The Abbott government has announced a A$20 billion medical research “future fund”, to help discover what Treasurer Joe Hockey calls the “cures of the future”, paid for with money generated as a result of major changes to health policy.
The fund, expected to be “biggest medical research endowment fund in the world” within six years, will be capital protected, with net interest earnings used to fund medical research. Distributions to medical research are expected to be around $1 billion by 2022-23, effectively doubling the government’s direct medical research funding. Distributions of $20 million are expected in 2015-16.
It comes as the government warns of unsustainable health-care spending, which currently costs 4.1% of GDP, expected to rise to 7% if no changes are made.
From July 2015, the government will introduce a $7 co-contribution payment for GP consultations and out-of-hospital pathology. Concession card holders and children will also pay the fee, capped to the first ten services. Of this, $5 of every $7 will go to the medical research fund.
Australians will also pay an extra $5 towards the cost of each Pharmaceutical Benefits Scheme (PBS) prescription from July next year. Concession card holders will pay an extra 80 cents.
In a major blow to the states, the government will pull back from its commitment to increase public hospital funding, indexing funding to a combination of growth in the consumer price index and population, from 2017-18.
From 2016, a new Medicare Safety Net will be introduced with lower thresholds for most people. Indexing on all Medicare rebates, excluding GP services, will remain frozen until July 2016, and the Medicare Levy Surcharge and Private Health Insurance Rebate income thresholds will not be indexed.
“Primary Health Networks” will replace the Medicare Locals established by the former Labor government. The networks are expected to align more closely with state and territory health network arrangements to “reduce duplication of effort,” and align with recommendations made by former chief medical officer John Horvath following his review of Medicare Locals.
The Abbott government will honour its commitment of $200 million for dementia research, and contribute $95.9 million in 2014-15 to expand the National Bowel Screening Programme. It will also provide an additional $14.9 million over four years to establish ten new headspace sites and conduct an evaluation of the program.
The government will also provide $22.8 million to replenish the National Medical Stockpile, renegotiating responsibilities for the stockpile with the states, and commit more than $100 million to encourage school children to take part in sport activities.
The government will abolish Health Workforce Australia, which is tasked with ensuring the health workforce has appropriate skills and training, and consolidate its functions into the Department of Health, saving $142 million over five years.
The National Preventative Health Agency will be abolished, saving $6.4 million over five years.
The government will also provide funding to defend international legal proceedings initiated by tobacco companies as a result of the Plain Packaging Act, however has not disclosed the funding amount.
Rolling expert responses to follow.
Overview
Stephen Duckett, Professor of Health Policy at La Trobe University and Director of the Health Program at Grattan Institute
Pre-budget softening up does not obscure the harsh reality of the 2014-15 budget decisions. Bulk billing is gone, health reform agreed by all states and territories is demolished, funding to the states is slashed and promises are broken.
The big decision is about a $7 co-payment for GP visits. Floated five months ago, ramped up by the Commission of Audit, universally condemned by health experts, the budget introduces a co-payment of $7 for each general practitioner visit and any out-of-hospital pathology and X-rays.
The existing rebate for these services is reduced by $5 but doctors will be allowed to recoup $7 by levying a patient charge. A “safety net” is introduced after the first ten services for pensioners and card holders.
The effects are known: budget savings will be made – over $1b a year – off the backs of the poorest and most vulnerable. People who miss out on the safety net will now miss out on care as well.
States will be allowed to charge $7 for hospital emergency department visits, but probably won’t. Despite the pre-budget airing, abolition of bulk-billing was not disclosed pre-election and surely counts as a surprise from a government that promised no surprises. Co-payments are increased for pharmaceuticals, more rapidly than inflation, further increasing patient hardship.
The Rudd-Gillard national health reforms were a mixed bag, slowly being implemented and agreed by the states and territories. The big change, making the Commonwealth share in the cost of increases in hospital admissions and other activity, comes into effect in six weeks’ time.
