Growing out-of-pocket health care costs are creating barriers to essential care for many Australians and arguably leading to increased hospital costs. Over time they will undermine the universality of Medicare and widen health disparities in our community. Despite this, the Abbott Government is intent on increasing Australians' individual health care costs, claiming variously that the health care budget is unsustainable, price signals are needed to reduce GP visits, budget deficits must be addressed and increased funding is needed for medical research.
Regardless of the validity of the Government's claims, it is clear that we need to improve the way in which we manage out-of-pocket costs within our health care system. The current financing mechansims and safety-net arrangements are inadequate to ensure that growing numbers of Australians with long-term medical conditions can manage their health care costs and afford the services they need.
Given the compexity of Australia's health care system, with funding and service delivery responsibilities split between different levels of government and the public and private sectors, this is a wicked problem to solve. There is no silver bullet and effective solutions are unlikely to be found through simple 'add-ons' to the currentfunding system. Effective solutions are likely to be multi-faceted and will require a potent mix of evidence, ideology, consultation and leadership to be successful.
To kick-start the necesary analyses, debates and policy formulations, we have developed a discussion paper on out-of-pocket costs, focusing on Medicare-funded services. The paper sets out the parameters of the problem and canvasses some promising areas where solutions may be found. Our purpose is not to dictate future policy directions but to present the current evidence and to galvanise thought, expertise and engagement to address this issue of faireness and equity.