drivers wants a fair rate of pay and safety conditions..... well ... how about we make the user pay?

    The most Unionised organisations in this nation are business, doctors, police, fire brigades, and nurses.... never a peep against them in the War Against Unions - maybe they are considered part of City Hall and are thus sacred cows.

    Criticising those is like criticising motherhood.... *rolls eyes* ....
    TREBOR
    17th Aug 2018
    10:18pm
    Oh - and lawyers... forgot them...
    Cowboy Jim
    18th Aug 2018
    4:15pm
    Well yes - that is where we are, paid $4850 for the 2 of us up front, pointless leaving it in the account as you get no interest but you get a discount for paying ahead. Sure I would rather have the money for other purposes but we feel better in old age. No wonder young ones drop out in great numbers.
    MICK
    17th Aug 2018
    10:02am
    We supposedly have Medicare but since inception the out of pocket costs have been increasing yearly. We now only have part Medicare and health is subsidised but no longer free unless you collapse on the street and get taken to the nearest hospital for treatment..
    Not a Bludger
    17th Aug 2018
    3:40pm
    OMG - Mick again, grizzling ang groaning and practising being permanently outraged.
    Check out the price of a dishwasher or refrigerator etc repair, Mick, before you again repeat your union and Getup propaganda.
    Knows-a-lot
    17th Aug 2018
    4:04pm
    Easy for a smug, rich Lieberal Party shill to say...
    roy
    17th Aug 2018
    4:16pm
    Well said Not a Bludger but MICK is too old and sour to change now. Perhaps he'll be h happier and more contented in the next world.
    TREBOR
    17th Aug 2018
    10:20pm
    Pardon me, roy - but Mick was just stating the facts.....

    Shame on you all for ganging up on someone offering reality into the discussion.

    I see there's a roy and a Roy - Pardon me, Roy - is Mick the cat that chewed the Lib's views?
    Rae
    17th Aug 2018
    10:56am
    I've been in health insurance since 1971. I used it once for a baby when I needed an extensive stay in hospital due to complications. There were some out of pocket costs but nothing like those we experience now.
    My son needed a $1800 test for blood in the urine. He was fine and the test wasn't covered by either medicare nor the insurance company. Waste of money really.
    I needed a basel cell removed and used a cosmetic surgeon. Bad move. Not covered by medicare nor the health fund once again and cost $1200.
    I'm still in private but tend not to use it. I rarely bother with the doctor. It's a $46 out of pocket to see the GP anyway and no concession for medicine as I'm self funded.

    Health Insurance will be the first insurance I ditch as times get tougher.

    I would love that nearly $7 billion to go to the health system instead of the insurance system and then we wouldn't need private insurance at all.
    Triss
    17th Aug 2018
    2:16pm
    I would guess that if the $7 billion went into the health fund all the practitioners would increase their fees, that seems to be what happens when government steps in.
    Rae
    17th Aug 2018
    2:30pm
    I think the AMA have created the shortage of doctors and need curtailing. They are only another form of union after all.

    Medicare could have been a Government run entity with staff paid as teachers, nurses, firefighters are and university costs cut through scholarships.

    The nurses, teachers, police seem able to cope with average wages when told they are very essential but we can't afford what they are really worth so suck it up for duty of service.
    George
    17th Aug 2018
    8:59pm
    Yes, AMA is an union with excessive influence in both Setting Fees (Illegal in any other area), and also preventing import of more medical personnel or increasing local supply through University places.
    We need a Govt with guts to change this situation - both Liberal & Labor are incapable, and we can't see a Trump-like alternative to act independently to address the influence of such vested interests.

    Only option is to Vote Out all sitting MPs (by putting them last in preferences), and see if the whole system can be shaken up with more Independents, etc.
    tisme
    17th Aug 2018
    11:08am
    I dont smoke/drink/eat out/go out , on a pension who can afford it mostly goes on rent. but being a pensioner means loooooooooooooong waits for specialists dentist 4 years and counting. ear doctors a year , etc etc I always thought the government was trying to create a health system like America
    Knows-a-lot
    17th Aug 2018
    4:07pm
    The scumbag Lieberals certainly are. Boot the bastards out of office at the next election. At least an ALP government would have a heart.
    fairgo
    17th Aug 2018
    11:12am
    Over the years sitting back observing the posts it has only been recently that I have posted.
    I have observe 2 participants as really trolls hoping to inflame others or to get their kicks. No doubt many observe this childish behaviour.
    TREBOR
    17th Aug 2018
    12:37pm
    You ain't got nuthin' on me, copper!
    roy
    17th Aug 2018
    12:44pm
    fairgo, would you please name him or her or them to see how many of us agree, thanks.
    TREBOR
    17th Aug 2018
    2:10pm
    Fair enough - I'm all for open government and accountability...... a free exchange of information is one guarantee of a free society...... JFK said that....
    TREBOR
    18th Aug 2018
    12:51am
    I nominate Le Geezer Ancien, who may well be olbaid - and heemie....

