Pensioners left 'waiting to die' in regional Victoria as specialist healthcare costs rise
- Replies 15
Eddie and Wendy Rushforth worked their whole lives but now, in their own words, say they're "sitting at home waiting to die" due to rising medical costs.
Mr Rushforth underwent surgery to remove bowel cancer four years ago, but it is the possible recurrence of his cancer that has the couple worried.
Mr Rushforth, 79, is supposed to have quarterly CT scans on his abdomen and has been on a waitlist for five months for a colonoscopy.
But at $550 in up-front costs for every CT scan, the couple from Mildura in north-west Victoria say they cannot afford it.
"I'm not going to any of them. What will be, will be," Mr Rushforth said.
"Whatever the outcome is, it is inevitable.
"Where does a pensioner get $550?"
In the Rushforths' case, the couple would pay the $554 up front to the radiology provider, and Medicare would provide a rebate of $459, leaving them $95 out of pocket.
The couple said that, as age pensioners, the price was still too much.
The Grattan Institute analysed Bureau of Statistics and Australian Institute of Health and Welfare data from 2018 to 2024, which showed that 2 million Australians were forgoing specialist treatment every year, and half of those were because they could not afford it.
The institute's research into specialist care found that although seven in eight GPs in Australia offered bulk-billing to some patients, it was just one in three for specialists.
It also found that since 2010, specialist fees had risen by 73 per cent on top of inflation.
Peter Breadon, the research's lead author and the Grattan Institute's health program director, said Australians wanting treatment were either "paying really high fees" to a private specialist or "potentially facing a really long wait for a free public clinic visit".
He said the public health system was not stepping in to compensate when a level of private care decreased, leaving Australians in an "unenviable position".
"Specialist care has really been running on autopilot, and we need to make a lot of changes right throughout the system to make sure Australians can get the care they need," Mr Breadon said.
He said tying government funding to specialists working in towns that needed them would help address health deserts in regional Australia, while employing more specialists in the public health system would address accessibility and affordability.
Mr Breadon also said specialists charging three or more times what the government paid them should lose access to the Medicare subsidy altogether.
In February this year, the federal, state and territory governments agreed to delay a new National Health Reform Agreement until next year.
The Grattan Institute wants the agreement to set a "red line" that dictates health care must reach certain levels, and a trigger for targeted investment if it falls below that level.
It has also called for changes to Service Australia's Medicare system so specialists are paid sooner than the 90 days they can wait up to at the moment.
ADIA said it also wanted an overturn of Medicare billing policies that prevented radiology practices from charging patients only the gap fee.
Chief executive Chris Kane said the $550 fee for the Rushforths was necessary to cover running costs.
"A CT scanner, for example, costs between $500,000 and $1.5 million, depending on the features, and then there's the other costs like rent and IT," Mr Kane said.
"The rebate is inadequate because in radiology, we had a 22-year Medicare rebate freeze between 1998 and 2020. And in the case of CT, there was a 2 per cent cut to CT rebates in November last year."
Mr Kane said private radiology clinics could afford to bulk-bill only when the Medicare rebate kept up with the cost of providing the service, and that larger rebates would mean smaller gap fees for patients.
In a statement, federal Health Minister Mark Butler said specialist fees were "starting to get out of control in some parts of the country".
"It's causing real harm to Australian patients, with people simply now unable to afford to visit their specialist, and it's having a huge impact on their health," he said.
"Costs are highly variable, with some specialists charging high fees, much higher than a specialist just around the corner of the same quality."
Mr Butler said the government was upgrading its Medical Costs Finder website to provide Australians with more transparency on fees.
The Rushforths say living in regional Australia means they are caught up in the nation's postcode lottery where it is harder to find a healthcare specialist or GP that will bulk-bill.
They say they also cannot afford to travel the 4.5 hours to the nearest capital city of Adelaide in South Australia.
"He feels dreadful about it because he goes, 'Oh, well, I'll just go home and die'," Ms Rushforth, 71 said.
"To me, that crushes my heart because I really love my husband."
Written by Tyrone Dalton, ABC News.
Mr Rushforth underwent surgery to remove bowel cancer four years ago, but it is the possible recurrence of his cancer that has the couple worried.
Mr Rushforth, 79, is supposed to have quarterly CT scans on his abdomen and has been on a waitlist for five months for a colonoscopy.
