The high medical gap fees are having a serious impact on people’s health care.
The high medical gap fees are having a serious impact on people’s health care.

Why Aussies can’t afford to go to the doctor

AUSTRALIANS are spending nearly $30 billion on out of pocket health expenses a year, according to a new report that exposes an affordability crisis in health care.

And the bill is so massive, 1.3 million patients delay or don't see a doctor, have a medical test or use a medicine because they can't afford it.

This $30 billion - which equates to $1,195 per person - includes charges for medicine, glasses, dentists, hearing aids and wheelchairs.

Hefty doctors charges are adding to patient costs with a massive $3 billion a year in medical gap fees not covered by Medicare or health funds.

New data on out of pocket spending on Medicare services released by the Australian Institute of Health and Welfare has also exposed the importance of the rising bulk billing rate as a myth.

Two in three patients pay a gap fee to see their GP.
Two in three patients pay a gap fee to see their GP.

While it is true the number of medical services bulk billed has risen to record levels of 86 per cent this is not the same as the number of patients being bulk billed.

The AIHW data shows only 66 per cent of patients are bulk billed by their GP and one in three are paying up to $51 out of their own pocket to see their doctor.

In total half of all patients incurred out of pocket medical expenses for either GP or specialist care, blood tests, X-rays and other scans the report shows.

It is worse for specialists with seven in ten patients making some out of pocket payment to cover their bill, with some patients forking out up to $177 in gap fees.

Of the 9.1 million patients who had a scan in 2016-17 one in four paid an out of pocket fee as high as $199.

Nearly half, (44 per cent) of women paid an out of pocket fee for out of hospital obstetric services.

 

The high medical gap fees are having a serious impact on people’s health care.
The high medical gap fees are having a serious impact on people’s health care.

 

More than half the women in Northern Sydney paid more than $227 out of their own pocket each time they saw their obstetrician, ten times more than women in Gippsland who paid gap fees of just $21.

Out of pocket costs faced by patients vary by region with those in Western Queensland paying $104 a year while those in Western Sydney facing bills of $206 on average.

The ten per cent of patients with the highest out of pocket medical costs in Northern Sydney were paying up to $876.

Across Australia 1.1 million people spent $601 or more on medical gap fees.

Seven in ten residents in the ACT had to pay medical gap fees, the highest proportion in the nation and their gap fees were also larger in size.

Northern Sydney residents were the next most likely (62 per cent) to pay medical gap fees while residents of the city's west and South West were the least likely to pay gap fees (32 per cent).

In Melbourne it was residents in the South East of the city that were most likely to pay gap fees (53 per cent), those in the North West of the city were least likely to face gap fees (41 per cent).

In Queensland residents in the Brisbane North area were most likely to face medical gap fees (55 per cent) while those on the Gold Coast were least likely to pay gap fees (43 per cent)

In South Australia residents of Country South Australia were most likely to face gap fees (57 per cent).

In Tasmania 60 per cent of patients faced gap fees, the third highest number in the nation after the ACT and North Sydney.

 

Patients don't get scripts filled because they can’t afford to. Picture Getty Images
Patients don't get scripts filled because they can’t afford to. Picture Getty Images

 

The high medical gap fees are having a serious impact on people's health care with the report revealing 663,000 people delayed or did not see a GP due to cost.

A further 274,000 people delayed or did not have a scan or a medical test due to cost and 538,000 people delayed or did not see a specialist because of the cost.

Growing medical gap fees are being driven by the government's four year freeze on Medicare rebates and they are undermining the value of health insurance.

Health Minister Greg Hunt has asked the Chief Medical Officer Brendan Murphy to report on the problem and suggest solutions which are expected to include a website where patients can check medical charges before choosing their doctor.



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