New evidence from the NRHA shows that, without some special provisions being made, a seven dollar GP co-payment for patients currently being bulk-billed would have particularly severe consequences for people in rural and remote areas - and their GPs.
Rural people already postpone or avoid medical consultation at higher rates than people in the cities. This is the case for 17 per cent in the Major cities but for 20 per cent of those in regional areas and almost 35 per cent of those in remote areas.
Calculations using data available to us show that if the Budget decision relating to GP co-payments was to be implemented evenly across the board, the average out-of-pocket cost per service for seeing a GP would almost double in all geographic areas. This would be after allowing for the impact of the ten-consultation rule and the new safety net.
If no special allowances are made, people living in Outer regional and Remote areas will, on average, pay a higher per service out-of-pocket cost than those in the Major cities and have less services per year.
In Very remote areas people will pay, on average, a lower cost per service than city people but will have only 2.9 GP services a year compared with 5.8 per year in the Major cities and 5.9 a year in Inner regional areas. Some people, particularly in more remote areas, have no access to a GP at all and, for them, a seven dollar co-payment would be little more than a pleasant dream.
Despite such disadvantages it is people in regional and remote areas who have poorer health and face greater health-risk factors. There is a gradient from Major cities to Very remote areas in a number of indicators of socio-economic status, such as the proportion of low income families with children and the proportion of school leavers who participate in higher education.
The consequences of these social vulnerabilities and of poorer access to primary care include the higher rates of potentially preventable hospital admission for rural people that already exist: 2,600 per 100,000 in Major cities compared with 6,430 per 100,000 in Very remote areas. It would be a disaster to make these even worse by further impairing access to doctors, pathology and medicines.
The proportion of total health care costs paid by individuals in Australia is - at 19 per cent - already high by world standards. Australian patients pay around 11 per cent of the cost of medical services. The Budget proposals for higher co-payments - if implemented across the board - would be inherently unfair and, if the purpose is to reduce total expenditure on health care, they will fail.
Tim Kelly – Chairperson:0438 011 383
Gordon Gregory – Executive Director:02 6285 4660