Australians paying more out-of-pocket for health than most developed nations


Consumer Health Forum chief executive Leanne Wells called for action from both major parties to address spiralling costs borne by patients across the health system.

“We’re among the highest out-of-pocket spending countries in the OECD. We know that people are just not going to the GP, filling scripts, following up on specialist referrals, because of cost,” Ms Wells said.

“That’s a concern, because they’re going to be missing out on basic healthcare and having later diagnoses – meaning they’ll need treatment for more advanced illnesses.”

The issue came into sharp relief on the campaign trail in Melbourne on Monday, when a man fighting leukaemia and facing huge out-of-pocket health costs challenged both major party leaders to look after the nation’s “battlers”.

In an unscripted moment captured on live television, Rob Gibbs interrupted Mr Shorten’s press conference to share his frustration over the $20,000 he had spent on his treatment over four years – including a $1500 incurred for an MRI scan earlier in the day.

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Health Minister Greg Hunt claimed on Monday that Labor’s bulk billing plan would cost $6.8 billion, but it emerged this was based on a Health Department costing of a different proposal.

The Labor plan only applies to specialist consultations and is costed at $433 million by the Parliamentary Budget Office, part of a $2.3 billion cancer funding package.

Mr Hunt’s claim prompted Labor’s health spokeswoman, Catherine King, to write to departmental secretary Glenys Beauchamp on Monday demanding clarification of her role in “providing analysis of Opposition policy … for partisan purposes”.

Ms Beauchamp said in her response that the department had calculated the cost of increasing the Medicare rebate for all 420 cancer item numbers to the Australian Medical Association’s recommended fee, at the government’s request before caretaker mode.

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Asked if the resulting $6.8 billion figure highlighted the reality of out-of-pocket costs for cancer patients, Trade Minister Simon Birmingham said Mr Shorten had “promised the earth, but is going to deliver relatively little” after “coming out and trying to make a big hero of himself in his budget reply speech”.

“What we are doing is running our appropriately budgeted, careful approach … Bill Shorten, however, appears to have decided that there are cheap political headlines to grab in this space,” Senator Birmingham said.

“But worse than that … he hasn’t even done the effective homework to work out what it would cost, how he would pay for it, and how many people would be left out.

“It seems as if more than 400 different treatments may well be completely ignored under Bill Shorten’s policy promises.”

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Grattan Institute health economist Stephen Duckett said any effort to address out-of-pocket costs must look at the role of insurers, with increased complexity and exclusions leaving private patients with hefty medical bills.

“The people who have the biggest out of pocket costs are those with private health insurance,” Dr Duckett said.

Labor has promised a Productivity Commission inquiry into the sector, while the Morrison government has brought in a new star rating system – but back-tracked on changes to extras policies banning some natural therapies.

Ms Wells said her research showed that Australians wanted certainty about being able to access the right healthcare when they needed it, and were not reassured by the “piecemeal approach” to funding through election promises.

“If we really want to strengthen our health system what would be really helpful for the electorate to see a long term plan,” she said.

Dana is health and industrial relations reporter for The Sydney Morning Herald and The Age.

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