Billions in out-of-pocket costs show urgent need for investment in preventive health: RACGP

Doug Hendrie

16/08/2018 3:51:21 PM

A new report shows that Australians are spending almost $3 billion a year on out-of-pocket non-hospital healthcare expenses.

RACGP President-elect Dr Harry Nespolon has called on the Government to increase funding for the Medicare rebate by at least 18.5% to make up for the five-year freeze on rebates.
RACGP President-elect Dr Harry Nespolon has called on the Government to increase funding for the Medicare rebate by at least 18.5% to make up for the five-year freeze on rebates.

Half of all Australian patients – almost 11 million people – faced out-of-pocket expenses for healthcare outside of a hospital in 2016–17, a new report from the Australian Institute of Health and Welfare (AIHW) shows.
Patients are shelling out $3 billion a year on non-hospital Medicare services. 
The median expense was $142, but around 1.1 million people spent $601 or more, according to the ‘Patients’ out-of-pocket spending on Medicare services 2016–17’ report.
RACGP President-elect Dr Harry Nespolon told newsGP the report emphasises the need for urgent investment in preventive healthcare.
He called on the Federal Government to increase funding for the Medicare rebate by at least 18.5% to make up for the five-year freeze on rebates, echoing the RACGP’s submission to the Medicare Benefits Schedule (MBS) Review 
‘Half of Australian patients are experiencing increasing out-of-pocket costs, with the highest costs coming from services outside of the general practice setting,’ he said.
‘Patients want to spend more time with their GP, and it has been shown that the more time a patient spends with their GP the better their long-term health will be.
‘More effort must be made to keep patients out of hospitals and away from costly out-of-pocket expenses.’
The report showed that nearly a quarter of total out-of-pocket non-hospital costs came from GP visits.
Dr Nespolon said that much of this expense could be attributed to patients who needed longer appointments, where the Medicare rebate was lacking.
‘The reality is, long and complex consultations are not properly compensated by patients’ Medicare rebate,’ he said.
‘[This] means that patients who can afford longer consultations must pay an out-of-pocket expense and those who can’t are at risk of struggling with their long-term health.’
The AIHW report showed that 21.1 million people had at least one Medicare-subsidised visit to their GP in 2016–17, and 34% of these patients paid something towards the cost of the service.
An estimated 1.3 million people over the age of 15 delayed or did not seek help from GPs, specialists, imaging or pathology services when they needed them.
Federal Health Minister Greg Hunt said he had requested that the Commonwealth’s Chief Medical Officer, Dr Brendan Murphy, work to address ‘large and sometimes unanticipated out-of-pocket medical fees some patients face.’
The AIHW report comes on the same day Minister Hunt announced new Medicare data showing that bulk-billing rates were now at a historic high of 86.1% in 2017–18, with an increase of more than 5.7 million services a year.
But, according to Dr Nespolon, these statistics refer to the percentage of services bulk billed, rather than the percentage of patients bulk billed for all of their care.  
Dr Nespolon added that the rate of increase in bulk billing is slowing, with the 0.4% rise in the past 12 months the lowest since 2009–10.
The peak body for Australia’s public and not-for-profit hospitals, the Australian Healthcare and Hospitals Association (AHHA), described the Medicare data as misleading.
AHHA Chief Executive Alison Verhoeven said that high bulk-billing figures give the impression that the patient does not have to pay in 85% of all GP and similar doctor consultations.
‘The reality, seen in the AIHW report, is that across Australia one in every two such patients accessing Medicare-subsidised services had to pay something out of their pocket in 2016–17,’ Ms Verhoeven said.
Health Minister Greg Hunt said Medicare funding is now at record levels.
‘These figures released today can only be achieved thanks to Australia’s world class GPs and doctors. I want to thank them for their tireless work in supporting Australian patients,’ he said.

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Dr Viviane S Leventhal   17/08/2018 10:41:03 AM

To Dr Harry Nespolon , I agree with your findings . I am a Life member of the RACGP member of AIMA & Specific Interests & ASLM . I know that AIMA has an interest in Researching new modalities to determine if they provide E-Based solutions for better outcomes especially in Chronic Disease management and wanted to make you aware that there are researchers with the capability of doing that & that the work will be happening . Also to point out that Toronto Primary Health Physicians ( GPs ) have circulated their proposal that more research be done @ the GP level globally in collaboration with other countries & that they be the Lead Team . I correspond with Dr Vicki Kotsirilos