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Government policies driving health divide

Government policies driving health divide - Featured Image

More than a fifth of patients in some areas have avoided seeing a doctor or filling a prescription even though they need care, with many saying they are put off by the cost.

Although a majority Australians report little difficulty in seeing their GP, the latest snapshot of patient experience from the National Health Performance Authority shows that in parts of rural New South Wales, Queensland, Western Australia and Tasmania, many people are avoiding or delaying treatment because of cost, running the risk of developing more serious and expensive-to-treat health problems.

Just as worrying, in some areas up to one in 10 say they cannot afford to fill their prescriptions, raising concerns around the management of serious chronic diseases such as diabetes and the treatment of infections.

The results underline the city-country divide in access to affordable care. While Australia-wide it was common for between 15 and 25 per cent of patients to complain of how long they have to wait to get an appointment with their GP, only around 2 to 4 per cent of those in major metropolitan areas said they could not afford to see their doctor, while in rural and regional Australia the rate was two to four times as high.

Related: Copayments and the evidence-base paradox

Chair of the AMA Council of General Practice Dr Brian Morton said strong competition between medical practices in urban areas drove high rates of bulk billing and helped contain patient out-of-pocket charges.

But the relative scarcity of doctors in country areas, and the need for adequate remuneration to recruit and retain them, encouraged lower rates of bulk billing and higher patient charges.

Dr Morton said this was not the fault of individual practitioners, and was instead the result of Federal Government policies including to screw down the value of Medicare rebates and hold back investment in training and support for rural GPs.

Dr Morton said of even greater concern when it came to preventive care was the relatively high instance of patients delaying or forgoing medicine because of expense.

He said patients, particularly those with a number of co-morbidities that had to be managed simultaneously, often faced a hefty monthly pharmacist bill.

For instance, he said, a patient with high blood pressure might be on three different medications which would cost more than $100 a month. If two or more people in a household have on-going courses of drugs, the costs can quickly mount up.

The consequences of foregoing treatment can be severe, Dr Morton said. Patients identified as at risk of heart disease who decide not to take prescribed statins can suffer a build-up of plaque in their blood vessels that can lead to blocked arteries, blood clots and other serious circulatory problems.

Protecting affordable access to care was at the centre of the AMA’s campaign late last year and early this year against the Abbott Government’s plans for a GP co-payment.

The AMA warned that charging a co-payment would deter many of the sickest and most vulnerable in the community from seeking care, creating the likelihood that their health would deteriorate and need more significant and expensive treatment later on.

And the latest official figures on national health spending suggest the pressure on patients to contribute to the cost of there is increasing.

The Australian Institute of Health and Welfare reported in September that the Commonwealth’s share of total health spending has plunged from almost 44 per cent to 41.2 per cent in just five years.

At the same time, individuals and families are shouldering more of the burden. In the past decade, the contribution of patients to the cost of health care has grown by an average of 6.2 per cent a year in real terms.

Adrian Rollins

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