But at $550 in up-front costs for every CT scan, the couple from Mildura in north-west Victoria say they cannot afford it.
"I'm not going to any of them. What will be, will be," Mr Rushforth said.
"Whatever the outcome is, it is inevitable.
"Where does a pensioner get $550?"
In the Rushforths' case, the couple would pay the $554 up front to the radiology provider, and Medicare would provide a rebate of $459, leaving them $95 out of pocket.
The couple said that, as age pensioners, the price was still too much.
Australians not getting specialist care
According to the Grattan Institute, the Rushforths are not in a unique position.The Grattan Institute analysed Bureau of Statistics and Australian Institute of Health and Welfare data from 2018 to 2024, which showed that 2 million Australians were forgoing specialist treatment every year, and half of those were because they could not afford it.
Peter Breadon says Australians are "paying really high" medical fees. (ABC News: Darryl Torpy)
The institute's research into specialist care found that although seven in eight GPs in Australia offered bulk-billing to some patients, it was just one in three for specialists.
It also found that since 2010, specialist fees had risen by 73 per cent on top of inflation.
Peter Breadon, the research's lead author and the Grattan Institute's health program director, said Australians wanting treatment were either "paying really high fees" to a private specialist or "potentially facing a really long wait for a free public clinic visit".
He said the public health system was not stepping in to compensate when a level of private care decreased, leaving Australians in an "unenviable position".
"Specialist care has really been running on autopilot, and we need to make a lot of changes right throughout the system to make sure Australians can get the care they need," Mr Breadon said.
The research shows 2 million Australians are skipping specialist treatment. (ABC News: Darryl Torpy)
He said tying government funding to specialists working in towns that needed them would help address health deserts in regional Australia, while employing more specialists in the public health system would address accessibility and affordability.
Mr Breadon also said specialists charging three or more times what the government paid them should lose access to the Medicare subsidy altogether.
In February this year, the federal, state and territory governments agreed to delay a new National Health Reform Agreement until next year.
The Grattan Institute wants the agreement to set a "red line" that dictates health care must reach certain levels, and a trigger for targeted investment if it falls below that level.
Hope for reform
The Australian Diagnostic Imaging Association (ADIA), the peak body for private radiology clinics in Australia, has repeatedly called on the federal government to provide patient bill relief.It has also called for changes to Service Australia's Medicare system so specialists are paid sooner than the 90 days they can wait up to at the moment.
ADIA said it also wanted an overturn of Medicare billing policies that prevented radiology practices from charging patients only the gap fee.
Chris Kane wants changes to Medicare billing policies. (ABC News: Kyle Harley)
Chief executive Chris Kane said the $550 fee for the Rushforths was necessary to cover running costs.
"A CT scanner, for example, costs between $500,000 and $1.5 million, depending on the features, and then there's the other costs like rent and IT," Mr Kane said.
"The rebate is inadequate because in radiology, we had a 22-year Medicare rebate freeze between 1998 and 2020. And in the case of CT, there was a 2 per cent cut to CT rebates in November last year."
Mr Kane said private radiology clinics could afford to bulk-bill only when the Medicare rebate kept up with the cost of providing the service, and that larger rebates would mean smaller gap fees for patients.
ADIA says the Medicare credit to specialist clinics needs to increase. (ABC News: Kyle Harley)
In a statement, federal Health Minister Mark Butler said specialist fees were "starting to get out of control in some parts of the country".
"It's causing real harm to Australian patients, with people simply now unable to afford to visit their specialist, and it's having a huge impact on their health," he said.
"Costs are highly variable, with some specialists charging high fees, much higher than a specialist just around the corner of the same quality."
Mr Butler said the government was upgrading its Medical Costs Finder website to provide Australians with more transparency on fees.
Regional Australians suffering
Eddie and Wendy Rushforth say they can't afford the cost of medical appointments. (ABC News: Wade Stephens)
The Rushforths say living in regional Australia means they are caught up in the nation's postcode lottery where it is harder to find a healthcare specialist or GP that will bulk-bill.
They say they also cannot afford to travel the 4.5 hours to the nearest capital city of Adelaide in South Australia.
"He feels dreadful about it because he goes, 'Oh, well, I'll just go home and die'," Ms Rushforth, 71 said.
"To me, that crushes my heart because I really love my husband."
Written by Tyrone Dalton, ABC News.
.png){kind=icon}
