Rural residents shell out more for health services as hidden costs emerge

Living in the bush, by the beach, or in a quiet country town is the dream for many Aussies—fresh air, friendly neighbours, and a slower pace of life.

But what happens when you need urgent, life-saving medical care? For thousands of Australians living outside our major cities, the answer is: you pay a hidden health tax, both in dollars and in stress.


Let’s take the story of Phil Leahy from Port Douglas, Queensland, as a case in point.

Phil, a successful business owner and founder of MedCart, was recently diagnosed with an aggressive form of throat cancer—p16-positive oropharyngeal squamous cell carcinoma (OPSCC), to be precise.

This type of cancer, often linked to the human papillomavirus (HPV), typically starts in the tonsils or at the base of the tongue.


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Rural Australians face higher costs and major challenges accessing vital healthcare not available locally. Credit: David Gyung / iStock


Phil’s diagnosis turned his world upside down. He was forced to leave his rainforest home and relocate to Brisbane for an intensive eight-week treatment plan involving both radiation and chemotherapy.

Why? Because the nearest major hospital in Cairns couldn’t provide the dual treatment he needed.

And so began a journey that’s all too familiar for many regional Aussies: the long, expensive road to accessing the healthcare city-dwellers take for granted.


The True Cost of Country Living: More Than Just Petrol

While city folk might grumble about traffic and parking at the hospital, regional Australians face a much bigger challenge.

Phil and his wife, Annabel, suddenly had to juggle the cost of travel, accommodation (even a 'cheap' Airbnb was $170 a night), food, and transport—on top of the emotional toll of being separated for weeks.

Annabel, meanwhile, had to step up as both CEO of the family business and caretaker of their home, which, being in the rainforest, doesn’t exactly look after itself.

For many, these extra costs can run into the thousands. And that’s before you even factor in lost income, the stress of being away from loved ones, and the uncertainty of navigating a complex health system.


Private vs Public: The Great Healthcare Dilemma

Like many Australians, Phil had always paid for private health insurance, believing it would give him better access and flexibility.

But he was shocked to discover that, as an outpatient, many of his expenses—accommodation, meals, transport, and some medications—weren’t covered, even after decades of paying premiums.

In contrast, if he’d gone through the public system and been admitted as a public patient in a public hospital, Medicare would have covered almost everything: treatment, accommodation, and medications.

It’s a crucial difference that isn’t always made clear, especially when you’re making decisions under the stress of a new diagnosis.

Phil’s experience is a wake-up call for anyone living outside the big smoke: 'Have a good think about whether you want to declare that you’re going private.

You might want to just go with public and get everything covered,' he advised.

While he praises the care he received from private doctors and nurses, he admits he wishes he’d known more about the public system’s benefits before making his choice.


The Rural Health Gap: A National Issue

Phil’s story isn’t unique. According to the Australian Institute of Health and Welfare (AIHW), people in rural and remote areas have higher rates of hospitalisation, injury, and death than those in major cities.

They’re also more likely to have to travel long distances or even relocate for specialist care.

This 'postcode health penalty' is a real and growing problem. It’s not just about cancer, either—heart disease, diabetes, and mental health issues are all harder to manage when you’re hours away from the nearest specialist.

And while there are some government schemes to help with travel and accommodation costs, many say they don’t go far enough.


Phil is now pushing for clearer information, stronger support, and better access to critical treatment for people living in regional areas.

He’s calling for more transparency around the true costs and differences between public and private healthcare.

He also wants improved support for patients and families who need to travel for treatment, including more affordable places to stay.

Ultimately, he believes investing in regional health services is essential so that fewer Australians are forced to leave home just to get the care they need.
Key Takeaways
  • Australians living in rural and regional areas face significant extra costs and challenges accessing vital healthcare, often having to travel or relocate for treatment unavailable locally.
  • Private health insurance does not always cover all expenses, with out-of-pocket costs for accommodation, food, and transport often falling to the patient, even after decades of paying premiums.
  • Many people outside of major cities are not fully informed about the practical differences between public and private healthcare, and might be better off financially using the public system in serious health situations.
  • There is a strong call for clearer guidance, better support, and improved access to life-saving care for those living outside metropolitan areas, highlighting inequities in Australia’s health system.
Have you or someone you know faced similar challenges accessing healthcare outside the big cities? What advice would you give others in the same boat? Share your experiences and tips in the comments below.