This meant the Commonwealth would meet 45% of the cost of increased admissions, but would only pay what was the “efficient” cost of that growth. This was to rise to 50:50 sharing in 2017, but the budget tears up that signed commitment and goes back to funding population growth only. Hundreds of millions of grants to the states are also for the chop.
But while the ink is barely dry on those agreements and the legislation, more changes are foreshadowed. The alphabet soup of agencies created by the reforms are to be rationalised. It is unclear whether the savings will come from back-room bureaucrats or from programs. If the former, it can be supported. If it is the latter and we lose an emphasis on prevention, better transparency of funding flows and better measurement of hospital activity, we’ll all be the poorer.
Medicare Locals, the inappropriately named but much-hyped primary care platform introduced as part of the Rudd-Gillard changes, are for the chop, despite pre-election promises from the prime minister and health minister Peter Dutton.
Sixty-one Medicare Locals will be replaced by probably a third that number at most, making them hardly local any more. Again the devil will be in the detail but it is doubtful whether local engagement and responsiveness to local needs can be maintained in the new, larger structures.
Another big surprise in the budget is to hypothecate much of the savings to a $20 billion dollar endowment for medical research. How the endowment will work (and whether the interest from the endowment will be truly additional research funding) is unclear. This is certainly a positive move for research, but there will be few researchers who will like where the money is coming from.
Medicare co-payment
Anne-marie Boxall, Director of the Deeble Institute for Health Policy Research, Adjunct Lecturer at University of Sydney
The government has announced a co-payment for general practice (GP) services of $7 for all patients, starting 1 July 2015. GPs can choose to waive the co-payment, and they will be paid an incentive payment if they do not charge concession card holders or children under 16 more than the $7 co-payment.
To discourage people who should be going to a GP from going to emergency departments, the government is removing the restriction that prevents state and territory governments from charging co-payments for GP-like visits to hospital emergency departments.
The GP co-payment is expected to deliver savings of $3.5 billion over five years. These savings will be achieved in two ways.
First, the government will reduce the Medical Benefits Scheme (MBS) rebate for standard GP consultations by $5; currently, the rebate for Level B consultations (less than 20 minutes duration) is $36.30. The MBS rebate will only be reduced for concession card holders and children under 16 for the first ten visits in a year. After that, it will be increased to current levels. The reduction in MBS rebates is a direct saving for the government.
The co-payment will also generate savings by acting as a deterrent for GP use. The rationale is that if people have to pay, they will only go to the GP if they really need to. Fewer visits to GPs mean less expenditure on the MBS.
The co-payment proposal has been widely criticised by many in the health sector because out-of-pocket costs in Australia are already relatively high by world standards, and there are concerns that increasing them further will:
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– reduce necessary use of GP visits (for preventive services such as immunisations, for instance, or cancer screening), and
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– be an unfair burden on people with lower incomes, who also tend to be in poorer health and are most likely to defer visits to the GP because of cost.
These concerns are justified based on international evidence where co-payments for health care have already been trialled (see for example here and here).
International bodies, such as the World Health Organization and OECD, are also critical of the over-reliance on co-payments as a means of financing health care because they are a relatively blunt instrument for controlling costs, and exacerbate inequalities.
There is little reason to believe that the impact of co-payments will be any different here, which means that the most vulnerable in our society will bear the brunt of this short-term savings initiative.
Co-payments for Pharmaceutical Benefits Scheme (PBS) medicines
Philip Clarke, Professor of Public Health at Melbourne University
In regard to pharmaceuticals, the main change has been the adoption of the recommendation of the Commission of Audit to raise the patient contribution for general patients by $5 (from $37.70 to $42.70) and for concessional patients by $0.80 (from $6.10 to $6.90) in 2015.
They will also raise the level of the safety net at which these contributions are reduced. All these changes will deliver savings of $1.3 billion over four years.
As I argued in my recent article for The Conversation, general co-payments are already quite high by world standards and these are at a level that may discourage use of beneficial medications. They also have the potential to increase downstream costs, for instance, through increased hospitalisations.
