The purpose of the project was to analyse the OOP expenditure on health care as directly reported by Aus households group into older households (those aged greater than 65) and younger households (those aged less than 65).
The project was designed by analysis the statutory data collected by the ABS.
The setting of the project was determined by the sample of 9774 households across all states and territories. The main outcome was determined as finding the OOP expenditures on health care.
The results determined from the project found older households estimated an expense of $3585 +- $686 (9.4 per cent) of total expenditure on all goods and services while younger households had expenses of $3377 +- $83. The cost of medicine was found to be affected reduced as a result of the copayments with the Pharmaceutical Benefits Scheme and the cost of private health insurance (PHI) was the most expensive item for the younger households.
The results also found the OOP expenses was $28.7 +- billion compared with $21.2 billion as found by the Australian Institute of Health and Welfare (A government funded organisation). The institute's figure was based on data collection and did not include the premiums of PHI.
Conclusions: OOP expenses account for almost a quarter (22 per cent) of the total health care costs in Australia.
Mean yearly OOP expenditure was slightly higher for the older households compared with the younger households, despite the fact that the older households had significantly lower income and had greater access to health care cards, which were used to defray additional health care costs associated with age.
Other Facts:
- Australia spent $121 billion on healthcare in the 2009 Fiscal year. Estimates found this amount was funded by 44% Federal, 26% state and local while the remaining 18% came from copayments and individuals.
- The study excluded people living in remote areas, residents of non-private dwellings, foreign diplomats and defence personnel.
- Estimates show that there were 8.40 +- 0.03 million households in Australia; of these 1.76 +- 0.02 million had a reference person aged 65 years, and are referred to as the older households. Older households accounted for just over one in five households in the study. The two groups of households, older and younger, varied significantly in terms of their living arrangements (household composition), income, access to health care cards and PHI.
- Most of the older households (86% +- 1.2%) consisted of couples only or lone persons, while most of the younger households (63% +- 0.5%) were couples with or without children.
- Study doesn't extend to the assessment of financial records and is based on estimated provided by the participants.
- The OOP determined in the study is more than the AIHW, but their study was based on the statutory data collections and did not include the cost of PHI premiums.
The study lists previously that compared the OOP expenses was referenced in the opening statement that referred to the finding of households pay for almost 25% of the nation’s health costs.
The Australian centre for Health Research (AHCR) proposed a new AUD$6 co-payment for access to bulk-billed general practitioner services. This is because 80 per cent of GP visits are bulk-billed.
The AHCR claims the co-payment would save the federal government budget $750 million a year.
Originally GP visits were bulk-billed as during the Howard years there was a large decline in bulk billing, as GPs made up the lost income by on-charging their patients, this results in a political crists as consumers turned to government services.
Evidence of unnecessary demand for GP services? Bettering the Evaluation and care of Health (BEACH) completed study from 1998 that found GP visits had increased due to the complexity of issues GPs could handle increasing and the rise of chronic illnesses (like Type 2 Diabetes).
The RAND study - Purpose was to perform a Health Insurance Experiment (HIE) and compare with today's quality of health care and determine whether it's still relevant. The HIE was found completed in the 1970s to determine the impact cost sharing took on the national health care rebate.
The study found today's health care has an increased demand on managed care, as has prescription drug use. The study found the cost sharing can be manipulated to reduce waste without damaging health of quality care.
Cost sharing cuts the expenditures by reducing visits but has little effect on the cost of treatment once care is sought. it is widely believed, cost increases are driven by treatment expenses and new technologies, cost sharing can reduce the cost at the various points but may have little effect on the overall rate of cost growth.
Six dollar co-payment to see a doctor: a GP’s view
The GP says the question is, are co-payments likely to reduce GP visits? Yes. Are they likely to deter only “unnecessary” GP visits? No.
The RAND study had poor outcomes for those with vision or high blood pressure, with the group being predicted as having a higher risk of dying.
900,000 people in the United States: co-payment increases were followed by a reduction in GP visits but also by significant increases in hospitalisation. These effects were biggest in those with lower income, less education and with pre-existing illness.
"Co-payments may have adverse health consequences and may increase total spending on health care.”
The vast number of GP visits are for managed conditions like high blood pressure, immunisations, "check-ups", respiratory tract infections, depression, diabetes and back pain etc.
The GP says costs are best managed by assisting patients in learning how to manage their own health conditions and by reducing the number of unnecessary prescriptions and repeat visits that could be managed by the patients once given the correct advice.
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