The Times Australia
The Times World News

.

Last year, half a million Australians couldn't afford to fill a script. Here's how to rein in rising health costs

  • Written by Stephen Duckett, Director, Health and Aged Care Program, Grattan Institute
Last year, half a million Australians couldn't afford to fill a script. Here's how to rein in rising health costs

Nearly every Australian uses some part of the health system every year, whether it be going to the GP, getting a prescription filled, or seeing a specialist.

Despite having a universal health-care system, we often still pay for these services out of our own pockets.

Sadly, these out-of-pocket payments are unaffordable for many Australians – so they skip the trip to the doctor, or defer going to the chemist.

This is bad for those individuals, but also bad for taxpayers and the economy. It makes people sicker, widens inequities, and puts further strain on the health system down the track.

In the Grattan Institute’s latest report[1], we identify what governments should do to make health care more affordable for more Australians.

Who is missing health care because of cost?

In 2020-21, more than half a million people[2] deferred or did not fill a prescription because of cost. Nearly half a million decided not to see a specialist because of cost.

Read more: We need more than a website to stop Australians paying exorbitant out-of-pocket health costs[3]

People with chronic conditions have much higher health-care costs, particularly if they have multiple chronic conditions; they spend between A$200-600 on average on health care each year[4].

But they are also less likely to be able to afford their ongoing care because their chronic condition can make it more difficult to keep or get a job.

Many of these people who are forgoing health care due to cost are younger, particularly younger women:

Grattan analysis of ABS Patient Experiences Survey, 2020-21 Younger people tend to have fewer savings, and can therefore find it harder to afford care. And women are more likely to have chronic health conditions. About 55% of people with two chronic conditions are women[5], and 60% of people with three or more chronic conditions are women. Chronic conditions are becoming more common, so more and more Australians will be facing higher health-care costs and are at risk of missing needed care. Over the past ten years, average out-of-pocket payments rose by 50%[6], and they will continue to rise unless governments act now. Pharmacist takes medicine from a cupboard.
Out of pocket costs are likely to rise without government action. Unsplash/National Cancer Institute[7]

What can be done?

The federal government can do much more to reduce out-of-pocket payments and avoid unnecessary costs down the line.

Cost of medicines

While Australia has a world-renowned Pharmaceutical Benefits Scheme (PBS) that helps keep many medications affordable, Australians are still spending nearly A$3 billion on PBS-listed prescriptions each year, including A$1.5 billion on mandatory co-payments[8] and A$1.4 billion on PBS-listed prescriptions[9] which cost less than the co-payment.

The federal government should lower the cost of prescriptions for people taking five or more medications for chronic conditions, after their GP conducts a medication review triggered by a computer-generated alert.

We estimate this could reduce inappropriate medication use for about 300,000 patients.

Read more: Poor and elderly Australians let down by ailing primary health system[10]

The government should also extend the duration of prescriptions for some medications to reduce the number of Pharmaceutical Benefits Scheme co-payments people have to make to pharmacies.

Tests and scans

The government should abolish the out-of-pocket burden from diagnostic services, such as blood tests and scans.

Australians spend about A$400 million on these services each year[11] – even though patients aren’t the real users of these tests, doctors are.

Doctor types on laptop/
Doctors are the real users of tests and scans. Unsplash/National Cancer Institute[12]

With these services now frequently provided by large corporations, the federal government should fund them directly through a commercial tender instead.

Patient enrolment

The government should expand the voluntary patient enrolment scheme to people with two or more chronic conditions.

Patient enrolment is where a patient can enrol in a GP practice and nominate a GP to be their “usual doctor”. It can help make care more affordable for people with chronic conditions by reducing their exposure to out-of-pocket payments.

Greater GP stewardship over a person’s care could reduce inefficiencies in areas such as routine repeat prescriptions and routine renewal of specialist referrals.

Read more: Why it costs you so much to see a specialist – and what the government should do about it[13]

The government has already committed to this reform for people older than 70. If it was expanded to younger people, we estimate an additional 1.7 million people would be eligible for the program.

Bulk billing

The vast majority of health services people receive outside hospital are “bulk-billed” – meaning the patient pays nothing out of pocket. But bulk-billing rates for specialists and allied health are still far too low – at about 46% for specialists and 56% for allied health[14].

The federal and state governments should expand the number of health-care services provided free of charge, particularly in lower-income areas and areas where bulk-billing rates are especially low.