What the budget has not taken up is the Commission of Audit report recommendations on reducing the cost of generic drugs and other pricing anomalies. For example, we are current paying more than $1 extra per tablet to add aspirin to the drug clopidogrel.
Forgoing these savings here will be costly as more than $1 billion each year is being spent relative to other countries, such as England and New Zealand, which have more efficient health-care systems. In these circumstances, it’s hard to understand why the government has not tried to tackle this waste, particularly as they have budgeted for an additional $380 million over four years to fund the listing of a range of new drugs.
Clearly, it is consumers, particularly those with chronic diseases, rather than the pharmaceutical industry or pharmacists that will feel the pain from these budget measures.
Preventative health
Mike Daube, Professor of Public Health Policy at Curtin University
This is a distressing budget for anyone concerned for the community’s health. Among massive health system cuts and increased personal health costs, the once-modest funding for prevention has become almost invisible.
The loss of the National Partnership Agreement for public health will mean cuts to important programs around the country dealing with obesity, cancer prevention, diabetes and other conditions that result in massive costs to the health system.
The Australian National Preventive Health Agency and Australian Institute of Health and Welfare are gone.
It looks as though even new funding for medical research (and note – “medical research”, not “health and medical research”) seems to have been taken from prevention funding.
Increased health-care costs for individuals will discourage people from seeking medical help – resulting in more preventable and expensive health problems.
There are two positives: it is a huge relief that tobacco media campaigns will continue – we desperately need those to complement tobacco tax increases and plain packaging.
And the commitment to an expanded bowel cancer-screening program is also welcome.
But those apart, it’s a dark day for Australia’s health and health services, and especially for prevention. Nobody can doubt our health services and future health are the big losers. The crazy part of all this is that it’s preventive programs that ultimately save the system money.
Medicare Locals
Fran Baum and Sara Javanparast, Southgate Institute for Health, Society & Equity at Flinders University
The cuts to the Medicare Local program proposed the Hovarth Review released yesterday have been confirmed in tonight’s budget. Medicare Locals will be replaced by Primary Health Networks, which will be set up through open tender and encouraged to partner with private health insurers – a major policy change.
This is a retrograde step for the Australian health system.
Sixty-one Medicare Locals were introduced by the Gillard Labor government and progressively established by mid-2012. Since then, they have been conducting needs assessments and devising plans designed to improve locally provided primary health care services. These services include GPs, mental health, physiotherapy, speech pathology, podiatry and community nursing.
Most Medicare Locals have been planning and implementing after-hours care plans, mental health, Aboriginal health, e-health, and aged care programs. Some have also addressed social determinants of health and community capacity-building strategies.
Medicare Locals were established to deal with the symptoms of a fragmented system that offers an uncoordinated patchwork of service plagued by cost-shifting battles between federal and state governments. It’s too early to have made a definitive judgement about their success.
The new Primary Health Networks will be much larger, clinically focused, and there will be a significant period of inactivity while they’re being set up. They seem to have no mandate for health promotion or disease prevention even though these are very important.
This structural change risks losing the investment and work that has been conducted and reduces the chance that we will have a more efficient and effective disease prevention primary health care sector that can help stem the tsunami of demand for expensive hospital services.
Other comments…
Public Health Association of Australia (PHAA): media release
The PHAA described the Budget as both regressive and short-sighted, with low income and disadvantaged Australians being slugged with cost-saving measures while the fortunes of the wealthy go untouched.
“This Budget is dominated by cuts to spending in key areas that will effectively kick people while they are down and result in an increasing burden on the health system over time. Many of the funding cuts appear to be short sighted approaches that do not recognise the health and economic costs associated with the growing burden of chronic disease. Almost $8.6 billion will be cut from the Health Budget over 4 years,” said Michael Moore, PHAA CEO.
“We vehemently oppose the introduction of a $7 co-payment for GP visits, out-of-hospital pathology and diagnostic imaging services – a regressive measure that will invariably create barriers to accessing primary care for disadvantaged Australians and ultimately lead to larger burdens on hospitals. The longer term impact will be compounded by a $5 co-payment for PBS-listed medicines and the abolition of the National Preventive Health Agency, General Practice Education and Training Limited and the Australian Medical Local Alliance.
