The Times Australia
The Times World News

.

First Nations people in the NT receive just 16% of the Medicare funding of an average Australian

  • Written by Stephen Duckett, Honorary Enterprise Professor, School of Population and Global Health, and Department of General Practice, The University of Melbourne
First Nations people in the NT receive just 16% of the Medicare funding of an average Australian

Medicare, Australia’s universal health insurance scheme, provides financial protection against the cost of medical bills, and makes public hospital care available without any charge to the patient. For the large majority of Australians in urban settings, it is a brilliant system[1] – providing subsidised access to care.

But subsidised access is only useful for those who have access. If there is no doctor nearby, there is nothing to subsidise. This creates a huge inequity – most of Australia has good access to doctors, but the Northern Territory does not.

And what’s worse, there is no effective policy to redress the inequity that payments flow to areas where there are doctors.

In our recently published paper[2], we found NT residents receive roughly 30% less Medicare funding per capita than the national average (A$648 compared with A$969).

The gap is worse for First Nations Australians in the NT, who attract only 16% of the Medicare funding of the average Australian.

Read more: Labor's health package won't 'strengthen' Medicare unless it includes these 3 things[3]

We measured the extent of the problem over the years 2010–20. We used the federal government’s published figures on Medicare to explore the impact of this uneven workforce distribution on Medicare billing in the NT.

The differences are stark.

The inequitable funding is even worse when the poorer health status of First Nations Australians and the additional costs associated with geographical remoteness are taken into account. The NT has a younger age profile than the rest of Australia, but this explains only one-third of the gap. What’s going wrong with the funding? Despite Medicare’s intended universality, the NT is systematically disadvantaged. People in the Territory have poorer access to primary health care, which includes GP services and those provided by Aboriginal community-controlled health services. Aboriginal health services receive some special additional funding separate from the Medicare-billing funding. However, even with that extra funding, there is still a shortfall[4] to NT residents of about A$80 million each year. The NT government receives a relatively higher proportion of the GST funding pool in recognition of its challenges with remoteness and Indigenous services. But this is calculated assuming NT residents have the same access to Medicare as all other Australians. As we have shown, they don’t and so the extra GST funding does not result in a fair funding stream to meet NT primary care needs. The outcome of inadequate primary health care funding is increasing reliance on hospital services. People’s chronic health conditions worsen if they’re not well managed in the community and this increases the risk they will need a hospital admission, especially for “potentially preventable hospitalisations[5]”. NT hospitals experience excessive pressure of workload and complexity as a result. Woman sits on a hospital bed, her back to the door.
Poorer access to primary care services results in more hospitalisations. Shutterstock[6]

We have shown previously that effective primary health care for remote patients with chronic, long-term diseases can substantially reduce their use of hospital services[7] and result in better health outcomes at a lower cost.

When visiting the NT in 2000, one of the architects of Medicare, John Deeble[8], observed the funding failure first hand and suggested another form of health-care financing was needed to adequately support remote primary health care.

In terms of health equity and our national commitment to close the life expectancy gap for First Nations peoples, the status quo is undeniably short-changing our efforts.

What needs to be done?

There needs to be a reset in how we finance remote primary health care services in the NT.

The value proposition is excellent. Due to the extreme health needs and vulnerable populations, the return on investment is high[9] – more than A$5 in saved acute care costs for every dollar invested.

The federal government’s Health Care Homes funding reform trial was very successful in remote NT communities[10]. For the first time, service providers received flexible funding to care for patients’ chronic conditions, rather than a fee for each service they provided. It also enabled the provider and patient to develop a relationship.

Unfortunately the Health Care Homes program ended in June 2021[11], and has not been renewed. This program should be reinvigorated for chronic disease care in the NT and extended to include other core programs of mental health and suicide prevention, and child and maternal health.

The federal government should take this opportunity to get remote primary health care financing right and ensure Medicare funds reach those who need them most.

Read more: How do the major parties rate on Medicare? We asked 5 experts[12]

Acknowledgement: Xiaohua Zhang, Jo Wright, and Maja Van Bruggen from the Northern Territory Department of Health are co-authors of the journal article on which this article is based.

References

  1. ^ brilliant system (www.commonwealthfund.org)
  2. ^ recently published paper (www.publish.csiro.au)
  3. ^ Labor's health package won't 'strengthen' Medicare unless it includes these 3 things (theconversation.com)
  4. ^ shortfall (www.publish.csiro.au)
  5. ^ potentially preventable hospitalisations (www.aihw.gov.au)
  6. ^ Shutterstock (www.shutterstock.com)
  7. ^ reduce their use of hospital services (bmchealthservres.biomedcentral.com)
  8. ^ John Deeble (en.wikipedia.org)
  9. ^ return on investment is high (www.mja.com.au)
  10. ^ was very successful in remote NT communities (www.amsant.org.au)
  11. ^ Health Care Homes program ended in June 2021 (www1.health.gov.au)
  12. ^ How do the major parties rate on Medicare? We asked 5 experts (theconversation.com)

Read more https://theconversation.com/first-nations-people-in-the-nt-receive-just-16-of-the-medicare-funding-of-an-average-australian-183210

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

Tricia Paoluccio designer to the stars

The Case for Nuturing Creativity in the Classroom, and in our Lives I am an actress and an artist who has had the privilege of sharing my work across many countries, touring my ...

Duke of Dural to Get Rooftop Bar as New Owners Invest in Venue Upgrade

The Duke of Dural, in Sydney’s north-west, is set for a major uplift under new ownership, following its acquisition by hospitality group Good Beer Company this week. Led by resp...

Prefab’s Second Life: Why Australia’s Backyard Boom Needs a Circular Makeover

The humble granny flat is being reimagined not just as a fix for housing shortages, but as a cornerstone of circular, factory-built architecture. But are our systems ready to s...

Melbourne’s Burglary Boom: Break-Ins Surge Nearly 25%

Victorian homeowners are being warned to act now, as rising break-ins and falling arrest rates paint a worrying picture for suburban safety. Melbourne residents are facing an ...

Exploring the Curriculum at a Modern Junior School in Melbourne

Key Highlights The curriculum at junior schools emphasises whole-person development, catering to children’s physical, emotional, and intellectual needs. It ensures early year...

Distressed by all the bad news? Here’s how to stay informed but still look after yourself

If you’re feeling like the news is particularly bad at the moment, you’re not alone. But many of us can’t look away – and don’t want to. Engaging with news can help us make ...