Second-class citizens — The rural health divide
Authors
Media release
Australians living in non-urban areas are dying younger, often from preventable diseases. These deaths could be avoided if these communities had access to timely and affordable healthcare. With access to care, including primary, specialist, and allied health services, diseases can be diagnosed, managed, and even prevented.
Medicare is not designed for non-urban Australians, and it continues to fail people living in rural and remote communities. These areas are experiencing shortages of medical professionals, including general practitioners and specialists. Partly due to these shortages, people in these communities attend medical appointments less regularly than city-dwellers, meaning less Medicare benefits subsidies flow to these areas, despite their generally older and sicker populations. Together, these factors mean that Australians living in non-urban areas experience worse health outcomes and lower life expectancies. Despite rural and remote areas having barely any private hospitals and fewer specialists, non-urban residents are pushed to buy private health insurance they cannot use and subsidise the insurance of urban dwellers. This system is inequitable, bad for human health, inefficient and costly. Instead of spending on preventing or avoiding illness and disease, significant resources are spent on treating these illnesses. Fixing this system will involve considerable change, either by amending the Medicare system to better recognise how it fails rural and remote residents, or by recognising these issues as a fundamental market failure and providing primary health services directly through government-run clinics and programs.
In summary, we make the following four recommendations:
- Recommendation 1: Apply a remoteness loading across all Medicare items and ensure they are specifically weighted to benefit individuals and healthcare providers residing in non-urban areas.
- Recommendation 2: Implement funding models that combine traditional Medicare billing with guaranteed base salaries and additional funding for multidisciplinary teams practising in non-urban areas.
- Recommendation 3: Directly provide primary health services in rural and remote communities. This could be directly controlled by the Commonwealth Government or via Commonwealth support for State and Territory Governments.
- Recommendation 4: Residents of rural and remote Australia should be exempt from private health insurance surcharges and forced coverage in areas where private hospital services are not reasonably accessible.