“These agencies focused on promoting preventive health approaches and primary health care designed specifically to reduce pressure and costs in hospital and acute settings. It is vital that there are agencies at the national level to protect and progress the national interest in key areas such as primary health care and preventive health.
“It has long been said that prevention is better than cure – certainly prevention is cheaper than treatment – and it’s false economy to cut funding in these areas to achieve short term savings. As it stands, only about 2% of the health budget is spent on prevention – if the Government wants to reduce pressure on the health budget over time, they should actually be looking to increase that figure. Instead, expenditure on prevention is reduced dramatically.
“Cuts in funding to Indigenous Affairs Programs (over $121 million over 4 yrs), dental health programs ($635 million over 4 yrs) and the National Partnership Agreement on Preventive Health (over $367 million over 4 yrs) are similarly counter-productive and are likely to be particularly expensive over time. It certainly flies in the face of the Government’s purported commitment to prevention and Closing the Gap in health outcomes for Indigenous Australians.
“Cutting nearly $54 million over the next two years from the Partners in Recovery mental health initiative is also likely to increase the burden on families, communities and the acute care sector. It is essential that there are comprehensive and cross-portfolio approaches to key health issues – like mental health – at the national level.
“This budget effectively puts the boot into disadvantaged, marginalised and low income Australians in a way that will invariably result in greater costs to the health system in the long term. It’s long term pain for short term gain – these spending cuts will cost a lot more over time. It’s not fair, it’s not right and it’s certainly not smart from an economic perspective. The creation of a new Medical Research Fund will do nothing to mitigate a diminished focus on preventive health at the national level.
“This really is a killer Budget in more ways than one,” he said.
Stephen Leeder, Emeritus Professor of Public Health and Community Medicine at the School of Public Health and Menzies Centre for Health Policy, Editor-in-Chief, Medical Journal of Australia
The GP GST (which is what it is) will hit the poor, the chronically ill who already scrape. They will go to public hospitals to be paid for by an increase in STATE GST or lotteries or whatever. What on earth is going on?
The GP GST reminds me of the early days of hypothecation of the tobacco tax to pay for the opera! Probably need to rethink the linkage of that tax with the support of medical research.
By tradition Treasury HATES hypothecated taxes! Whole bunch of them in this budget – medical research, roads and so on. How sustainable?
Australian Medicare Local Alliance (AML Alliance): media release
The coordination of primary health care has been severely disrupted following the Federal Government’s decision to scrap the Medicare Locals’ national body, the AML Alliance.
AML Alliance Chair, Dr Arn Sprogis said the Government’s plan for primary health care is to destroy what’s already there only to re-establish another primary health care system – effectively primary health care 2.0.
“Between now and July 2015 as the Medicare Locals come to an end, it will be every Medicare Local for itself and any coordination will be via the health bureaucracy which is ill prepared and incapable of delivery,” Dr Sprogis said.
“Health services at the frontline will be in disarray beyond 2015 as another primary health care system is re-built and re-established,” he said.
“The losers tonight are patients, carers, health professionals and other Australians who need health services coordinated and supported now and not when they are re-arranged. Medicare Locals and the AML Alliance comprise the only national network that has the capacity to work with communities and health care providers to coordinate prevention, care improvement and cross sector initiatives and to find the gaps in services that are needed today, not after July 2015.
“Through its national-local structure of the AML Alliance, State Coordinators and 61 regional Medicare Locals, the Medicare Local network can think nationally, act locally and work quickly at the grassroots. This network structure provides government with national infrastructure to implement change initiatives at the health care coalface with clinicians, practices and other health care organisations while also linking with and attaining input from relevant national agencies.
“As of June 2014 there will be minimal coordination or primary health care nationally as what’s left of the Medicare Local network will now rely on bureaucrats embedded in Canberra to manage the system without AML Alliance,” Dr Sprogis said.