Our analysis shows that if state and federal governments invest an additional A$710 million a year on these reforms, they could save Australians about A$1 billion in out-of-pockets a year, and enable more people to get the care they need, when they need it. That’s a healthy return on investment.

References

  1. ^ latest report (grattan.edu.au)
  2. ^ more than half a million people (www.abs.gov.au)
  3. ^ We need more than a website to stop Australians paying exorbitant out-of-pocket health costs (theconversation.com)
  4. ^ A$200-600 on average on health care each year (grattan.edu.au)
  5. ^ 55% of people with two chronic conditions are women (www.abs.gov.au)
  6. ^ average out-of-pocket payments rose by 50% (www1.health.gov.au)
  7. ^ Unsplash/National Cancer Institute (unsplash.com)
  8. ^ A$1.5 billion on mandatory co-payments (www.pbs.gov.au)
  9. ^ A$1.4 billion on PBS-listed prescriptions (www.pbs.gov.au)
  10. ^ Poor and elderly Australians let down by ailing primary health system (theconversation.com)
  11. ^ A$400 million on these services each year (www1.health.gov.au)
  12. ^ Unsplash/National Cancer Institute (unsplash.com)
  13. ^ Why it costs you so much to see a specialist – and what the government should do about it (theconversation.com)
  14. ^ 46% for specialists and 56% for allied health (www1.health.gov.au)

Read more https://theconversation.com/last-year-half-a-million-australians-couldnt-afford-to-fill-a-script-heres-how-to-rein-in-rising-health-costs-178301

Times Magazine

Headless CMS in Digital Twins and 3D Product Experiences

Image by freepik As the metaverse becomes more advanced and accessible, it's clear that multiple sectors will use digital twins and 3D product experiences to visualize, connect, and streamline efforts better. A digital twin is a virtual replica of ...

The Decline of Hyper-Casual: How Mid-Core Mobile Games Took Over in 2025

In recent years, the mobile gaming landscape has undergone a significant transformation, with mid-core mobile games emerging as the dominant force in app stores by 2025. This shift is underpinned by changing user habits and evolving monetization tr...

Understanding ITIL 4 and PRINCE2 Project Management Synergy

Key Highlights ITIL 4 focuses on IT service management, emphasising continual improvement and value creation through modern digital transformation approaches. PRINCE2 project management supports systematic planning and execution of projects wit...

What AI Adoption Means for the Future of Workplace Risk Management

Image by freepik As industrial operations become more complex and fast-paced, the risks faced by workers and employers alike continue to grow. Traditional safety models—reliant on manual oversight, reactive investigations, and standardised checklist...

From Beach Bops to Alpine Anthems: Your Sonos Survival Guide for a Long Weekend Escape

Alright, fellow adventurers and relaxation enthusiasts! So, you've packed your bags, charged your devices, and mentally prepared for that glorious King's Birthday long weekend. But hold on, are you really ready? Because a true long weekend warrior kn...

Effective Commercial Pest Control Solutions for a Safer Workplace

Keeping a workplace clean, safe, and free from pests is essential for maintaining productivity, protecting employee health, and upholding a company's reputation. Pests pose health risks, can cause structural damage, and can lead to serious legal an...

The Times Features

The Role of Your GP in Creating a Chronic Disease Management Plan That Works

Living with a long-term condition, whether that is diabetes, asthma, arthritis or heart disease, means making hundreds of small decisions every day. You plan your diet against m...

Troubleshooting Flickering Lights: A Comprehensive Guide for Homeowners

Image by rawpixel.com on Freepik Effectively addressing flickering lights in your home is more than just a matter of convenience; it's a pivotal aspect of both home safety and en...

My shins hurt after running. Could it be shin splints?

If you’ve started running for the first time, started again after a break, or your workout is more intense, you might have felt it. A dull, nagging ache down your shins after...

Metal Roof Replacement Cost Per Square Metre in 2025: A Comprehensive Guide for Australian Homeowners

In recent years, the trend of installing metal roofs has surged across Australia. With their reputation for being both robust and visually appealing, it's easy to understand thei...

Why You’re Always Adjusting Your Bra — and What to Do Instead

Image by freepik It starts with a gentle tug, then a subtle shift, and before you know it, you're adjusting your bra again — in the middle of work, at dinner, even on the couch. I...

How to Tell If Your Eyes Are Working Harder Than They Should Be

Image by freepik Most of us take our vision for granted—until it starts to let us down. Whether it's squinting at your phone, rubbing your eyes at the end of the day, or feeling ...