Read more: A simple check could have saved his life—now his family is demanding answers
 

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Thank you Phil ( and SDC) for exposing the extent of the private/public rural/regional Health FAILURE. ANY rural/regional patient has a story to tell around the discriminatory nature of health “care” from
a cost and aligned convenience perspective. For those who have paid private health cover for decades, few have read the fine print around funding health care OUTSIDE of our locality. Travel, food and accommodation, etc. and MANY have witnessed tragic cases of failure to connect or progress with treatment because of those costs. The withdrawal of public funding for many basic imaging etc procedures is also contributing to failure to engage with professionals. We need competent system oversight, regular auditing, effective management in Treasury and leadership respect for regional/rural consumer/patient health. Health should NOT be accorded the privileged few.
 
Thank goodness I live in WA.
As many of you are aware my daughter has her many trials over the last 16 years with a very similar cancer.
Through three separate operations she lost her tongue , which was rebuilt by the fantastic surgeons at SCGH She had 12 weeks radiation after the first operation, along with chemo.
Through the public health system this has cost us nothing financially. Through the PATS scheme all our travel expenses have been covered and free accommodation was provided at Crawford Lodge where we were given a full family suite for the 12 werks free of charge. This is right next to the hospital and you can ring for the hospital buggy to pick you up if you don't feel like walking.
To all those who sent their love and best wishes for my daughter yesterday I thank you all so much.
I am so happy to report she came through the operation with flying colours.
The surgeons are happy so far and her heart behaved itself throughout. All that remains to be seen is the healing process which can be hampered because of the damage done by radiation.
I'm off to see her now, she should be a little less groggy this morning.
Again, thank you all for your best wishes💕
 
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My husband had the same cancer. Thank heaven we were able to get him treatment at the Albury/Wodonga Cancer Centre. But I have to travel to Melbourne for surgeries on my spine every few years. It does take its toll on finances even though I get some money back for travel. There is a big difference between states on what they cover.
 
In the early 1950s (could have started in the late 1940s) my Grandma had cancer that made her tongue sore.
It gradually spread through her stomach over the years then caused a huge brain haemmorage. Apparently operating caused it to gallop according to our GP. She went for a holiday with a relative who took her to a different Doctor who operated. All those years ago very little or any cancer treatments were available
 
Omgosh i did not realise the difference between public and private costings... so if you go public you pay nothing but don't get the choice of dr/specialist or hospital or when.. if you go private you get those choices but pay extra on top of your yearly membership fee... have i understood that as correct... when you are admitted for these treatments,do you get a choice of going public or private if you have private insurance, do you have to go private?
 
Omgosh i did not realise the difference between public and private costings... so if you go public you pay nothing but don't get the choice of dr/specialist or hospital or when.. if you go private you get those choices but pay extra on top of your yearly membership fee... have i understood that as correct... when you are admitted for these treatments,do you get a choice of going public or private if you have private insurance, do you have to go private?
That's right. You don't have to go private,you can go public. When you're admitted they will ask if you have private insurance, just say no and they'll put you down as public. Obviously it needs to be a public hospital.
You may not get to choose your Dr but just because a Dr works in a private hospital doesn't make him any better than the Drs in public hospitals. They just charge more.
My daughter couldn't have received any better treatment than she got at SCGH
and she had a private room in ICU for about the first 10 days after each operation.
I gave up my private health cover many years ago. It's just too expensive.
 
Thank goodness I live in WA.
As many of you are aware my daughter has her many trials over the last 16 years with a very similar cancer.
Through three separate operations she lost her tongue , which was rebuilt by the fantastic surgeons at SCGH She had 3 weeks radiation after the first operation, along with chemo.
Through the public health system this has cost us nothing financially. Through the PATS scheme all our travel expenses have been covered and free accommodation was provided at Crawford Lodge where we were given a full family suite for the 12 werks free of charge. This is right next to the hospital and you can ring for the hospital buggy to pick you up if you don't feel like walking.
To all those who sent their love and best wishes for my daughter yesterday I thank you all so much.
I am so happy to report she came through the operation with flying colours.
The surgeons are happy so far and her heart behaved itself throughout. All that remains to be seen is the healing process which can be hampered because of the damage done by radiation.
I'm off to see her now, she should be a little less groggy this morning.
Again, thank you all for your best wishes💕
I hope that your daughter continues to recover well and manages to regain her health. The worries never stop, do they?
 