Australian Healthcare and Hospitals Association (AHHA)
“Minister Dutton’s first health budget looks like a magician’s sleight of hand, with the cost burden shifted to the states and consumers; GPs given some sweeteners to manage co-payments; and a medical research fund which is big on promises but small on detail.
The AHHA says the introduction of co-payments will hurt those who require care the most – the elderly and those with chronic disease, and result in them delaying or avoiding seeking care, or being driven to public hospital emergency departments that are already stretched.
Of even greater concern to states and territories, it said, will be the lack of clarity around funding for hospitals beyond the next two financial years, with health and hospital funding swept up into the broader review of Commonwealth-state funding relations.
The AHHA welcomed investments in bowel cancer screening, youth mental health, some rural workforce initiatives, dementia research and ongoing support for e-health, but said the lack of focus on preventive health is “very short-sighted” and the medical research fund will be limited both by lack of funding clarity and its very narrow view of health.
It also welcomed moves to “reduce the alphabet soup of agencies” that have emerged over recent years and resulted significant duplication in data collection, analysis and reporting, although it would have preferred to have seen the retention of the Australian Commission on Safety and Quality Health Care as a separate agency with a broader role. But it said the redesign of the consolidated agencies should ensure that their objectives and structures are “fit for purpose”, and for leaders of the new agencies to be equipped with the knowledge, experience and skills to initiate major organisational change.
Finally, the AHHA said the decision to delay negotiations on the new National Partnership Agreement for additional Adult Public Dental Services threatens to reverse the recent improvements in waiting times for public dental care.
“There is still no sign of the National Oral Health Promotion Plan that has languished on the desk of the current and previous Health Minister for over 12 months. This, together with the latest cuts, raises concerns about the Government’s understanding of the importance of oral heath to overall health and its links with chronic disease.”
The Rural Doctors Association of Australia (RDAA)
The Rural Doctors Association of Australia (RDAA) said it is pleased that the rural health sector has been spared substantial funding cuts amidst a wider healthcare budget of dramatic cost-cutting, but the introduction of a $7 Medicare patient co-payment for GP consults is of serious concern to rural patients and rural doctors.
“The new arrangements will only make it much more difficult for rural Australians, who are among Australia’s poorest people, to afford healthcare. It will also put additional pressure on rural practices and doctors, not only in terms of additional red-tape but also in terms of them having to cut already low consult fees for patients who simply cannot afford the co-payments.
“In many cases, patients unable to afford a GP consult will seek treatment at their local hospital. Because many rural doctors work at both their local general practice and the local hospital, they will experience an increasing number of hospital call-outs, including after-hours call-outs.
The RDAA welcomed a number of initiatives:
- – the doubling of the Practice Incentives Program teaching payment for doctors and practices that are providing training to medical students and young doctors—at a cost of $238.4 million
- – the introduction of a new $52.5 million program of infrastructure funding for rural and remote practices, to enable the practices to build the facilities required to take on more trainee doctors
- – an additional 300 GP training places and 500 new nursing and allied health scholarships with a focus on boosting the regional and rural health workforce
But it was very disappointed that the “highly successful” Prevocational General Practice Placements Program (PGPPP) will be abolished, given its success in attracting doctors to general practice and ultimately rural general practice.
It welcomed reform of the existing Medicare Locals system, to be replaced by Primary Health Networks, but is concerned about the difficulties for rural PHNs in delivering services following the increase in geographic areas they will be given under the new arrangements.
Cancer Council Australia: media release
At least 35,000 Australian bowel cancer deaths will be prevented thanks to a $95.9 million, four-year plan to finalise Australia’s National Bowel Cancer Screening Program in the 2014-15 budget.
Cancer Council Australia CEO, Professor Ian Olver, applauded the Minister for Health, Peter Dutton, for committing to the completion of the program, which was introduced 10 federal budgets ago.
“Bowel cancer is the second-largest cause of cancer death in Australia, yet most cases can be cured if detected early,” Professor Olver said.
