Zoë Wundenberg | Medicare, health system needs to be strengthened

We've long-since held our Medicare system up as a shining light on the global stage of healthcare, claiming it is "a world class health system, with primary care at its core" (to quote the report).

We need to put our money where our mouth is.

The biggest Medicare gap that Australia has to deal with is healthcare for those living in poverty.

Last year, The Australian Institute of Health and Welfare acknowledged "socioeconomic factors are key determinants of health", with people in lower socioeconomic groups being at greater risk of poor health, due to having "higher rates of illness, disability and death, and liv[ing] shorter lives than people from higher socioeconomic groups."

In fact, people living in the lowest socioeconomic areas are 1.5 times as likely to die as their wealthier counterparts.

It's confronting to read that, isn't it? It's so ingrained in our understanding of healthcare and socioeconomics that there is a term for it: the social gradient of health, i.e. the wealthier you are, the healthier you are likely to be.

Chronic illness also favours the wealthy.

Those living in the lowest socioeconomic areas of Australia bear a burden of disease that is staggeringly higher than those who are in the highest socioeconomic areas: 2.4 times as high for type 2 diabetes, 2 times as high for coronary heart disease, 1.6 times as high for stroke, 1.2 times as high for dementia.

This may be the latest data, but it's not breaking news. We've known about this correlation for years.

Accessibility to healthcare is significantly problematic. The news of the (now-defunded) additional 10 Medicare psychology sessions was a widely welcome initiative, however, still needing to cover the financial gap between the Medicare rebate and the private fee made the program inaccessible for many living in poverty, and those living in regional, rural, and remote areas.

Waitlists are another issue, with many mental health providers having waitlists of six months or longer, meaning that our struggles remain our own even when they have reached the tipping point of us finally seeking help.

Waitlists for paediatricians and specialist services (especially in regional areas) is another issue.

Even if you can afford the gap payment, getting in to see the specialist you need is a challenge unto itself.

Over 12 months for a gastroenterologist when your GP suspected cancer? Two years for a paediatrician appointment to assess your child for autism?

Not even shocking. You even have to wait one to two weeks on average at our local medical clinic for an appointment with your own GP - I don't know about you, but I've never been able to forecast when I will be unwell two weeks into the future.

Availability of qualified GPs and specialist healthcare providers, especially in regional and remote areas plays a significant role in healthcare stress.

Those living in poverty cannot easily traipse to the nearest metro centre for specialist appointments even if they could afford the Medicare gap.

Inaccessibility to healthcare notwithstanding finances has led to online telehealth services popping up, where you book an appointment online and a GP will call you back within the day to discuss your needs over the phone.

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Technology allows for e-scripts to be sent to your chemist, thus even removing the need to see a GP in person at all. This service is accessible and convenient, but it's not appropriate for everything, and you don't get to claim a Medicare rebate on the fee, often being out of pocket $50 a pop for a 30-second phone call and a script for antibiotics.

Furthermore, with increasing numbers of GPs now refusing to bulk-bill patients and changes to Medicare provisions on scans etc., the "slashed" maximum costs of PBS medications is like treating a third degree burn with aloe vera, particularly when you realise that the minimum costs of PBS medications (i.e. concession prices) actually increased from $6.80 to $7.30 from the January 1 this year.

So those living in poverty were once again pinged with a price hike, despite the media reports of costs declining.

We need more funding. $750 million is just not enough. We need more healthcare practitioners in regional areas. We need bulk-billing for those "coordinated multidisciplinary teams of providers" recommended in the report, and we need to value every member of our community - no-one should be left behind.