What worries me about going public is the, possible, waiting times for surgery and treatment. My wife had to have back surgery a few years ago and after seeing the surgeon for the first time she was asked if she had any plans for the next week. We were told to leave his office while he saw the next patient and during that time speak to our private fund and check cover for certain item numbers. The surgeon then booked her in for major surgery within 6 days. Would that have happened in the public system I wonder? More recently she had to have a heart procedure for a problem that she had been putting up with for years. the surgeon had her in the hospital the next week. Yes we did have to pay $500 “hospital fee” each time but peace of mind and immediate treatment made it well worthwhile. The second surgery involved travelling from the Wimmera in Vic to Melbourne (350kms) but having family nearby made it easy.
 
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I have had stage 3 Adema carcinoma of the lung for almost 5 years now and I cannot say enough for the care I have received through the public system in WA. They have always treated with dignity and respect making my cancer journey much more bearable.
luckily I live in Perth so did not need travel and accommodation assistance but I have not been out of pocket for anything else.
I never have and never would have private health as you never get what you paid for.
Thanks to my Oncology team and Fiona Stanley Hospital. They are awesome
 
surely he has a health fund. he owns a huge company. I have a hell of a lot of health issues, not rich but I have a health fund, that has so far probaly spent Hundreds of thousands on me. far outpays what i pay. I am starting to get a bit tired of all these ones on here with their problems. The problems do not belong to us as most of us have our own to bear.
 
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I have had stage 3 Adema carcinoma of the lung for almost 5 years now and I cannot say enough for the care I have received through the public system in WA. They have always treated with dignity and respect making my cancer journey much more bearable.
luckily I live in Perth so did not need travel and accommodation assistance but I have not been out of pocket for anything else.
I never have and never would have private health as you never get what you paid for.
Thanks to my Oncology team and Fiona Stanley Hospital. They are awesome
so you are in the public system bleeding it. Health fund users are saving the government funds, unlike you.
 
I had breast cancer in one breast and at the time was living in Tweed Heads. The nearest place for daily treatment which I had to have for six weeks, was at a private hospital in Tugun, on the Gold Coast. Luckily my car was new and I was able to drive up each day for my treatment, but the treatment made me tired and the drive back to Lismore made me even more tired. I would drop onto the bed when I arrived home and sleep for hours.
Then of coursae the cost of treatment plus petrol made it very expensive.
 
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I hope that your daughter continues to recover well and manages to regain her health. The worries never stop, do they?
Thank you I am hoping that this will be the last. They say she can go home tomorrow, but quite a few recalls coming up just to keep a check on the healing process.
What worries me about going public is the, possible, waiting times for surgery and treatment. My wife had to have back surgery a few years ago and after seeing the surgeon for the first time she was asked if she had any plans for the next week. We were told to leave his office while he saw the next patient and during that time speak to our private fund and check cover for certain item numbers. The surgeon then booked her in for major surgery within 6 days. Would that have happened in the public system I wonder? More recently she had to have a heart procedure for a problem that she had been putting up with for years. the surgeon had her in the hospital the next week. Yes we did have to pay $500 “hospital fee” each time but peace of mind and immediate treatment made it well worthwhile. The second surgery involved travelling from the Wimmera in Vic to Melbourne (350kms) but having family nearby made it easy.
My daughter's first surgery was done within 2 days. The surgery took 13 hours
to remove 1/3rd of her tongue and the lymph nodes in her neck and rebuild her tongue from a piece of her arm.
The second and third were much the same, loosing her whole tongue.
The longest she had to wait was two
weeks

Urgent cases are prioritised, but my knee replacement is on the waiting list I'm told 6 to 12 months.
 
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surely he has a health fund. he owns a huge company. I have a hell of a lot of health issues, not rich but I have a health fund, that has so far probaly spent Hundreds of thousands on me. far outpays what i pay. I am starting to get a bit tired of all these ones on here with their problems. The problems do not belong to us as most of us have our own to bear.
The expenses of travel and accommodation may not be covered by health fund.
 
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