Out-of-pocket pain: the $10,000 issue

A national survey by the Consumers Health Forum of Australia has found that out-of-pocket medical bills exceeding $10,000 have become commonplace for patients with breast cancer and certain chronic conditions.

The ‘Out of Pocket Pain’ survey drew 1,200 responses, many from people shocked to learn that despite having health insurance they still had to pay thousands of dollars out of their own pockets for critical surgery, other treatment and diagnostic scans.

The survey and a companion report, ‘Hear Our Pain’, containing scores of personal stories of people’s experience with treatment costs, were released yesterday (April 5).

“The responses to the survey give a disturbing insight into the high costs of medical care, and challenge the notion that everyone can access the care they need in Australia,” Consumers Health Forum CEO Leanne Wells said.

“We’ve heard from pensioners and single mothers who have foregone recommended care because of cost, from many people exasperated to find that the insurance they’ve held for many years will not cover gaps of thousands of dollars, from patients who learn belatedly of unexpected extra costs for junior surgeons, anaesthetists and MRI scans, and from people who’ve had to call for special access to their superannuation funds to cover the bills.

“Our results affirm what we know from the OECD, ABS and Australian Institute of Health and Welfare: Australian consumers face higher-than-average out-of-pocket costs, and this translates into people often avoiding visiting a GP, failing to fill scripts and not acting on a specialist referral due to cost. This shouldn’t be happening in a country with the wealth of Australia.

“The expense is made more difficult by the uncertainty and complexity of the relationship between treatment and costs, with varying levels of cover, or no cover, provided by health funds and by Medicare.

Among key results of the survey are:

  • More than a quarter of respondents treated for breast cancer incurred out-of-pocket costs of more than $10,000.
  • More than a third of respondents with chronic conditions such as multiple sclerosis reported out-of-pocket costs of more than $10,000.
  • One in six respondents said that out of pocket costs had a significant impact on their lives.
  • The frequently expressed view that using private health insurance would expose people to more costs.
  • A third of respondents said the out-of-pocket costs were not explained to them before treatment.

Ms Wells was joined at the launch of the report at Parliament House in Canberra by the CEO of consumer advocacy group Choice, Alan Kirkland, and National Rural Health Alliance CEO Mark Diamond.

For the full story, visit: https://chf.org.au/media-releases/out-pocket-pain-10000-issue-0

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