Medical costs for south-west patients at record highs, government data shows

The data from the Australian Institute of Health and Welfare looked at a spectrum of healthcare areas from general practice and allied health to specialties like surgery and anaesthetics, and showed the proportion of the costs covered by Medicare for each service steadily declining over time.

The trend was Australia-wide and The Standard analysed south-west local government areas of Warrnambool, Moyne, Corangamite and Glenelg, finding each area had suffered similar drops.

Melbourne University associate professor of general practice Jo-Anne Manski-Nankervis said the declining subsidies were a result of long-term government policy.

"What you're seeing there is the Medicare rebates have not kept in line with inflation, so that means there is an increasing gap between what the government reimburses through Medicare and how much it actually costs to provide the service," Professor Manski-Nankervis said.

The downward trend has been well publicised in general practice, with GPs waging a campaign over several years to lift a long-term freeze on the Medicare rebate they could claim.

Professor Manski-Nankervis said as GPs found it harder to make ends meet many left the field, making it more difficult for patients to access services, especially bulk billing clinics. In regional areas, which had fewer GPs to begin with, the pattern was exacerbated.

These pressures showed up in the data, where Warrnambool, Corangamite and Moyne were consistently below the state and national average for GP subsidies, but were also below average for GP attendance, suggesting patients were struggling to access services.

Glenelg bucked the trend, consistently offering GP subsidies higher than both the Victorian and Australian average, as well as better attendance figures, showing a healthy number of GPs in the municipality.

But while GPs have grabbed the headlines the subsidies for specialist medical services have dropped more over the long term and sit at 55 per cent of the full cost, compared with 85 per cent for general practice.

Factoring in the much higher baseline cost for such services, the increase in out-of-pocket costs has been much higher for specialists than for GPs.

Unlike with general practice, the south-west had better than average subsidy rates for specialist care, but recorded consistently lower "services per person" rates, showing it was harder to access specialist care.

Surgical and anaesthetic services were the worst for south-west patients, consistently falling below a 50 per cent subsidy for services that were already inaccessibly expensive for many. In Corangamite Medicare covered just 37 per cent of the cost of anaesthetics services.

The south-west population has consistently been diagnosed as older and sicker than the state or national average, which makes the lack of services and dwindling subsidies an even heavier burden for the population.

Professor Manski-Nankervis said this was a worry for those with chronic illnesses.

"The data clearly shows people are paying more out of pocket for these things," she said.

"So if you've got lots of people with chronic conditions and they're having to pay more for their care, that would be adding up for them."

For some, this means they give up on accessing services at all, missing out on healthcare they need and ending up in the hospital system with more serious or acute problems.

The federal government recently announced improvements to the funding for GP subsidies, but Dr Manski-Nankervis said the changes only affected a small group of the most vulnerable.

"I don't think people realise that for most people those costs won't change," she said. "It will be interesting to see how that plays out."