Health Co-Payments will Fail According to New Consumer Report

A new report about health co-payments shows they will fail to generate cost savings for the health system and will hit the chronically ill and people on low incomes the hardest

The report, release today by the Consumers Health Forum of Australia (CHF),  the national not-for-profit peak body representing two million health consumers across the nation, is a response to Health Minister Peter Duttons call for a national conversation on making health care sustainable. New CHF CEO Adam Stankevicius says CHF wants to ensure any changes are evidence-based and are not at the expense of those most in need of care.

“Australians already pay for a higher proportion of their health costs through co-payments than do people in other countries.  “The analysis CHF commissioned on co-payments shows even higher co-payments would be counter-productive, hitting the needy but failing to deliver an overall economic benefit,” Me Stankevicius says.

“Australians contribute double the proportion of health funding in out-of-pocket payments to that of people in the UK or France. “Over 17% of the nation’s total health costs are already being paid by health consumers, straight out of their own pockets.”

The CHF commissioned the special report by consumer health costs expert and author, Jennifer Doggett. Ms Doggett’s comprehensive analysis found that:

• Co-payments will result in people delaying treatments, leading to higher health costs overall.
• There is no evidence to show there will be overall cost savings but there is a clear risk of compounding existing problems and further disadvantaging people.
• Co-payments will create more financial hardship, have a big impact on sick and poor people and compound existing disadvantage.
• Introducing co-payments will result in decreased access to health care.
• The report says existing co-payments already cause financial hardship for many consumers – particularly people with chronic conditions and/or on low incomes.
• The report says there is a significant body of international evidence to show co-payments create barriers to access for health care for many consumers without decreasing overall health costs.
• The report reveals a huge 17% of all total health care expenditure in Australia is now being funded by individual co-payments.  It is now the largest non-government source of funding for health, goods and services and is significantly higher in Australia than most OECD countries.

The hardship many Australians already experience because of health costs has been borne out by a CHF on-line survey of health consumers.  It has found that of 400 respondents, 58% pulled out of getting medical attention altogether because of out-of-pocket costs.

The CHF survey reports 75% of people said they had deliberately not seen – or had delayed seeing a health professional – when they needed to, mainly because of cost.

More than 1 in 5 reported in the survey that they had had to spend between $1,000 and $2,000 a year already in out-of-pocket health costs.  Nearly two thirds (62%) revealed they’d spent more than $500 on out-of-pocket health costs.

Adam Stankevicius said, “Our aim is to present an informed consumers’ response to proposals for co-payments.  Introducing an extra fee to see the doctor and any new co-payments would be an ad-hoc and unproven step.”

“It will impact heavily on the people most likely to need help – people on low incomes and the chronically ill.”

The CHF says ABS Statistics already show at least 10% or more of Australians don’t get recommended medicine/treatment due to cost.

Mr Stankevicius says massive numbers of people would be hit by a co-payment as at least 80% of GP services are currently bulk-billed.

“It will likely mean many more people will be going straight to a hospital emergency department, adding great pressure to already strained hospitals. “If a fee is introduced, evidence from Australia and overseas indicates it will keep some people away but is unlikely to reduce the overall cost of health care because unattended sick patients then end up in hospital.”

The new survey revealed the widespread stress that not being able to afford healthcare can place on individuals and families.

Mr Stankevicius said, “We are talking about people such as an older Australian who has waited for two years for a knee replacement or the many people who don’t have money to see a specialist or parents going without basic necessities like fresh bread and milk to meet children’s medical bills.”

A consumer from Melbourne’s South East stated:  “It’s a Catch 22 situation.  With good management I might be able to get back to work to afford the health care I need, but without the healthcare, my condition is undertreated and undermanaged…and I am unable to work.  Lack of health care has a massive impact on all facets of life.”

Leonie Havnen, of Sydney, had to arrange for early release of some of her superannuation to cover ongoing treatment for breast cancer.  She estimates she has now spent $50,000 in out-of-pocket expenses to ensure she got the treatment she needed. “Bringing in more co-payments would be outrageous.”

“I know how quickly medical costs can add especially when you are diagnosed with a life threatening illness.  To put the added pressure of reducing Medicare rebates to those who already pay so much for their health care would be an absolute travesty.  You will see more people succumb to their illness because they can’t afford the health care they need to live” says Ms Havnen.

One estimate suggests over 14,000 Australians have applied to the Department of Human Services to access their super to pay for health costs – and 8,000 people were given access to $79 million.

Delia Scales, a Melbourne nurse, has described as “disastrous” her experience with medical costs after being referred for private treatment for breast cancer. She was given no upfront quote for doctors’, pathology tests or chemotherapy treatment.  Full payment  was demanded beforehand.  “I quickly ended up over $10,000 out of pocket…”   After transferring to a public oncologist, she was told that her expensive pathology tests were ‘irrelevant’ and that chemotherapy for grade one cancer was worth only ‘2% risk reduction’.

Ms Doggett, whom CHF commissioned to assess the latest research on co-payments, said:  “Australia has no national policy on co-payments and there has been no comprehensive consumer or community consultation on this issue.

“Introducing new co-payments into an already inconsistent and inequitable ‘system’ of co-payments risks compounding the existing problems and further disadvantaging those already experiencing difficulties affording their health care.”

The CHF says there needs to be systematic change to the health system.  It says Australians are already amongst the hardest hit in the world when it comes to out of pocket costs.  Many consumers don’t see medical specialists, doctors or dentists purely because of cost.
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