Commonwealth fund warns against higher cost barriers to health care

18 Jun 2014

The latest report from the highly respected international foundation, the Commonwealth Fund, highlights the dangers of the Government's poorly designed system of patient co-payments for general practice, pathology and imaging visits.

AMA President, A/Prof Brian Owler, said today that the report - Mirror, Mirror on the Wall, How the Performance of the U.S. Health Care System Compares Internationally - ranks 11 health systems across the globe on a range of criteria.

A/Prof Owler said the report shows that, despite the claims of the Government, Australia has a sustainable health system with the lowest level of expenditure on health as a percentage of GDP across all the countries included in the comparison.

“Australia's health system is performing quite well, ranked 4th overall,” A/Prof Owler said.

“However, the report also shows that the cost of accessing health care for patients is a significant issue.

“Australia was ranked towards the bottom (9th) on cost-related problems in accessing health care.

“According to the report, 16 per cent of Australians in 2013 did not fill a prescription; skipped recommended medical tests, treatment, or follow-up; or had a medical problem but did not visit a doctor or clinic in the past year because of cost.

“This is the situation now, before the introduction of a co-payment. The Government’s co-payment will significantly increase the cost barriers to quality health care for Australians, especially the poorest and sickest.

“Under the Government's proposed model, there are co-payments applied at multiple points in the health system - and these are excluded from the Medicare Safety Net.

“A patient who is sick and needs tests, repeat GP visits, and medication during an episode of illness would face a significant accumulated financial burden.

“Overseas experience has shown this to be a significant barrier to care for people in disadvantaged groups, discouraging them from seeing their GP, getting a test, or having their prescription filled

“This will inevitably increase costs in other parts of the health system as people go to the doctor much later and much sicker.

“It is widely acknowledged by many countries that lowering barriers to primary care is the key to improving overall health outcomes and making their health systems sustainable.

“But Australia is moving in the opposite direction and risks going backwards in comparison to similar countries.

“The Government did not consult with the profession over the design of its co-payment model – and it shows.

“The Government must scrap the current co-payment model and seek expert health advice on a better policy direction,” A/Prof Owler said

The AMA opposes the Government’s Budget measures on health, including the co-payment, because they will interfere with Australia's well-balanced system of affordable health care and high quality patient outcomes by:

  • putting  higher financial barriers in place for people wanting access to primary care (general practitioner services, radiology, and pathology) so that their health care issues can be dealt with early and quickly – with the elderly, the chronically ill, people on restricted incomes, and Indigenous Australians the hardest hit;
  • increasing the cost of medicines;
  • lowering financial safety nets for access to medical care and medicines; and
  • reducing funding for public hospital services, which will impact on their capacity to meet the needs of those in the community who cannot afford private health care.

The Commonwealth Fund is a private foundation that aims to promote a high performing health care system that achieves better access, improved quality, and greater efficiency, particularly for society's most vulnerable.

The Commonwealth Fund’s latest report is available at


18 June 2014


CONTACT:        John Flannery                     02 6270 5477 / 0419 494 761

                            Odette Visser                      02 6270 5464 / 0427 209 753


Follow the AMA Media on Twitter:
Follow the AMA President on Twitter:
Follow Australian Medicine on Twitter:
Like the AMA on Facebook