Health Care Affordability Needs A Makeover

There’s a big difference between having a bad hair day and getting sick, writes Jennifer Doggett, and that’s why we need more action on health care affordability

Former health minister Kay Patterson was fond of asking people who complained about the cost of health care how much they paid their hairdresser. Her not very subtle point was that if someone could afford $60 for a cut-and-blowwave then they shouldn’t complain about a similar expense to see their GP.

What the then Senator Patterson didn’t take into account was that the need for medical care is generally much more urgent (and less predictable) than the need for a haircut.  People don’t plan to get sick or have an injury. And they don’t plan to pass on an illness to other family members who then also require medical care. Unlike a bad hair day, a period of sickness can restrict earning capacity making it more difficult to come up with the up-front payment required for many health services. These factors make budgeting for health expenses more difficult than planning for other areas of household expenditure.

From a community perspective, there are also good reasons why we should be more concerned about the consequences of leaving a health problem untreated than delaying a visit to the hair salon. When people can’t afford timely and preventive health care, their problems get worse and ultimately require more expensive treatment. This ultimately has a greater overall social and economic impact on society. The same cannot be said for delaying hair appointments. People with dark roots and untamed frizz are not clogging up emergency departments and diverting scarce hospital resources from other areas of need because they couldn’t afford high quality hair care advice when their problems were first identified.

There is substantial evidence that in Australia many people struggle to afford the cost of medical and health care. Last week the Australian Bureau of Statistics (ABS) released the results of the first national Patient Experience Survey, examining health care for Australians in the last 12 months.

The survey found that some people delayed or did not get some types of medical care due to cost.  For example in the past year:

  • 1 in 16 people had delayed seeing or not seen a GP;
  • nearly 1 in 10 people with a prescription had delayed getting or did not get their medication; and
  • around 1 in 10 people referred to a medical specialist had delayed seeing or did not see the specialist.

This confirms other Australian and international research which has found that many people in our society forgo recommended medical treatment because of cost issues.

This risks undermining the success of many of the planned health reform initiatives.  It doesn’t matter how well integrated, ehealth-enabled or multi-disciplinary a new primary care centre is if someone in need of a GP can’t afford the $60 upfront payment needed to get in the front door. Often the issue is not so much the total cost but the available cash required to access care. Our system of Medicare and private health insurance rebates, coupled with safety nets which usually require significant outlays before they kick in, can create problems for those without ready access to cash and savings. Many of these people would have no difficulty affording the cost of care over the longer term, if they could plan and budget for this expense.

A health credit card and a single safety net for health care, as proposed by the CPD, would solve this problem without requiring a major injection of additional funding or a restructuring of the health system. It would particularly assist people with chronic conditions whose health care expenses are – through no fault of their own – much higher than average.

Structural reform of our health system is important and should be pursued by whichever party wins the election. However, for this reform to deliver better health outcomes across our population we need to also ensure that essential health services are accessible to all who need them.

When 10 per cent of people requiring prescription medication or specialist medical care can’t afford to access these services within the recommended timeframe, we have a problem.

Any politician who doesn’t agree should go and get a haircut and a real job.