The Huge Cost Of Staying Healthy In Australia Revealed

"Out-of-pocket" costs are rising and some Aussies are avoiding seeing a doctor.

What you need to know
  • Australian patients paid $3 billion dollars for services such as seeing a GP, specialist or getting an ultrasound in 2016-2017
  • 1 in 2 patients dipped into their own pockets for non-hospital treatments
  • Where you live influences how much you have to pay - residents in the ACT cough up more for medical care and those in western Sydney pay far less

One in two Australian patients forked out a total of $3 billion a year to top up GP fees and other medical costs that are not fully covered by Medicare.

A new government report by the Australian Institute of Health and Welfare (AIHW) found 10.9 million people paid “out-of-pocket” expenses when they visited a doctor for non-hospital treatments.

For the first time, the AIHW also examined what non-hospital healthcare costs based on the medical specialty as well as the region the patient lives in.


Medicare-subsidised services such as seeing a specialist or paying a gap to see a local GP were the most common expenses.

More than one third of Australians paid to see a specialist and it cost one in four patients to visit a GP. The next most common service was diagnostic imaging which includes ultrasounds and x-rays.


More than 7 in 10 people who had specialist consultations had out-of-pocket costs, and for these patients the median “gap” per visit was $64.

Seeing an obstetrician was the fourth most common expense followed by allied health services -- which includes psychologists, speech pathologists and physiotherapists.

The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) said the report signals a need for the government to support those planning to have children.

“These new figures show that the Government needs to reassess its support of new mothers urgently. Mothers and couples planning to have children should expect more from their Government,” President of RANZCOG, Professor Steve Robson said.


There were big difference in the amount patients paid depending on where they lived.

Patients in Northern Sydney forked out an average of $206 for Medicare services which was the highest in the country. In Western Queensland it’s a little more than half of that -- costing $104.

The proportion of patients with out-of-pocket costs for imaging tests was five times higher in some areas than others.

Just 31 percent of Northern Territory patients paid extra for a non-hospital service, but for those living in the ACT 69 per cent dipped into their pockets.

The median gap fee to see a GP ranged from $12 in western Sydney but cost almost triple in the ACT ($32).

The Australian Medical Association and Royal Australian College of General Practitioners are lobbying for Medicare rebates to be increased to help close the gap.


Over the 12-month period more than one million Australians put off seeing a doctor because they could not afford it.

People living in remote and rural areas were worst affected with and more likely to delay or avoid seeing a doctor.

Patients in metropolitan areas were less likely to have out-of-pocket costs than patients in regional areas.

‘For patients who incurred out-of-pocket costs, the median amount each patient spent in the year was $142—but patients living in some areas paid almost double that of others’, AIHW spokesperson Michael Frost said.

Health Minster Greg Hunt pointed to the overall increase in the number of Australians accessing bulk-billing services. State and federal  governments contributed $19 billion towards these services in 2016–17.

“Medicare funding is at record levels and the comprehensive data released today shows more Australians are seeing their doctor without having to pay than ever before,” said Hunt.

Hunt said the Commonwealth’s Chief Medical Officer is now working with the medical profession to address the “large and sometimes unanticipated out-of-pocket medical fees some patients face.”

He also said the Coalition added important items to Medicare -- such as support for renal dialysis in remote communities, MRI scans for prostate cancer and 3D mammography test for the early detection of breast cancer.

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Featured Image: Getty Images.