    I'm sure there are a few other contenders..... Bonny is gone but the stench of corruption remains.... the rain comes down and washes the garbage from the streets.. but the stench remains.... the stench of corruption and decay ...

    Big Al has a chance... maybe a bronze...... could be a silver.... has the stench of one who feels an Entitlement to tell the peasants what is best for them.....
    Cowboy Jim
    18th Aug 2018
    4:20pm
    L'Ancien Geezere - J'aime ce nome. Out est-il maintenanat??
    koshka
    17th Aug 2018
    11:42am
    Health care, Transport, Education are the most important aspect of our existence so it should be PUBLIC. Yes I may sound a C...but think about...Our present Gov only cares about the rich get richer. and they go to Church!!! Just a hypocritical show off.
    Knows-a-lot
    17th Aug 2018
    4:09pm
    Couldn't agree more!
    Cowboy Jim
    18th Aug 2018
    4:24pm
    koshka - you are right you sound like a Commo, wonder how much you contributed. People I know who want everything for free have been on the take for most of their days. Comrade Knows-a-lot is right there with you, do not be sooo envious!
    koshka
    17th Aug 2018
    11:46am
    About Public services we should give to Gov. all we pay to Private Health Insurances...to Universities...to motorcars Insurers etc. so the Gov would have the resources to provide us with honest services and no make money as these Private enterprises do...never satisfied blind greediness...
    Rae
    18th Aug 2018
    9:10am
    Yes indeed. If you cut the profit takers and shareholders out it is less expensive and more efficient. Privatisation is a con in the delivery of certain essential services and utilities.
    Joy Anne
    17th Aug 2018
    12:02pm
    Not everyone Drinks, Smokes and eats Fastfood. I don't. I was in a Health Fund had to opt out on Penaion pay $600 a fortnight in rent. So your comment is bias especially for Pensioners.
    Rae
    17th Aug 2018
    2:38pm
    Yes there is a point when it is no longer affordable and it's getting closer for a lot of us. Pity about the tens of thousands of $$$ we have already paid. I wish I had hindsight sometimes. That money in a dedicated account would be terrific to have now.

    Who would have dreamed the insurance industry and medical industry would become so greedy.

    Also olbaid fails to mention a lot of disability in later life is due to poor work practises and mismanagement. Especially for physical work sites.
    TREBOR
    17th Aug 2018
    10:23pm
    And never forget, Rae, that many 'responsible managements of business' have divested themselves of any responsibility for disabilities developing in older age, due to the simple ability to just boot out their workers and treat them as part-time casual and as contractors... no responsibility for long-term disabilities developing when you can do that.

    They're all thieves and liars - all the way to the top of government in this nation... ye've my word on it.
    Rae
    18th Aug 2018
    9:11am
    It's a shame TREBOR that a Nation that prided itself on fairness has sunk so low.
    Old Man
    17th Aug 2018
    12:14pm
    Reading the article suggests that the main cause of health care is the lack of control on the fees charged by medical practitioners. I can see no way to fix this as medical practitioners are, in the main, businessmen and businesswomen. Any business sets its prices because of market forces and I can't see how any government can dictate to a private citizen how they should conduct their business.

    A solution could be to establish government run clinics staffed by doctors on a salary but these would not be available Australia wide. I don't know how people in rural and remote areas finding it too hard to get to a pharmacist or a medical specialist can be helped unless governments subsidise those services. There may not be enough custom to justify pharmacists and specialists to establish a business in rural and remote areas.

    I know there are stories around as to the hardship suffered by people who have been placed on a waiting list in the public health system but I wonder what the percentage is of those people as against those who get treated in a timely manner. Governments cannot be all things for all people and even the best legislation is the one that disadvantages the least amount of people.
    TREBOR
    17th Aug 2018
    2:13pm
    Partial socialised medicine with doctors on salary (as they are in hospitals etc as interns and such)?? ... Truly we have the most curious mix of doctoring...... they can be business people on salaries and retainers for certain jobs - my old doc down south was on call for obstetrics and made a motza but the hours were deadly. He picked up a retainer plus some extras while carrying on his private practice as well.... hmmmm...

    He also used to fly his own plane once a week to a small village that had no doctor..... once I sat down with him and suggested he needed a holiday, since if he went down, so did we all.

    I'm a pretty good quack myself..... just not qualified.
    Knows-a-lot
    17th Aug 2018
    3:59pm
    We can thank to hopeless Lieberal government for this, and greedy doctors.
    George
    17th Aug 2018
    8:25pm
    Matt's comment “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” is his own. NOT necessarily shared by most YLC members as he seems to suggest with his next comment about members condemning the two-tier system.
    The two-tier system is a valid approach to give CHOICE, otherwise it would be a Communist system with no choice and some people may end up suffering pain / dying waiting in queues!

    However, BOTH Medicare and the Private Health Insurance (so-called, but only paying limited amounts back, thus not bearing the Risks) are BROKEN.
    Medicare must pay reasonable fees to Medical Specialists, but then also insist on Capped fees with say max 25% extra allowed based on experienced / experts being able to charge.
    Private Health Insurance MUST pay for ALL Gaps, not some or partially, even Pharmaceuticals gaps - then we can call it an Insurance system.

    We also need competition, hence import as many more Medical Specialists as needed to get this competition going.

    May a RC is needed urgently into the whole Medical system MESS, as politicians don't seem to have a spine for real reform actions!
    TREBOR
    17th Aug 2018
    10:27pm
    Yes - Australians have a choice - pay too much for too little and with huge gaps anyway - or pay via taxes without subsidies and only get real treatment in an emergency (as defined by doctors in their Union).

    I think pretty much the entire range of REAL ills in the current medical care system have been discussed here by a few enlightened souls who know the difference.

    That $6.4B or $7B (the figures seems, like most government figures, malleable) would be far better put into the overall health system. Anyone who wishes to use a private hospital or a private fund can take the user pays system so beloved of the 'right'... and pay full price.
    George
    17th Aug 2018
    11:40pm
    I have to disagree that "$6.4B .... would be far better put into the overall health system", as then those in the private system can also ask that they be exempt from the Medicare Levy - if they are to use a fully privatised system. Getting another $6.4B into the public system also would not improve that system if everyone then went back into the Public system as the Private system would cost too much.

    The system we have - of the Govt contributing some (limited) money to the private sector is OK as long as they also get on top of the many issues I and others have raised and fix this blasted messy system.

    The main problem is the Out-of-Pocket issue - in both Medicare and the Private Health System - laws need to change to stop this gouging of customers - that's why a RC may be needed.
    TREBOR
    18th Aug 2018
    12:28am
    I'm just sticking it to the acolytes of the 'user pays' idea...... you want... you pay..... everyone else rides on their taxes...
    Rae
    18th Aug 2018
    9:21am
    As incomes continue to fall and prices rise a lot of the Health Insurance Funds are going to go into receivership taking our money with them. There is no way they can afford the boomers now with young workers unable to afford the insurances.
    Surely those in policy development can see this coming.

    This is yet another dumb Thatcher/Reagan? Howard/ neo-liberal failure.

    Like Electricity. They took a perfectly good, efficient and cheap product and stuffed it up to the point of near collapse and unaffordability for around 40% of the population.
    Cowboy Jim
    18th Aug 2018
    4:28pm
    Rae - in that case it is cash hidden away somewhere when you need it as a sort of self insurance, just make it US$ as they do not change their notes much and all are freely useable at any time.
    TREBOR
    19th Aug 2018
    1:43am
    So Rae simply demands your payments back from a health fund and then turns it into US dollars, Jim? Maybe puts it in the Channel Isles like olbaid, so it pays no tax, and can be drawn on at leisure to cover costs?

    Right you are, Guv...

    Sounds like a government Future Fund put aside for their exclusive benefit... just a little peccadilo put aside from 'consolidated revenue' to ensure that politicans etc never suffer any loss due to mismanagement of the economy... we'll all do throw our cash into an offshore account tomorrow.

    That'll fix it!
    TREBOR
    19th Aug 2018
    1:45am
    So olbaid/Old Geezer can bring in untaxed profits and then use that to establish more profit that can be sent to the Channel Isles.....

    Sounds like a fine argument for a tax on all incoming and outgoing dollars to me... that'll fix the budget emergency.

    (next argument - I'm waiting with a loaded gun)....
    Anonymous
    19th Aug 2018
    2:19am
    wrong again Trebor
    Rae
    19th Aug 2018
    8:34am
    TREBOR I can't see any solution except something like a 0.05% transaction/transfer tax on money.

    Far too much legislation means the biggest global players pay nothing.

    As to us all moving our cash off shore. We actually could and it would be a very nasty sort of revenge indeed. The sort served cold.
    I've been gradually doing it myself as I have no faith in either party to do anything other than continue to deplete revenues and use further austerity in the nutty class warfare they are waging.

    You can't bring in untaxed profits though TREBOR unless you have a subsidiary you borrowed heaps off at ridiculous interest rates. Then you might actually get an ATP check like Murdoch did.

    Perhaps you could borrow heavily from the ex to invest. I'd run it by the accountant.
    Sophie
    20th Aug 2018
    11:45am
    QUOTING OLBAID...

    "Health Insurance costs around $2500. Perhaps cut down on grog, smokes and fast food , then you get the benefit of health cover and at the same time need less medical attention"

    I don't usually post on this section of the forum..but the above comment caught my eye as it is the first on the thread. I am appalled that you have the audacity to say such a thing olbaid..HOW DARE YOU? Do you know people's circumstances? What gives you the right to make such derogatory remarks to some members of the community who might be doing it tough?

    Now to the topic...I think healthcare should be a basic human right in a wealthy country such as ours. People who need it should not have to pay through the nose. people should not have to forego GP visits because they can't pay. However..I think many people front up to their GP for things so minor that wastes both time and money. How to deal with this requires some thought...but it definitely is an area that needs attention.
    OnlyGenuineRainey
    20th Aug 2018
    9:15pm
    Have to agree with you about olbaid, Sophie. Such arrogance! What a nasty piece of work!

    And olbiad is WRONG. Health insurance costs many folk much more than $2500 per year, firstly because of the Lifetime loading, and secondly because having health insurance renders you liable to pay gap charges often whereas the uninsured often get the same treatment free. I know of cancer patients who are very relieved they don't have insurance, and one with private insurance whose gap fees sent the family bankrupt.


    I don't drink, smoke or eat fast food (never have!), yet I have substantial health care needs due to neglect and deprivation in childhood and the after-effects of serious illness as a baby. My partner has very extensive health needs due to neglect and abuse in childhood and some significant workplace injuries.

    People who make nasty assumptions about the cause of other people's problems are just disgusting and vile, olbaid. I wonder you don't have major health problems resulting from not having a heart! And being so bitter and twisted and judgemental usually makes for hardened arteries and a damaged brain. (Well, the latter you DO have. That's very apparent from the garbage you write!)

    Yes, Sophie, healthcare SHOULD be a basic right in our wealthy country.
    lainee
    20th Aug 2018
    10:35pm
    Some decades ago (50's 60's) in Qld, the Ambulance Centre offered free first aid. This reduced many GP or public hospital visits. The ambulance officer advised people if they required GP or Hospital treatment or further investigation. I used the service 3 times--- Once when 4 years old my foot caught in a bicycle wheel when a passenger on my father's bike-- My heel was severely lacerated which the Ambulance Officer cleaned and dressed, Then I spilt some boiling dripping on my leg when 10 years old. Once again it was examined at the Ambulance Centre and advice given, but didn't require medical treatment. The third time much later I had a swollen nose from a face whack.After 3 weeks I consulted the Ambulance who diagnosed a minor break but said it was probably knitting by now. People also used to request info and advice from Pharmacists re minor ailments.Their advice was respected and often resulted in seeking further medical interventions. I don't know why this type of service was ended.
    Noodles
    21st Aug 2018
    3:53pm
    I can name four clinics where I live who bulk bill and I am sure there are more. If people look they will not have to pay to visit a gp


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