“Our research shows the Government’s commitment to bring the program’s full implementation date forward by 14 years will prevent at least 35,000 bowel cancer deaths over the next 40 years. By filling in additional gaps in the bowel cancer screening program from July next year, the benefit in lives saved will be maximised while full roll-out occurs.”
Professor Olver also commended the Government for its unprecedented commitment to medical research investment through its proposed $20 billion futures fund.
“Minister Dutton was always adamant that the Government would be guided by the evidence when it came to major investments in cancer care,” he said. “We are seeing that tonight with the $95.9 million for bowel cancer screening. Importantly, the new funding shows the Government’s preparedness to invest in programs that will realise their full health and economic potential over the longer term.
“We look forward to working closely with the Abbott Government on its research program to help ensure that future investments are also based on the best available evidence.
“The renewed commitment to medical research should put the Government in a position to collect and disseminate independent evidence to address the changing needs of an ageing population and challenges such as obesity.”
Arthritis Australia: Short-sighted budget cuts will increase health costs in the long term
The Federal budget’s cuts to health are a false economy which will force more people to go without essential medical care, leading to poorer health outcomes and driving higher costs to the health system in future, Arthritis Australia warns.
“Hitting patients with increased costs for doctor’s visits, tests and medicines may improve the budget bottom line in the short term, but could prove counterproductive in the longer term, by stopping people going to the doctor or taking medicine when they need to,” said Ainslie Cahill, CEO of Arthritis Australia. “This is likely to lead to more expensive complications and hospitalisations down the track.”
Ms Cahill said those most in need of care would be the hardest hit.
“The impact will be greatest on people with low incomes and those with chronic illnesses such as arthritis who need regular medical care to manage their condition and prevent it getting worse. These people are usually the least able to afford extra costs.
“We know that many people with arthritis already struggle with the costs of managing their condition, and they are often on low incomes because their arthritis has forced them to work lessor leave the workforce early,” Ms Cahill said. “The extra costs in this budget will be an enormous blow and a huge barrier to accessing appropriate care.”
“ABS statistics show one in ten Australians already delays or goes without seeing a GP, or essential medicines, because of the cost,” she said. “We expect this number will rise significantly as a result of the new budget measures.”
“Consequently, more people with arthritis will suffer pain and disability due to poor management of their condition and this is likely to lead to greater recourse to expensive joint replacements which might otherwise be avoided. With a joint replacement costing around $25,000, equivalent to 750 Medicare-funded GP visits, this really does seem to be a false economy.”
“If the government really wants to reduce future health costs, better options are available, including better prevention and management of chronic conditions. Our recently launched Time to Move: Arthritisstrategy includes a range of possible options including sorts injury prevention and better management of people on waiting lists for joint replacement surgery, which together could save up to half a billion dollars in costs.”
AMA Victoria
Today’s Federal Budget announcement holds nothing but pain for Victorians. Just as no one is immune from sickness, no one will be immune from these dramatic increases in out-of-pocket health expenses.
Victorians will be hammered by:
- $7 GP co-payment
- Pathology and imaging fees
- $5 increase to medications (80 cent increase for concession card holders)
- States will be given the power to introduce an Emergency Department fee
- An increase in the Medicare Safety-net threshold, and
- A freeze on private health insurance rebates.
Through a revision of the National Health Reform Agreement, Victoria is set to lose $670m in direct funding for public hospitals. Victoria will also lose access to reward funding, which was previously available. Reward funding provides an incentive for hospitals to meet important performance targets, such as the number of patients receiving surgery within clinically recommended times.
“This will affect Victorians’ access to important health services, it will increase waiting times for surgery and emergency care, and lead to a likely reduction in overall capacity,” newly elected AMA Victoria President, Dr Tony Bartone, said tonight.
“This Budget will impede access to healthcare and a number of people will defer seeking treatment for serious medical conditions due to the cost barrier.
“As a GP, I am also greatly concerned by the introduction of fees for pathology services, as many of my patients require multiple and repeated tests as part of ongoing clinical management. For example, if you’re on the blood medication Warfarin, blood tests might be ordered every three days. All of these additional costs will put healthcare out of reach.
“These changes will lead to blood tests and GP visits being viewed as “luxury” items and may mean that patients have to choose between important medical treatments or putting food on the table.
“The Government needs to stop hitting general practice. General practice is not the problem, it is the solution,” Dr Bartone said.
Australian college of Nursing -From ‘health for all’ to ‘health for some’
The Australian College of Nursing (ACN) is concerned by the announcement in last night’s budget that the Australian Government plans to introduce co-payments to previously bulk billed Medicare services, and increase the co-payment for PBS-listed medicines.
Kathleen McLaughlin, ACN Executive Manager, said that ACN is deeply concerned that individuals and families will be burdened with co-payments they can ill-afford. Australia’s out-of-pocket expenditure for health care is already high compared to the OECD average, and Australians’ biggest share of these costs comes from paying for curative care and pharmaceuticals.
“Out-of-pocket costs create a barrier to consumers’ access to health care and this barrier is greatest for individuals who have the least ability to pay as well as people with chronic and complex conditions. The introduction of co-payments will undoubtedly undermine the very real principles of universal access and equity in health care that the introduction of Medicare enshrined,” said Ms McLaughlin.
Health services should be available to all members of our community on the basis of need, not the ability to pay. We already have evidence from the Australian Bureau of Statistics that 5.4% of Australians who needed to see a GP in 2012-13 delayed seeing or did not see a GP at least once because of the cost. The introduction of co-payments and the reduction of Medicare rebates will only see this figure increase.
Amongst the hardest hit will be people with chronic conditions. A recent study* found that people with chronic kidney disease, residing in Western Sydney, spent a mean of $907 every three months on out-of-pocket medical costs. For 71% of study participants this constituted more than 10% of their household income and 57% of households in the study reported financial hardship as a result. The budget measures announced last night will only add to the hardship of people already burdened by ill health.
Those in need of health care should not carry such a financial impost whilst there remains the opportunity to increase efficiencies and reduce wastage in our health care system.
ACN will be advocating on behalf of all Australians for the Government to re-consider the implementation of these inequitable health measures.
NACCHO Budget Response: Pressure on Indigenous health outcomes
The National Aboriginal Community Controlled Health Organisation (NACCHO) has welcomed continued funding for the 150 Aboriginal Community Controlled Health Services around Australia announced/confirmed in Budget 2014.
Justin Mohamed, Chair of the National Aboriginal Community Controlled Health Organisation, said the Aboriginal population is growing and demand for services is increasing at more than 6% per year.
“The 2014 Budget funding means we can continue to provide high quality, culturally appropriate health care to our people for another year,” Mr Mohamed said today.
“However, we also need long-term planning and budget resources to build on recent health gains and create lasting improvements to the health of Aboriginal people.
“There is great risk that the introduction of a $7 co-payment for doctor’s visits will create new barriers to healthcare for many Aboriginal and Torres Strait Islander Australians, including additional red tape for Community Controlled Health Organisations.
“Most Aboriginal and Torres Strait Islander Australians are low income earners and suffer the highest level of chronic disease, requiring regular GP visits.
“State and territories have also been given the green light to charge for hospital emergency visits, creating a dangerous situation where people may not present for serious medical treatment for fear of the cost.
“We will get the most benefit from policy that encourages Aboriginal people to seek medical attention and seek it early, not make it even harder for them to get the care they need.
“It is also vital that the Federal Government guarantees the $80-90 million cut across Aboriginal Health does not impact on-ground services and Aboriginal health outcomes.
“Aboriginal Community Controlled Health Organisations have a proven track record in providing a range of quality employment and education opportunities for Aboriginal people and boosting local economies.
“Given cuts to Aboriginal health and employment budgets they are even more valuable – providing employment and training opportunities to our people which in turn boost local economies and tackle some of the huge barriers to Aboriginal people achieving economic independence and quality of life.
“Healthy communities keep our kids in school, keep our adults in the workforce and allow great opportunities for Aboriginal contributions to the economy and broader community,” Mr Mohamed said.
Source: Multiple