Almost two million Australians are avoiding essential specialist medical treatment due to unaffordable out-of-pocket costs. This alarming trend impacts the short- and long-term health and well-being of our nation’s children. Australians are facing high out-of-pocket costs. Australia’s Grattan Institute found most patients do face high out-of-pocket expenses. After all, millions of people are becoming increasingly desperate to find and afford the care they need.
Peter Breadon, the health program director at Australia’s Grattan Institute and the study’s lead. He made sure they understood the bad news was in the trend. He drew attention to the exorbitant out-of-pocket medical expenses Australians are now incurring. This has pushed many people to go without necessary care. Those findings should be a beacon of light during a time when our healthcare system continues to struggle with costs and affordability.
One of those directly affected is 79-year-old Eddie Rushforth from Mildura. He and his wife Wendy focus on the economic and health care crises that most seniors are facing. Mr. Rushforth has been five months waiting for a colonoscopy. He has to get quarterly CT scans of his abdomen. The couple cannot afford the $550 up-front cost of a CT scan. Even once they receive a Medicare rebate of $459, they would still have an out-of-pocket expense of $95.
Financial Strain on Patients
The increasing burden directly impacts hard-working patients just like the Rushforths, who have toiled their whole lives. They are forced to be like the rest of America and “sit at home waiting to die,” without access to care. The couple’s plight highlights the growing toll being inflicted on everyone who depends on specialist visits and care.
The Rushforths face logistical challenges. For example, they may not be able to undertake a 4.5 hour trip to Adelaide—the nearest capital city in South Australia—where many of these services are located. This geographical barrier complicates their healthcare journey further worsening what is already a bleak financial scenario.
Veteran health advocate Chris Kane has long called for reforms to Medicare billing policies that would reward health outreach. He argues that existing pricing arrangements are driving ever more Australians to not seek out specialist care. Breadcrumbs Breadon’s passionate plea underscores an imperative for change. He makes the case that any specialist that charges three times or more of what the federal government reimburses should be banned from ever receiving Medicare subsidies. This suggested amendment is to incentivise more equitable pricing behaviours for the greater health of all Australians.
Impact on Healthcare Access
Since 2010, specialty fees have increased by 73 percent beyond inflationary increases that have made even sustaining treatment nearly impossible for so many patients. The growing financial burden has called into question health equity and access across urban and rural Australia. With costs increasing, millions of people are just one decision away from compromising their health in service of their financial well-being. This dire circumstance threatens their health and safety.
The government is finally responding to growing demands for transparency in medical costs. Ultimately, they want to relaunch the Medical Costs Finder website to remedy these shortcomings. This national campaign is designed to help Australians better understand their out-of-pocket fees for medical or hospital-based treatments and services. By increasing transparency, federal leaders are seeking to give patients the tools they need to make smart decisions about their healthcare alternatives.
Despite these efforts, many remain skeptical about whether such measures will be sufficient to address the systemic issues within the healthcare system. In February, the federal government, states and territories passed the National Agreement on Closing the Gap. They chose to put off the new National Health Reform Agreement until next year, leaving millions of patients in limbo as they wait for vital policy improvements that could make care more accessible.
Future Considerations
The increased scrutiny on the price of medicine and ability to reach care speaks to the systemic failures of the Australian system. Stakeholders from various sectors are calling for urgent reforms that prioritize patient needs while maintaining sustainable practices for healthcare providers.
Like the Rushforths, more Australians are experiencing the sudden shock of increasing medical costs. This means we need to start taking action now to make sure that everyone has equitable access to the specialist care they need. Without dramatic adjustments in policy and price mechanisms, millions of people are left to choose between a rock and a hard place. They end up having to go bankrupt to save their lives.
