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06 Jan 2015

Inquiry into out-of-pocket costs of health care

BCNA has made a submission to an inquiry being conducted by The Senate Community Affairs Committee into the out-of-pocket costs in Australian health care.

We know that women diagnosed with breast cancer can face significant out-of-pocket costs for treatment and care.

For women having their treatment in the private health system especially, there can be considerable ‘gap’ payments above the Medicare rebate for tests, treatments (e.g. surgery and radiotherapy) and doctors’ fees. The out-of-pocket costs associated with the co-payment for PBS scripts for chemotherapy and associated medicines can also add up.

There is also a range of procedures that currently do not attract a Medicare rebate and for which women may have to pay the full cost, including breast MRI scans, DXA bone mineral density tests and the Oncotype DX test.

Our submission includes details of the out-of-pocket costs of two women who had their treatment privately. Both have paid around $12,000 in out-of-pocket costs.

Women in both the public and private health systems also have to pay for a number of treatment-related items that are not covered by Medicare, including wound dressings, wigs and turbans, over-the-counter medicines and post-surgery bras. There are other indirect costs: travel, parking, child care, accommodation if coming from a rural area, and loss of income if unable to work during treatment.

BCNA’s submission discusses these issues and addresses the following points in the Inquiry Terms of Reference:

  • the current and future trends in out-of-pocket expenditure by Australian health consumers
  • the impact of co-payments on consumers’ ability to access health care, and health outcomes and costs
  • key areas of expenditure
  • the role of private health insurance
  • the appropriateness and effectiveness of safety nets and other offsets.

Please note that the closing date for submissions was prior to the release of the Federal Budget on Tuesday 13 May, so our submission does not address changes announced in the Budget.

Acknowledgements

BCNA thanks the women and partners who generously allowed us to share information about their out-of-pocket costs and the impact it has had on their lives.

We also thank Consumer Representatives Kym Berchtenbreiter (Vic) and Pat Hancock (Qld) and members of our Strategic Advisory Group for their assistance in producing this submission.

More information

For more information on the Inquiry into out of pocket costs, please consider the following resources: