Stories from the frontline about impacts of co-payments upon Aboriginal health and services

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Eighty submissions have been made to the Senate inquiry into out-of-pocket healthcare costs and the impact of the Government’s proposed co-payments, with public hearings to be held in Melbourne on July 3 and in Canberra on July 29.

(If any Croakey contributors or readers are interested in doing a systematic analysis of the submissions, please get in touch.)

Meanwhile, the submission from the Victorian Aboriginal Community Controlled Health Organisation (VACCHO) warns that introducing co-payments for visits to the GP and for out of hospital pathology and radiology services is “bad public health policy” and will be harmful for the health of Aboriginal and Torres Strait Islander peoples.

The submission says:

“There is no doubt that should the co-payments take effect, the ‘Gap’ will only widen.

VACCHO supports the need for a cost effective, efficient and sustainable health system. The proposed co-payment measures will undermine efforts to achieve this outcome.”

The VACCHO submission includes comments from interviews with CEOs, clinical and non-clinical staff, and clients of Aboriginal Community Controlled Health Organisations across Victoria.

A sampling follows:

Re barriers to access: A client, Wathaurong Aboriginal Co-operative, Geelong

“I probably won’t go to the doctor so much… (there’s) no chronic disease in the children but when (my) kids take days off school they have to have a medical certificate… we won’t be able to afford the visit, so I may get a fine because they can’t see a doctor. I have to get regular blood tests because of a health condition; this will mean I will delay the space between regular tests, which can be dangerous as I have a cyst in my brain which the blood tests detect changes in.”

 Re loss of focus on prevention: A staff member, Njernda Aboriginal Corporation 

 “My concern is …. What about the cost of preventative care? Now we really push preventative care, so we have our health assessments, you know… are you going to come in if you’re going to have to be paying for all of those things as a result of your health assessment?  We like to see what your cholesterol is doing, we do an overall ECG and you’re going to have to pay for each and every one of those now. So are people going to come in for their preventative health? No.”

Re poorer management of chronic conditions: A full-time employed mother of one, Melbourne

 “So, I’ve just been through the process of finding out that my (two year old) daughter has hearing issues… so I think about six tests it took, to find we had a hearing issue. I think we had to see the doctor about five times and had to visit a specialist. Then you know, even that $7, when it’s an illness or an on-going problem that you have to keep going back about, that can actually impact quite readily on whether you go to a doctor or not.”

Staff member, Njernda Aboriginal Corporation, Echuca

“It worries me because my chronic illness mob get to come and get free medication and if they need to see a specialist or allied health we will arrange that, then we pay for it and then take it to Medicare four or five things they have to do. If it’s going to cost money they won’t do it, they won’t go.”

Re less cost effective care: A GP, Goolum Goolum Aboriginal Co-operative, Horsham

“I think it’s strange the Government is targeting primary health care which is efficient, cheap and effective. Obviously there will also be a roll on effect on the numbers of people attending hospital Accident and Emergency departments for primary care issues which will be a waste of resources and more expensive.”

Jason B. King, CEO, Victorian Aboriginal Health Service, Fitzroy

“So at the moment for VAHS we’ve done calculation on last year’s Medicare income. We are looking just off (the $5 reduction in MBS rebates for non-exempt GP consultation items); we are looking to lose $100 -110,000 dollars. If we don’t collect the extra $7 we are probably looking at in excess of $250,000 or in that vicinity. That doesn’t include the $7 co-payment for blood tests, X-rays, and pharmacy bits and pieces, so it is going to be quite expensive for community in general, but for us that $200 grand is two and a bit Aboriginal health workers.”