Out-of-pocket health costs (OOPs) are a major challenge facing the Australian health system. Australians pay for a higher proportion of total health care in OOPs than do citizens of almost all OECD countries (see infographic below). In fact, OOPs are the third largest funder of health care in Australia, after Commonwealth and State/Territory Governments.
Yet despite the importance of OOPs in influencing access to health care, this area is a policy vacuum. We have no policy framework for addressing OOPs across the spectrum of the health system and no government department or body that takes responsibility for overseeing how these costs impact on consumers. In fact, we lack even the basic data on what consumers pay for a range of different forms of health care and how these impact upon different groups in the community.
A recent survey undertaken by the Consumers Health Forum demonstrates that consumers’ experience of OOPs is frequently unpredictable, inconsistent and inequitable. It showed that for many consumers OOPs create financial hardship and stress at an already difficult time of life. For some they mean a choice between vital health care and other necessities.
The establishment of the Ministerial Advisory Committee on Out-of-Pocket Costs, by the Federal Health Minister Greg Hunt in January 2018 was a positive indication that the Government was seriously looking at this issue. However, this group is dominated by representatives of the medical profession with only minimal consumer representation. It had not been able to make any noticeable progress towards addressing the problems facing consumers with high and unexpected health care bills.
AHCRA believes that the problems associated with OOPs can only be addressed through a consumer-focussed approach. This needs to include detailed research on the OOPs consumers experience across different areas of the health system. It also needs to involve much stronger consumer representation in any working groups or committees advising the Government on this issue.
Closing the Gap
AHCRA believes that Indigenous health is the number one health issue facing Australia. It is unacceptable that in Australia today Indigenous people have significantly poorer health and a much lower life expectancy than the non-Indigenous population.
AHCRA supports a comprehensive population-wide approach to Closing the Gap that incorporates the social determinants of health and empowers people to take control of their own lives and improve their health through culturally appropriate mechanisms.
At the centre of efforts to close the health and life expectancy gap are community- controlled health services which provide person-centred and to culturally relevant care, including both a biomedical and preventative health focus. These services and their representative body NACCHO, require more consistent and assured long-term funding to enable effective planning and capacity development that will deliver the best possible outcomes.
AHCRA supports the full implementation of the National Aboriginal and Torres Strait Islander Health Plan and allocating additional funding, including resources currently going into the PHI rebate to achieve the following:
- Allocate secure long-term funding to progress the strategies and actions identified in the National Aboriginal and Torres Strait Islander Health Plan Implementation Plan.
- Provide secure, long-term funding for the Rural Health Outreach Fund and Medical Outreach Indigenous Chronic Disease Program.
- Allocate sufficient and secure long-term funding to the Aboriginal Community Controlled Health Sector to support the sector’s continued provision of Indigenous-led, culturally sensitive healthcare.
- Build and support the capacity of Indigenous health leaders by committing secure long-term funding to the Indigenous National Health Leadership Forum.
- Reinstate funding for a clearinghouse modelled on the previous Closing the Gap clearinghouse, as recommended in the latest draft of the Fifth National Mental Health Plan.