Even wealthy Australians avoiding GP visits as cost of living hurts access to healthcare

The Guardian

22-10-2024

Even wealthy Australians are cutting back on doctor's appointments due to the cost of living, with new data showing the proportion of people in New South Wales who put off a GP visit because it was too expensive increased by 246% over the past four years.
A new NSW Council of Social Services (Ncoss) report, based on modelling of Australian Bureau of Statistics data by researchers at the University of Canberra, found healthcare had become less accessible for more people.
Those on low incomes still struggle the most to see a doctor: there was a 301% increase in the proportion of this demographic who delayed or avoided a GP visit due to the cost between 2020 and 2024.
But the proportion of people on middle and high incomes delaying or avoiding the GP also increased significantly: by 243%.
The researchers drew from the 2023 patient experience survey contained within the ABS's multipurpose household survey as well as original data estimations they produced.
They found a 'dramatic increase' in the proportion of people delaying or not seeing a GP due to cost – from 2.8% in 2020 to 9.5% in 2024.
In 2020, proportionally, 2.8% of NSW residents skipped a GP appointment because of the cost. This increased to 9.5% in 2024.
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People on low incomes attended an average of 5.7 GP appointments in 2020. In 2024 this fell to 4.8 appointments.
The report draws on the most recent census data to set the low income threshold at $540 a week in 2021 dollars. It presents all other results as 'medium/high income'.
The Ncoss chief executive officer, Cara Varian, said more people weren't seeing doctors because of the increasing costs of medical services – propelled in part by the dearth of bulk-billing GPs – as well as inflation in other areas such as energy.
'It's been really clear through this research that that reduction in access that's been driven by cost is actually being felt across all income levels, which was not the case four years ago,' she said.
'People's … ability to spend money on healthcare is reducing.'
The Ncoss report found that people in NSW living outside of Sydney were more likely to put off seeing both GPs and specialists and that their experiences were worse the further away they lived.
Although the number of visits to specialists and the proportion of people waiting longer than acceptable have remained relatively stable overall, experiences with delays due to cost 'worsened significantly', the report said.
In 2020, people in regional NSW attended an average of 1.3 specialist appointments a year. In 2024, this fell to 1.2.
While this was a difference of only 5.3%, the proportion of patients in regional NSW who said they had delayed or not seen a specialist due to cost rose by 202%.
In 2020, proportionally, 7.9% of regional residents delayed or didn't see a specialist due to cost. This increased to 24% in 2024.
Varian urged the NSW government to improve workforce planning to attract more doctors and dentists to the country, and to improve patient transport options.
'People who are in regional and rural NSW that are experiencing poverty are less likely to have private health insurance, and they're also less likely to be able to access the primary health care or specialist care that they need,' she said.
Emma Warren, a Newcastle resident who lives with the chronic inflammatory bowl condition Crohn's disease, said she had struggled to afford GP visits since her doctor had to stop bulk billing in December 2022.
Warren, an academic whose illness prevents her from working full-time, said it was also very difficult to book GP and specialist appointments at short notice because doctors were in short supply.
She said she was constantly worrying about how to afford medical appointments, medication and food while on the disability support pension.
'There's weeks I'm surviving on toast and ham sandwiches,' she said.
Warren said the state and federal governments should work together and make bulk billing a 'major policy focus'.
'I can't afford private health cover, I but I shouldn't need it as a disability pensioner,' Warren said.
'What are they doing so people like me can afford to see a doctor as much as they need to?'
Bulk billing is where a GP accepts only a Medicare rebate as payment for an appointment, making it free instead of charging a patient an extra 'gap' fee.
Australia lost more than 400 dedicated bulk-billing GP clinics from 2023 to 2024, according to Guardian Australia analysis.