Some Australians have to pay up to $600 out of pocket expenses not covered by Medicare.
Some Australians have to pay up to $600 out of pocket expenses not covered by Medicare.

The true cost of staying healthy in Australia

MEDICARE is fast failing to cover the costs of most doctors' services with some patients having to pay more than $600 extra a year to stay healthy.

Half of all patients having non-hospital treatments have to pay extra to cover the gap between the doctor's bill and the Medicare subsidy.

The Government provides $19 a year for these services - including visits to GPs, specialists, imaging and obstetrics.

But the patients pay $3 billion on top of this.

These are the findings released today by the Australian Institute of Health and Welfare which challenge assurances bulk-billing rates are growing.

The AIHW reported half of Australian patients pay a contribution towards their non-hospital Medicare services, and the size of the out-of-pocket charge depends on where they live.

Its study found that nationally in 2016‒17, 10.9 million patients paid something from their own pockets toward their services.

This differs from the usually reported bulk-billing rate for GP services, those completely paid for by the government.

In 2016-17, 86 per cent of GP services were bulk-billed while 66 per cent of patients

had all of their GP services bulk-billed.

But location is a critical factor - specifically your Primary Health Network (PHN) area.

Just 31 per cent of Northern Territory patients pay extra, while the proportion is 69 per cent in the Australian Capital Territory.

In general, metropolitan patients were more likely to escape extra costs than those in regional Australia.

"For patients who incurred out-of-pocket costs, the median amount each patient spent in the year was $142. But patients living in some PHN areas paid almost double that of others," said AIHW spokesman Michael Frost said.

The median out-of-pocket cost per patient during 2016-17 ranged from $104 in Western Queensland to $206 in Northern Sydney.

For the 10 per cent of patients with the highest costs, there was also substantial variation across similar socio-economic areas.

For example, among patients living in lower socio-economic areas in the major cities, the top 10 per cent in Playford, South Australia were out-of-pocket at least $372 during 2016‒17, while those in Botany, NSW, were out-of-pocket at least $682.

The AIHW reported variation in how much patients pay out-of-pocket per service.

More than 7-in-10 people who had specialist consultations had out-of-pocket costs, and for these people the median 'gap' per specialist visit was $64.

Across local areas, the median out-of-pocket cost ranged from $36 to $97 per specialist service.

''A range of factors can influence out-of-pocket costs. These can include the types of services the patient requires, the availability of bulk billing and the cost of services in their area,' Mr Frost said.